The Links Between Education and Health

Abstract

University of Illinois, Urbana The positive association between education and health is well established, but explanations for this association are not. Our explanations fall into three categories: (1) work and economic conditions, (2) social-psychological resources, and (3) health lifestyle. We replicate analyses with two samples, cross-sectionally and over time, using two health measures (self-reported health and physical functioning). The first data set comes from a national probability sample of U.S. households in which respondents were interviewed by telephone in 1990 (2,031 respondents, ages 18 to 90). The second data set comes from a national probability sample of U.S. households in which respondents ages 20 to 64 were interviewed by telephone first in 1979 (3,025 respondents), and then again in 1980 (2,436 respondents). Results demonstrate a positive association between education and health and help explain why the association exists. (1) Compared to the poorly educated, well educated respondents are less likely to be unemployed, are more likely to work full-time, to have fulfilling, subjectively rewarding jobs, high incomes, and low economic hardship. Full-time work, fulfilling work, high income, and low economic hardship in turn significantly improve health in all analyses. (2) The well educated report a greater sense of control over their lives and their health, and they have higher levels of social support. The sense of control, and to a lesser extent support, are associated with good health. (3) The well educated are less likely to smoke, are more likely to exercise, to get health check-ups, and to drink moderately, all of which, except check-ups, are associated with good health. We conclude that high educational attainment improves health directly, and it improves health indirectly through work and economic conditions, social-psychological resources, and health lifestyle. he positive association between education and health is well established, but explanations for this association are not. Well educated people experience better health than the poorly educated, as indicated by high levels of self-reported health and physical functioning and low levels of morbidity, mortality, and disability. In contrast, low educational attainment is associated with high rates of infectious disease, many chronic noninfectious diseases, self-reported poor health, shorter survival when sick, and shorter life expectancy (Feldman, Makuc, Kleinman, and Cornoni-Huntley 1989; Guralnik, Land, Fillenbaum, and Branch 1993; Gutzwiller, LaVecchia, Levi, Negri, and Wietlisbach 1989; Kaplan, Haan, and Syme 1987; Kitagawa and Hauser 1973; Liu, Cedres, and Stamler 1982; Morris 1990; Pappas, Queen,