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The modifying influence of country development on the effect of individual educational attainment on self-rated health

Author

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  • Van Der Kooi, A.L.F.
  • Stronks, K.
  • Thompson, C.A.
  • DerSarkissian, M.
  • Arah, O.A.

Abstract

Objectives. We investigated how much the Human Development Index (HDI), a global measure of development, modifies the effect of education on selfreported health. Methods. We analyzed cross-sectional World Health Survey data on 217 642 individuals from 49 countries, collected in 2002 to 2005, with random-intercept multilevel linear regression models. Results. We observed greater positive associations between educational levels and self-reported good health with increasing HDI. The magnitude of this effect modification of the education-health relation tended to increase with educational attainment. For example, before adjustment for effectmodification, at comparable HDI, on average, finishing primary school was associated with better general health (b = 1.49; 95% confidence interval [CI] = 1.18, 1.80). With adjustment for effect modification by HDI, the impact became 4.63 (95% CI = 3.63, 5.62) for every 0.1 increase in HDI. Among those who completed high school, these associations were, respectively, 5.59 (95% CI = 5.20, 5.98) and 9.95 (95% CI = 8.89, 11.00). Conclusions. The health benefits of educational attainment are greater in countries with greater human development. Health inequalities attributable to education are, therefore, larger in more developed countries. Copyright © 2013 by the American Public Health Association®.

Suggested Citation

  • Van Der Kooi, A.L.F. & Stronks, K. & Thompson, C.A. & DerSarkissian, M. & Arah, O.A., 2013. "The modifying influence of country development on the effect of individual educational attainment on self-rated health," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 49-54.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301593_6
    DOI: 10.2105/AJPH.2013.301593
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    Cited by:

    1. Francesca Borgonovi & Artur Pokropek, 2016. "Education and Self-Reported Health: Evidence from 23 Countries on the Role of Years of Schooling, Cognitive Skills and Social Capital," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-16, February.

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