How education produces health: a hypothetical framework

Abstract

Background: High school graduates live six to nine years longer than high school dropouts. Those with less education are more likely to die prematurely of cardiovascular disease, cancer, infectious disease, diabetes, lung disease, and injury than those with more education. Although there is growing evidence that the education-health relationship is causal, and some mechanisms linking education to health have been proposed, there is no gestalt for thinking about the health production function of education. Purpose: The purpose of this article is to outline the mechanisms through which education may produce health. Design: I explore the health risk factors that are more prevalent among those with lower educational attainment to ascertain whether such risk factors plausibly cause the diseases for which the less educated are at risk. To examine these relationships, I conduct a review of the public health, economics, endocrinology, sociology, neurosciences, and other literatures. Conclusions: A remarkably clear path can be drawn between what we now believe to be the risk factors for disease and the primary causes of death among those with lower attainment. Although hypothetical, the pathways outlined in this article can be used as a basis for thinking about the health production function of education. These mechanisms may better allow policy makers to understand the relationship between education and health. They may also be used to guide future research on the health benefits of education. Finally, although the proposed pathways are hypothetical, there is good overall evidence that education produces health. Therefore, health benefits should be included as core outcome measures in future education research.