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Monday, June 3, 2019

Education, Income, and Health

Many posts have discussed inequalities in health. Obviously, affluent people can afford better insurance and health care, but there are other inequalities as well.

 Austin Frakt at NYT:
Some clever studies have teased out the causal effects of education by exploiting natural experiments. One, by the U.C.L.A economist Adriana Lleras-Muney, relied on state compulsory education laws enacted between 1915 and 1939. These laws required some children to obtain more education than they might have otherwise, resulting in longer lives for those that did so. According to the study, having an additional year of education by 1960 increased life expectancy at age 35 by 1.7 years.
Studies that relied on inducements for greater education because of a poor labor market or as a way to avoid the Vietnam draft found that increased education led to better health and a lower likelihood of smoking. This finding is one clue about how education may improve health. It can reduce people’s engagement in risky behaviors, perhaps because those behaviors could threaten the higher income that greater education typically confers.
But health behaviors can explain only a portion of the relationship between education and mortality. Education may also provide skills to analyze information and tackle complex problems — precisely what’s needed to navigate the modern health system and attend to chronic diseases.
There is also a correlation between education and income and weatlh, which also correlate with health.
Much of income’s effect on health may originate in childhood. Many studies demonstrate that children of wealthier parents are in better health, perhaps because of better access to prenatal care and nutrition, or because they live in less polluted environments. A healthier childhood often means a healthier adulthood. And children born to higher-income parents are more likely to obtain more education and have higher incomes themselves. That’s how the income-health relationship may propagate across generations.
Greater education and wealth can also confer greater social status or rank, which has also been linked to health. A landmark studypublished in 1978 found that higher-ranking British civil servants (like administrators) had lower rates of mortality due to coronary heart disease than lower-ranking ones (like messengers). Lower-ranked civil servants tended to be heavier; they had higher blood pressure and blood sugar, and smoked more. Many investigations have replicated this relationship between social rank and health.