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Why Does Education Improve Health? It's Complicated

Finnish researchers look for the elusive link between more schooling and better health—but find it's more complex than we might like.
(Photo: Alvin Trusty/Flickr)

(Photo: Alvin Trusty/Flickr)

Researchers have long known that more education spells better long-term health, though the cause of this connection is a source of debate. Perhaps more schooling leads to better jobs, scholars have hypothesized, which in turn comes with better medical benefits. Or maybe better socioeconomic status early in life points to better education and better health, so the two are correlated, but more education doesn't actually improve health. New research, however, indicates that the connection can't be boiled down to just one underlying cause.

While researchers aren't clear of the exact mechanisms that link education and health, the connection is indisputable: College graduates live about five years longer than those with less than a high school education, and they're a bit less likely to have diabetes and heart disease.

Previous work has shown that income, employment, and family background alone don't explain education's influence on health, suggesting that lifestyle choices across different social groups may explain the effect. Social support structures and preventative medicine might contribute as well.

College graduates live about five years longer than those with less than a high school education.

But there's still no clear pathway between education and well-being, so health researchers led by Marko Elovainio, a professor at the University of Helsinki's Institute for Behavioral Science, went in search of one. They began by using data on 3,596 people who took part in the Cardiovascular Risk in Young Finns Study beginning in 1980, when participants were between three and 18 years old. In follow-up interviews between 1997 and 2012, each person answered questions concerning their schooling and a variety of health indicators, including one that asked them to evaluate their health on a five-point scale.

After controlling for age and other variables, such as smoking, the researchers found that each additional year of education improved the study participants' self-reported health in later years by about 15 percent. More importantly, while education's effects on health were intertwined with the effects of social support systems, depression, and job demands, no single factor stood out as the one true link between schooling and health. Instead, there appeared to be a complex web of factors connecting education with health.

"Our results suggest that education really affects self-rated health ... and that despite multiple mechanisms linking the association, the effect of any single one is relatively small," Elovainio and his colleagues write today in the Journal of Public Health." [M]ultiple processes rather than a single underlying mechanism are likely to drive the educational differences in self-rated health."

Unfortunately, "multiple processes" doesn't help much when it comes to policy prescriptions, though the researchers have some suggestions. Ensuring children with health problems have access to good educations, providing help for those with depression or low self esteem, and improving social support systems would be valuable strategies, the team writes.

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