Might extended education decrease inequalities in health? - A meta-analysis

Abstract

Background: Health is substantially worse in less educated people, and extended education might potentially improve their health. A prerequisite for a beneficial health effect of education is that the effect is absolute. An absolute effect of education means that the health effect comes about independently of any effect on other persons. A relative effect, on the other hand, only contributes to individual competitiveness in relation to others. Studies of natural experiments of extended compulsory education, and other educational-policy changes, provide an option for the analysis of absolute effects of education. Published studies, however, present conflicting results. Methods: A meta-analysis was performed of European studies where the health effects of extended compulsory or secondary level education on low-educated individuals were investigated. Results: Twenty-two relevant publications were identified. The meta-analysis indicated statistically significant favourable effects of educational reforms on rates of mortality, self-reported poor health and obesity. The effects were, however, small, 1-4%. Conclusions: An educational reform that typically added one educational year in the least educated group was associated with a mean 2.1% reduction in mortality in men before age 40. This effect might be compared with the total educational gradients of mortality rates in Swedish men at ages 30-64. One extra year of education after compulsory education corresponds to a 41% reduction in mortality, which is 20 times more than the absolute effect of education found in this meta-analysis. Thus, it unlikely that extended compulsory education will substantially improve the health of the least educated individuals.