File Name: relationship between education and health .zip
Not a MyNAP member yet? Register for a free account to start saving and receiving special member only perks. Highlights of this session are presented in Box Woolf outlined five domains from the report U.
These include health care and public health which, he noted, account for only 10—20 percent of health outcomes ; individual behaviors; the physical and social environment; social and economic factors including education ; and public policies and spending, which shape the other four domains see Figure Differences in health outcomes are related to differences in how people and communities experience each of these domains. Key factors impacting health outcomes include.
Education, income, and wealth are among the most powerful predictors of health outcomes, Woolf said. In the United States, the risk of dying from any cause all-cause mortality is directly related to educational attainment. Woolf described this relationship as a gradient: for both men and women, the more years of education an individual has, the lower the risk of death Ross et al.
Similarly, people who have less educational attainment more frequently self-report fair or poor health Schiller et al.
This association between higher education and better health is demonstrable across a range of different health outcomes, Woolf said, and he shared prevalence data by education for coronary heart disease, stroke, lung diseases, diabetes, kidney disease, and others Schiller et al. There is a tendency in U. Analyzing data from Kaiser Permanente in Northern California, Woolf and colleagues found that the educational attainment—health outcome gradient persists even among patients in this integrated health system, whose members have equivalent access to health care.
Factors outside of the health care system contribute to the differences in health outcomes by educational attainment. Tremendous amounts of money are dedicated to health care in the United States, he said, but the importance of the social determinants of health, including education, is not always fully appreciated. He shared data that suggest that for every life saved by medical advances, seven. Recognizing that patients who have less educational attainment are at greater risk for chronic diseases is important for clinicians, Woolf said, but there are also broader implications of this association for decision makers outside of the health sector, such as employers.
A greater percentage of individuals with less educational attainment have difficulties with physical functioning—from walking, climbing steps, or handling small objects to lifting, carrying, or pushing large or heavy objects Schiller et al. An educated workforce is more capable of physically functioning in blue-collar jobs. In addition to higher productivity, a more educated employee population will experience lower health care costs, less absenteeism, and more presenteeism.
In a knowledge economy, it is difficult to separate the impact of education from that of income and wealth, Woolf said. People who have more education are more likely to obtain high-earning jobs and thus to have higher incomes and greater wealth. As with the education—health gradient, higher levels of income are associated with better health across a wide range of both physical and mental health outcomes Schiller et al.
Woolf added that people with less educational attainment are more dramatically impacted by societal trends. For example, although life expectancy in industrialized countries has been increasing for the past century, U. The factors behind this trend are complex.
Case and Deaton showed that this increase was concentrated among middle-aged whites, especially among Americans with less educational attainment Case and Deaton, Education can produce better health through multiple pathways see Figure For example, those who have more education have the ability to access more economic resources, such as better-paying jobs with health insurance benefits.
Having those resources, in turn, allows them to live in healthier neighborhoods and avoid a range of health hazards, from. In what is called reverse causality, health can also influence educational outcomes.
This education—health relationship is highly influenced by contextual factors, Woolf emphasized. These contextual factors, including both experiences and place, may often be the root cause of the correlation between education and health. Research has shown that adverse childhood experiences can influence health throughout life, leading to higher risks of depression, substance abuse, and chronic diseases later in life Felitti et al.
Place—the conditions in communities where people live—can also shape both health outcomes and educational outcomes. For example, life expectancy in Chicago varies as much as 20 years by census tract, with much lower life expectancies in Southside Chicago and similar areas.
Maps reveal that the areas that tend to have lower life expectancy are also areas where educational attainment is the lowest. Moderator Sharfstein asked about the extent to which the data on the importance of education for health are appreciated by health care leaders. Woolf responded that there has historically been a lack of awareness in the health care community about the importance of the social determinants of health. In recent years, however, health care systems have become more attentive to these issues, driven in part by health care reform.
Although health care systems have been focusing on addressing factors such as unstable housing and food security, there is increasing interest in investing in education, including not only education for children but also skills training for adults to compete for better jobs.
The issue of correlation versus causation was raised by a participant relative to the data on the association between education and health. Woolf acknowledged the problem, noting that more prospective studies are needed to demonstrate that improvements in education will improve health outcomes.
That said, although arguments could be made about the magnitude of the impact, the concept that improving education will improve health outcomes has been well established by numerous examples worldwide. The NRC and IOM committee found that life expectancy and other health outcomes in the United States were inferior to those in other high-income countries, across many different health metrics.
A systematic examination of potential causes revealed differences compared to other countries across all five domains that shape health. Among these, education was a key factor: after World War II, Americans were the most educated people in the world, he said, but educational outcomes in the United States have not kept pace with progress in other high-income countries or even in some developing economies, such as South Korea.
These countries have outperformed the United States in terms of their ability to educate young people and prepare them for successful careers. Another key difference is that many other high-income countries invest more per capita or as a proportion of their total spending in social services, education, and other factors that improve health. From a policy perspective, Woolf said, the United States needs to shift its priorities as a way not only to improve health outcomes but also to strengthen its economic competitiveness with these other countries.
If the U. Health inequities are a key health challenge in the United States, Sharfstein noted. He asked about the impact of educational challenges in. The five domains that shape health outcomes also drive health inequities, Woolf responded. There are other factors that influence health inequities e.
For a variety of reasons including racism , African Americans have, on average, a lower rate of graduation from high school and less success in obtaining 4-year degrees than white Americans. In marginalized communities, escaping the multigenerational cycle of poverty often depends on the ability of young people to get a good education. Woolf reiterated that education is important in shaping not only health outcomes but economic opportunity and social mobility.
Investments are needed to address the gaps in education that often exist to a greater degree in marginalized populations, both to improve health outcomes and to end the negative economic cycle that has historically trapped these communities in a state of persistent disadvantage.
Sanne Magnan of the HealthPartners Research Institute asked whether young people are still being encouraged to pursue higher education the way they were after World War II and whether, given the expense of a college education, there should be more investment in craft, trade, and vocational education.
He agreed that a 4-year degree was not the only way to break the cycle of poverty, adding that there is a great market demand for people who are trained in the trades and an underinvestment in vocational schools and community colleges. Sally Kraft from Dartmouth-Hitchcock inquired about the existence of any research on whether innovative ways of delivering education at lower cost e. Woolf replied that although the question was a good one, he was not familiar with research on that topic.
Education and health care significantly influence well-being and health outcomes, especially throughout adolescence. In fact, doctors note that performance in school is highly reflective of a child's current and future health. Despite knowledge of this connection, pediatricians are rarely aware of their patients' school performance and have a limited understanding of the education system.
Fostering collaboration and aligning efforts within the health and education sectors is a critical step towards building stronger and healthier communities. On June 14, , the National Academies convened a workshop to discuss how efforts within the health sector can support children's education from pre-kindergarten through 12th grade and to explore the barriers between these sectors.
The committee also examined case examples of health-education collaboration and opportunities in policy. This publication summarizes the presentations and discussions from the workshop. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Jump up to the previous page or down to the next one.
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This paper sheds light on the causal relationship between education and health outcomes. We use variation in the timing of educational reforms across these countries as an instrument for education. Using IV-probit models, we find causal evidence that more years of education lead to better health.
Bhashkar Mazumder, Cutler, David M. Cleland, John G.
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