PRB

(June 2011) Many people know that individuals with higher levels of education tend to live longer and healthier lives than individuals with low levels of education. In a recent study, Robert Hummer and colleagues built on this knowledge by demonstrating new important characteristics of the relationship between education and adult mortality in the United States.

Among their findings: Each year of education does not have the same “meaning” in terms of reduced mortality risk of U.S. adults; and the data on mortality of more highly educated individuals shows less dispersion than the data on mortality of less educated individuals. The researchers also refined key pathways by which educational attainment influences adult mortality risk, including much higher levels of cigarette smoking among the less educated; and better jobs, higher income, and greater access to health insurance and social ties and resources among the more highly educated. Hummer and his colleagues also determined that over the past two decades, there has been increasing inequality in mortality risk by education in the United States.

In a PRB Discuss Online, Robert Hummer, Centennial Commission professor of liberal arts at the University of Texas, Austin, answered questions from participants about the relationship between education and longevity in the United States.

June 9, 2011 NOON (EDT)

Transcript of Questions and Answers

OLASEINDE OLUGBENGA SUNDAY: Can the same factor—education—introduce lopsidedness in the adult mortality trend of the developing world like Nigeria, taking into cognizance, some other mortality risks exposure which are avoidable in the developed countries but prevail in the third world countries?
Robert Hummer: Thank you for your question…it is a good one. Overall, I would be surprised if a high level of education was not associated with greater longevity in Nigeria. Such a pattern will not be true for everyone, of course…that is, some highly educated people will die at relatively young ages. But following the work of sociologists Bruce Link and Jo Phelan, I view education as a very important flexible resource…a resource that allows highly educated people to generally make good decisions about their health and health behavior and benefit from the socioeconomic resources (such as good jobs and high income) that tend to come from achieving a high level of education. While I am unfortunately not an expert on Nigeria, I would expect that highly educated people in Nigeria will better be able to avoid health risks than less educated people and, therefore, on average live longer than their less educated counterparts.

J Kishore: Education means adopting healthy and useful behavior. Educated people are more aware of them so possibility to use them help them to live healthy and longer. Those people who are educated but do not want to change their behavior for healthy lifestyle would continue to live shorter than the lives of less educated who have changed their behavior to healthy lifestyle. Still it is worth to have educated population because its group effect on overall longevity should be beneficial. Will it be beneficial for Indian population?
Robert Hummer: Thank you for your question. I have little doubt that higher levels of education will be beneficial for the overall health and longevity of the Indian population. The relationship between education and longevity is strong in every context I have examined. While not every high educated person will live a long life and not every low educated person will die early, on balance, I do think that education works to improve health and improve longevity given all the data we have accumulated on the subject.

Dr. Anima Sharma: Hi, I am finding the topic of this discussion very interesting however, I have my own views when we talk about India or other third world countries. You know, relating education with longevity is a bit dicey in our case. I may be wrong but you know my observation is, we can correlate education with modern ways of life and modern ways of life give rise to modern types of work related diseases and urbanism. Ultimately, I find that my counterparts who are living close to nature, eating, breathing and living fresh natural life have better life expectency though these configurations have been affected by the development activities. It is a common belief in the countries like India that with education people become more prone to living artificial life and their life-style also changes, which finally affects their health and viz. a viz. longevity. In Developed countries the situation may be different and because I have no experience of working in the US hence I am not opposing your observations but I am humbly putting forward my experiences. Hope you will have something to say in this regards too.
Robert Hummer: Hello Dr. Sharma: Thank you for your question. This is a really, really interesting point you raise. And, unfortunately, I have no experience working with Indian data or on India. I guess I will offer two initial thoughts:

1. I think it will be really important to study the relationship between education, health, and longevity in India as it unfolds across time…and not only for the country as a whole, but also for different subgroups within the country (for example, separately in both urban areas and rural areas).
2. My experience with data from the United States and my review of European research suggests that high education is strongly correlated with good health and greater longevity in every context in which it is studied. This is because education is a critical, and flexible, resource that is used by individuals in ways that, on average, tend to work toward improved well-being and health across the life course.

 Thus, I would be surprised if a similar pattern did not unfold in India…but, of course, we’ll need data and studies to do this work!

Donald A. Collins, President: Isn’t it true that old people like me (I am 80 but thinking of those 65 and over) will continue to contribute increasingly to the nation’s work needs? This implies that we emphasize admitting skilled immigrants, not millions of unskilled as we now do.
Robert Hummer: Dear President Collins: Yes, it also seems to me that older individuals will become an even more important portion of the labor force looking ahead. Thus, I think increasing levels of education among adults will be more and more important in the years ahead—to improve skill levels, and to help keep people healthier and productive for many years. I have a forthcoming paper that shows that additional education during the adult years helps to improve health…so it is not just education that is obtained during childhood and adolescence that matters.

