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How and why studies disagree about the effects of education on health: A systematic review and meta-analysis of studies of compulsory schooling laws

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  • Hamad, Rita
  • Elser, Holly
  • Tran, Duy C.
  • Rehkopf, David H.
  • Goodman, Steven N.

Abstract

Rich literatures across multiple disciplines document the association between increased educational attainment and improved health. While quasi-experimental studies have exploited variation in educational policies to more rigorously estimate the health effects of education, there remains disagreement about whether education and health are causally linked. The aim of this study was to conduct a systematic review and meta-analysis to characterize this literature, with a focus on quasi-experimental studies of compulsory schooling laws (CSLs). Articles from 1990 to 2015 were obtained through electronic searches and manual searches of reference lists. We searched for English-language studies and included manuscripts if: (1) they involved original data analysis; (2) outcomes were health-related; and (3) the primary predictor utilized variation in CSLs. We identified 89 articles in 25 countries examining over 25 health outcomes, with over 600 individual point estimates. We systematically characterized heterogeneity on key study design features and conducted a meta-analysis of studies with comparable health outcome and exposure variables. Within countries, studies differed in terms of birth cohorts included, the measurement of health outcomes within a given category, and the type of CSL variation examined. Over 90% of manuscripts included multiple analytic techniques, such as econometric and standard regression methods, with as many as 31 “primary” models in a single study. A qualitative synthesis of study findings indicated that educational attainment has an effect on the majority of health outcomes—most beneficial, some negative—while the meta-analysis demonstrated small beneficial effects for mortality, smoking, and obesity. Future work could focus on inconsistent findings identified by this study, or review the health effects of other types of educational policies.

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  • Hamad, Rita & Elser, Holly & Tran, Duy C. & Rehkopf, David H. & Goodman, Steven N., 2018. "How and why studies disagree about the effects of education on health: A systematic review and meta-analysis of studies of compulsory schooling laws," Social Science & Medicine, Elsevier, vol. 212(C), pages 168-178.
  • Handle: RePEc:eee:socmed:v:212:y:2018:i:c:p:168-178
    DOI: 10.1016/j.socscimed.2018.07.016
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    3. Adriana Lleras‐Muney, 2022. "Education and income gradients in longevity: The role of policy," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(1), pages 5-37, February.
    4. Tatjana Begerow & Hendrik Jürges, 2022. "Does compulsory schooling affect health? Evidence from ambulatory claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 953-968, August.
    5. Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2020. "Who dies early? Education, mortality and causes of death in Norway," Social Science & Medicine, Elsevier, vol. 245(C).
    6. Janke, Katharina & Johnston, David W. & Propper, Carol & Shields, Michael A., 2020. "The causal effect of education on chronic health conditions in the UK," Journal of Health Economics, Elsevier, vol. 70(C).
    7. Viinikainen, Jutta & Bryson, Alex & Böckerman, Petri & Kari, Jaana T. & Lehtimäki, Terho & Raitakari, Olli & Viikari, Jorma & Pehkonen, Jaakko, 2022. "Does better education mitigate risky health behavior? A mendelian randomization study," Economics & Human Biology, Elsevier, vol. 46(C).
    8. Hofmarcher, Thomas, 2021. "The effect of education on poverty: A European perspective," Economics of Education Review, Elsevier, vol. 83(C).
    9. Courtin, Emilie & Nafilyan, Vahe & Avendano, Mauricio & Meneton, Pierre & Berkman, Lisa F. & Goldberg, Marcel & Zins, Marie & Dowd, Jennifer B., 2019. "Longer schooling but not better off? A quasi-experimental study of the effect of compulsory schooling on biomarkers in France," Social Science & Medicine, Elsevier, vol. 220(C), pages 379-386.
    10. Dahmann, Sarah C. & Schnitzlein, Daniel D., 2019. "No evidence for a protective effect of education on mental health," Social Science & Medicine, Elsevier, vol. 241(C).
    11. Lleras-Muney, Adriana & Price, Joseph & Yue, Dahai, 2022. "The association between educational attainment and longevity using individual-level data from the 1940 census," Journal of Health Economics, Elsevier, vol. 84(C).
    12. Viera Ivanková & Rastislav Kotulič & Jaroslav Gonos & Martin Rigelský, 2019. "Health Care Financing Systems and Their Effectiveness: An Empirical Study of OECD Countries," IJERPH, MDPI, vol. 16(20), pages 1-22, October.
    13. Xindong Xue & Mingmei Cheng & Wangyongxin Zhang, 2021. "Does Education Really Improve Health? A Meta‐Analysis," Journal of Economic Surveys, Wiley Blackwell, vol. 35(1), pages 71-105, February.

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    18. Hofmarcher, Thomas, 2021. "The effect of education on poverty: A European perspective," Economics of Education Review, Elsevier, vol. 83(C).
    19. Chen, Jiwei & Guo, Jiangying, 2022. "The effect of female education on fertility: Evidence from China’s compulsory schooling reform," Economics of Education Review, Elsevier, vol. 88(C).
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