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Cross-sectional schooling-health associations misrepresented causal schooling effects on adult health and health-related behaviors: Evidence from the Chinese Adults Twins Survey

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  • Behrman, Jere R.
  • Xiong, Yanyan
  • Zhang, Junsen

Abstract

Adult health outcomes and health behaviors are often associated with schooling. However, such associations do not necessarily imply that schooling has causal effects on health with the signs or magnitudes found in the cross-sectional associations. Schooling may be proxying for unobserved factors related to genetics and family background that directly affect both health and schooling. Recently several studies have used within-monozygotic (MZ) twins methods to control for unobserved factors shared by identical twins. Within-MZ estimates for developed countries are generally smaller than suggested by cross-sectional associations, consistent with positive correlations between unobserved factors that determine schooling and those that determine health. This study contributes new estimates of cross-sectional associations and within-MZ causal effects using the Chinese Adults Twins Survey, the first study of its type for developing countries. The cross-sectional estimates suggest that schooling is significantly associated with adult health-related behaviors (smoking, drinking, exercising) but not with own or spouse health outcomes (general health, mental health, overweight, chronic diseases). However, within-MZ-twins estimators change the estimates for approximately half of these health indicators, in one case declining in absolute magnitudes and becoming insignificant and in the other cases increasing in absolute magnitudes. Within-MZ estimates indicate significant pro-health effects for at least one of the indicators for own health (better mental health), own health-related behaviors (less smoking) and spouse health (less overweight).

Suggested Citation

  • Behrman, Jere R. & Xiong, Yanyan & Zhang, Junsen, 2015. "Cross-sectional schooling-health associations misrepresented causal schooling effects on adult health and health-related behaviors: Evidence from the Chinese Adults Twins Survey," Social Science & Medicine, Elsevier, vol. 127(C), pages 190-197.
    • Handle: RePEc:eee:socmed:v:127:y:2015:i:c:p:190-197
    DOI: 10.1016/j.socscimed.2014.11.011
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    5. Lång, Elisabeth & Nystedt, Paul, 2016. "Learning For Life? The Effects of Schooling on Earnings and Health- Related Behavior Over the Life Cycle," LiU Working Papers in Economics 4, Linköping University, Division of Economics, Department of Management and Engineering.
    6. Sudharsanan, Nikkil & Behrman, Jere R. & Kohler, Hans-Peter, 2016. "Limited common origins of multiple adult health-related behaviors: Evidence from U.S. twins," Social Science & Medicine, Elsevier, vol. 171(C), pages 67-83.
    7. Böckerman, Petri & Maczulskij, Terhi, 2016. "The Education-health Nexus: Fact and fiction," Social Science & Medicine, Elsevier, vol. 150(C), pages 112-116.
    8. Naomi Duke & Ross Macmillan, 2016. "Schooling, skills, and self-rated health: A test of conventional wisdom on the relationship between educational attainment and health," Working Papers 087, "Carlo F. Dondena" Centre for Research on Social Dynamics (DONDENA), Università Commerciale Luigi Bocconi.
    9. Lynch, Jamie L. & von Hippel, Paul T., 2016. "An education gradient in health, a health gradient in education, or a confounded gradient in both?," Social Science & Medicine, Elsevier, vol. 154(C), pages 18-27.
    10. Dursun, Bahadır & Cesur, Resul & Mocan, Naci, 2018. "The Impact of Education on Health Outcomes and Behaviors in a Middle-Income, Low-Education Country," Economics & Human Biology, Elsevier, vol. 31(C), pages 94-114.
    11. Youlu Zhang & Li Zhang & Fulian Li & Liqian Deng & Jiaoli Cai & Linyue Yu, 2022. "Offspring Education and Parents’ Health Inequality in China: Evidence from Spillovers of Education Reform," IJERPH, MDPI, vol. 19(4), pages 1-26, February.
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