Aberto Rizo: Having lived in Western European countries I have seeing seniors affected of chronic illnesses such as Diabetes, Arthritis, Cancers, Hypertension and Mental conditions, etc cared in hospices. I have also visited organized communities for seniors who are able to care for themselves. Is the “extended family model” type of care for the old prevalent in middle income countries a good alternative to promote? – Alberto Rizo G., MD, MPH, Bogota, Colombia
Robert Hummer: Dear Dr. Rizo: Unfortunately, I have no expertise on actual caregiving. My educated guess is that committed family members are usually important resources in terms of caregiving…

Rohit mehta: What step should India take to curtail the declining sex ration in the early age group and to improve it also?
Robert Hummer: I’m sorry, but I unfortunately am not an expert in research on sex ratios.

Tyjen Tsai: Do you distinguish between vocational education/training and general education in your study?
Robert Hummer: This is another excellent question…and it simply depends on the availability of data. Whenever possible, I do…and, for example, some of my work clearly shows that people with high school equivalency degrees (e.g., a GED) have higher mortality than people with standard high school degrees. They are not equivalent…at least in terms of their associations with mortality. So I do think such distinctions can be very important. Research-wise, I think it is very important to try and gather as much detail as possible about the education of individuals, so that we can better understand the health and mortality consequences of all forms of schooling.

Nir, F.: education leads to higher exposure of reading medical materials, knowing the importance of healthier nutrition, etc. my question is what are the explaning variables you use in order to quantify this exposure? and also what variables of education do you use (by years of schooling, diplomas, etc.)?
Robert Hummer: This is an excellent question. My work has focused on both years of schooling as well as degrees (e.g., High School Diploma, College Diploma, etc…). Each year of education is associated with reduced mortality. But my group’s work also clearly shows that:

1. Each additional year prior to a high school diploma is associated with reduced mortality, but not by all that much with each additional year.
2. The achievement of a high school diploma is associated with a very sizable reduction in mortality.
3. After a high school diploma, each additional year is associated with a sizable reduction in mortality that is of greater magnitude than the lower years of education.
4. There is no “ceiling effect” of education in terms of reduced mortality…even at very high levels of education, additional years are associated with lower mortality.

To explain this relationship (i.e., mediators), I use sets of variables that include earned income, social resources, health behaviors, and physiological markers of health.

Ryan: Regarding the problems young people are having today affording higher education, what effect do you see a potential/actual drop in college attendance having on health and mortality in the US in the near future as well as decades from now?
Robert Hummer: Dear Ryan: This is an excellent question…and I worry about this a lot. But I not only worry about this in terms of affordability, I also worry about it in terms of wide-ranging access to education and the quality of education.

My group’s research findings strongly suggest that education is increasingly important for health and mortality in the United States. And we also have shown that the effects of education play out over the life course…across decades and decades of time. Thus, my sense is that what we do now in terms of education—at all levels, not only including college—is going to impact the nation’s health for many decades looking ahead. In my view, educational funding and policy decisions are critical health policy decisions as well.

Diana Lavery: Hi Dr. Hummer, I was interested to read in one of your responses that there was no “ceiling effect”—meaning that even at very high levels of education, additional years are still associated with longer life expectancy. I think of years in very high levels of education to include a lot of high-stress situations, lower levels of sleep, lower income levels (especially for Ph.D. students), and increased debt—all things that I would associate with lower life expectancy (although I am not an expert). So are there reasons known as to why the “ceiling effect” does not exist?
Robert Hummer: Dear Diana: This is a great question. Until the last few years, we’ve had no national data, to my knowledge, on the mortality patterns of people with very high levels of education. And surely, the types of stresses/debts/etc…that you raise are very real and important. That said, my sense is that such stresses/debts are often short-term…and, over the life course, people who earn very high degrees are rewarded…with better jobs, higher incomes, stable access to care, fabulous access to health information and technologies, and very useful social networks. So, in the end, such benefits accumulate across the life course to result in lower mortality for persons with very high levels of education. Again, though, such findings are brand new, to my knowledge, so it will take more research to better understand the low mortality experienced by persons with very high levels of education.

Diana Lavery: Thanks Dr. Hummer, I work on measuring child well-being in the U.S., and I know that there is a significant amount of research that shows the importance of preschool for many later life outcomes. Does your study take into account those who attended preschool? If so, are there any interesting findings?
Robert Hummer: Sure! I sure wish I as able to take into account preschool education. Indeed, from a “human capital” perspective, education builds, or accumulates, across the life course, allowing individuals to gain greater control over their lives, apply knowledge in key situations, etc… So I would not be surprised to find out that education at all levels, even including preschool, had beneficial effects (on average) down the road for health and longevity. A related literature that my colleague Mark Hayward works in focuses on a range of “early life” conditions on health and longevity…and indeed, childhood experiences such as poverty and child health have impacts on adult health and mortality decades later. So I would not at all be surprised to see early life education having effects on adult health and mortality.

Thanks for the questions…and good luck with your work!