The Relationship between Education and Health “Better-educated people are healthier, enjoy higher levels of self-reported health, and have lower levels of morbidity, mortality, and disability…the longer you stay in school, the longer you are likely to live…” (Low, Low, Baumler, Huynh, 2005) “Quality of both the education received and the educational environment adds to the health protective effects of education.” (Ross and Mirowsky, 1999)

Illiteracy is Associated with Poor Health  Literacy is associated with knowledge about health, personal health status and use of health services (Council of Scientific Affairs, American Medical Association, 1999 )  For people with diabetes, hypertension and asthma, relationship between literacy level, health knowledge and skills for managing disease (own or family members)  Associated with higher healthcare costs - one study showed annual costs of $12,974 vs $2,969 and double hospitalizations for Medicaid patients  Associated with higher healthcare costs - one study showed annual costs of $12,974 vs $2,969 and double hospitalizations for Medicaid patients (Weiss 1999)

How is Education Related to Health? 1. Influencing work and economic conditions 2. Enhancing social and psychological resources 3. Enabling lifestyle and health behaviors 4. Directly influencing health (Ross and Wu, 1995)

Work and Economic Conditions  Well-researched connection between personal or household income and life expectancy  Marmot’s Whitehall Study - gradient in health status and mortality across job classification - connected to a sense of control over working conditions and demands  One study looked at relationship of education, work and income to CVD risk factors - found strongest relationship was with education (Winkleby, 1992)

Enhancing Social and Psychological Resources  Resources for making moral choices, informed judgments, increased sense of control, facilitating self-direction (Fogel, 1999)  Character development, self-control, self-efficacy and resilience  Social bonds to a caring adult, positive and consistent experience with goal setting  Larger support networks - positive health impact of social support

Lifestyle and Health Behaviors  People with more education are less likely to smoke, drink heavily, more likely to exercise and use the health care system (Ross and Wu, 1995; Ross and Mirowsky, 1999)  More years of education, less likely a person will “engage in negative health behaviors.” (Low, Low, Baumler, Huynh, 2005)  Lack of academic success for children is associated with: dropping out of school, tobacco smoking, alcohol and drug use, violence, delinquency, risky sexual behaviors, suicide ideation and behavior, unhealthly eating and lack of physical activity. (Low, Low, Baumler, Huynh, 2005)

Directly Influencing Health  Comparing various states’ compulsory education laws and census data show direct links to education and life expectancy (Lleras-Muney, 2002)  Are education and health related by some third variable? Ex: Genetic Factors and /or ability to postpone gratification? Study showed positive effects of education on health independent of these. (Arendt, 2001)

What do you think? 1. What’s missing? 2. Would you pick one (or more) of these pathways? 3. What do you base your decision on? 4. What is the pathway you propose?