Middle school popularity could be about more than being picked for sports, invited to parties and elected to student office. A recent study from Sweden suggests it could actually predict health for years to come.

The study, published in the Journal of Epidemiology and Community Health , looked at data from a long-term analysis of 14,000 Swedes between 1966 and 2003.

The unpopular sixth-grade kids in 1966 were up to nine times more likely to develop heart disease, four times more likely to be hospitalized with diabetes and twice as likely to attempt suicide than those who were popular. They also showed significantly increased risk of drug and alcohol abuse. The study says the statistics regarding health are not explainable by other factors like the child's family's occupation, income or education level.

According to the study's lead author, Ylva Almquist, a doctoral student at Stockholm University's Centre for Health and Equity Studies, popularity was determined by asking students to nominate three classmates they'd like to work with in class. "The idea is that individuals that have higher peer status also have a more central role in the school class. They have better information and more social influence," she says. "Thus, these individuals are not necessarily those who are traditionally perceived as popular—'cool' kids who smoke, drink and so on. But, rather, high status children are easygoing, nice to others, respected and well liked."

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