Education and Health

by

Robert A. Hummer, Lauren M. Perry

• LAST REVIEWED: 26 August 2013
• LAST MODIFIED: 26 August 2013
• DOI: 10.1093/obo/9780199756384-0096

Introduction

The relationship between education and health comprises important portions of the sociological, social science, and public health literatures. Over the last half-century, sociologists, economists, epidemiologists, and other health scientists have documented that people with higher levels of education live longer and healthier lives, on average, than people with lower levels of education. The education–health association is not uniform, though, either across time or when population subgroups or geographic areas are compared. Thus, a great deal of scientific work documents temporal, geographic, and demographic differences in the overall education-health association. Moreover, the strength of the education–health relationship tends to differ depending on which health outcome(s)—self-rated general health, the presence or absence of chronic conditions, whether or not individuals become physically disabled late in life, and so on—is the object of study. All told, there is a great deal of work in sociology, demography, and related disciplines dedicated to the accurate description of educational differences in health outcomes across population subgroups, over time, and for specific geographic areas. Beyond accurate description, the education–health literature is also characterized by important debates regarding the extent to which education is either simply correlated with health or whether education causally influences health outcomes. If education is causally related to health, what are the key mechanisms by which it does so? On the other hand, is the relationship between education and health spurious, that is, the result of factors that are common to both education and health (such as intelligence or parents’ socioeconomic background)? Scientific research tackling such issues is at the forefront of work in this area of study, in large part because the issue of causality is so central to policy debates surrounding education’s role in future improvements in population health. This article touches on the classic works, key scientific resources, important descriptive papers, and central debates that characterize this area of study.

Classic Works and General Overviews

The single most important classic work of scholarship in the area of education and health is Kitagawa and Hauser 1973. The authors amassed a data set based on 1960 US vital statistics and census records to document mortality differentials by educational attainment for women and men, for younger and older adults, and for the white and non-white populations. Their classic work served to greatly heighten awareness that educational attainment was related to major disparities in mortality rates and continues to be a takeoff point for many studies in the area. Recent works, such as Cutler and Lleras-Muney 2008, Ross and Mirowsky 2010, and Hummer and Lariscy 2011, most effectively serve to update scholarship in this area. No single theoretical perspective or empirical tradition dominates the education–health literature. Bruce Link and Jo Phelan’s fundamental cause theory of health argues that educational attainment is a flexible resource that individuals use to navigate the life course in healthier ways compared to people with less education (Link and Phelan 1995); when new technologies or challenging situations arise, it is people with higher levels of education who are best equipped to use the new technologies or effectively confront the challenges that lead to their overall higher levels of health and longevity. Mirowsky and Ross 2003 specifically emphasizes the human capital benefits that individuals develop with higher levels of education. They argue that higher levels of schooling provide individuals with the skills and resources that, far beyond the increased income associated with higher education, are necessary to live healthier and longer lives. Baker, et al. 2011 further develops this line of thinking by focusing on the cognitive skills that education helps develop and that are related to better health across the life course.

• Baker, David P., Juan Leon, Emily G. Smith Greenaway, John Collins, and Marcela Movit. 2011. The education effect on population health: A reassessment. Population and Development Review 37.2: 307–332.

  DOI: 10.1111/j.1728-4457.2011.00412.x

  Baker and colleagues focus on three objectives: (1) assessing the causal role of education in improved population health around the world, (2) thoroughly documenting the robustness of education’s effect on health, and (3) developing the hypothesis that education improves health through its effect on the development of high-order cognitive skills.

• Cutler, David M., and Adriana Lleras-Muney. 2008. Education and health: Evaluating theories and evidence. In Making Americans healthier: Social and economic policy as health policy. Edited by Robert F. Schoeni, James S. House, George A. Kaplan, and Harold Pollack, 29–60. New York: Russell Sage Foundation.

  Cutler and Lleras-Muney provide a comprehensive overview of the relationship between education and health. They document current US educational differences in health behaviors, health, and mortality. The authors also examine possible mechanisms accounting for the education–health relationship and discuss policy implications related to education and health.

• Hummer, Robert A., and Joseph T. Lariscy. 2011. Educational attainment and adult mortality. In International handbook of adult mortality. Edited by Richard G. Rogers and Eileen M. Crimmins, 241–261. New York: Springer.

  DOI: 10.1007/978-90-481-9996-9

  The authors provide an extensive overview of research on education and adult mortality. They provide a conceptual framework for understanding educational disparities in adult mortality and show basic patterns in this relationship. They discuss variation in the association over time, and across population subgroups and geographic contexts. Policy implications are discussed.

• Kitagawa, Evelyn M., and Philip M. Hauser. 1973. Differential mortality in the United States: A study in socioeconomic epidemiology. Cambridge, MA: Harvard Univ. Press.

  Using US data from 1960, Kitagawa and Hauser match death certificates of adults to census data using educational attainment as a measure of socioeconomic status. They find that higher educated individuals have lower rates of mortality than less educated individuals. Mortality differentials were greater among younger individuals and women.

• Link, B. G., and Jo Phelan. 1995. Social conditions as fundamental causes of disease. Journal of Health and Social Behavior 35:80–94.

  DOI: 10.2307/2626958

  Link and Phelan argue that social factors, including education, are fundamental causes of disease because they affect access to resources and multiple disease outcomes and maintain a relationship with health and disease outcomes despite changes in intervening mechanisms.

• Mirowsky, John, and Catherine E. Ross. 2003. Education, social status, and health. New York: de Gruyter.

  Mirowsky and Ross conduct a thorough analysis of the association between education and health in the United States. They argue that education is the “root cause” of health because it provides individuals with resources to shape and promote their health. They find that individuals with higher educational attainment have favorable health across many outcomes.

• Ross, Catherine E., and John Mirowsky. 2010. Why education is the key to socioeconomic differentials in health. In The handbook of medical sociology. 6th ed. Edited by Chloe E. Bird, Peter Conrad, Allen M. Freemont, and Stefan Timmermans, 33–51. Nashville: Vanderbilt Univ. Press.

  The authors explain why people with higher education have better health than those with lower education and why this inequality grows with age. They describe different mediators of the education–health association and contrast the conceptualization of education as human capital, which increases effective agency, with the conceptualization of education as a commodity.