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An education gradient in health, a health gradient in education, or a confounded gradient in both?

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  • Lynch, Jamie L.
  • von Hippel, Paul T.

Abstract

There is a positive gradient associating educational attainment with health, yet the explanation for this gradient is not clear. Does higher education improve health (causation)? Do the healthy become highly educated (selection)? Or do good health and high educational attainment both result from advantages established early in the life course (confounding)? This study evaluates these competing explanations by tracking changes in educational attainment and Self-rated Health (SRH) from age 15 to age 31 in the National Longitudinal Study of Youth, 1997 cohort. Ordinal logistic regression confirms that high-SRH adolescents are more likely to become highly educated. This is partly because adolescent SRH is associated with early advantages including adolescents' academic performance, college plans, and family background (confounding); however, net of these confounders adolescent SRH still predicts adult educational attainment (selection). Fixed-effects longitudinal regression shows that educational attainment has little causal effect on SRH at age 31. Completion of a high school diploma or associate's degree has no effect on SRH, while completion of a bachelor's or graduate degree have effects that, though significant, are quite small (less than 0.1 points on a 5-point scale). While it is possible that educational attainment would have greater effect on health at older ages, at age 31 what we see is a health gradient in education, shaped primarily by selection and confounding rather than by a causal effect of education on health.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:socmed:v:154:y:2016:i:c:p:18-27
    DOI: 10.1016/j.socscimed.2016.02.029
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    Cited by:

    1. repec:oup:geronb:v:73:y:2018:i:5:p:860-869. is not listed on IDEAS
    2. Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.
    3. Barr, Peter B. & Salvatore, Jessica E. & Maes, Hermine & Aliev, Fazil & Latvala, Antti & Viken, Richard & Rose, Richard J. & Kaprio, Jaakko & Dick, Danielle M., 2016. "Education and alcohol use: A study of gene-environment interaction in young adulthood," Social Science & Medicine, Elsevier, vol. 162(C), pages 158-167.
    4. repec:kap:poprpr:v:36:y:2017:i:5:d:10.1007_s11113-017-9431-7 is not listed on IDEAS

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