Good health linked to better education

Greg Baxter on a new report that looked at the health impacts of education and found that higher education levels are linked to better health in adulthood.
We know that education is a determinant of good health. But a debate rages about whether education, in some cases, causes better health, or whether it, like a number of other factors, is simply associated with better health. Last week, at the launch of a report by the Institute of Public Health, entitled, ‘Health Impacts of Education’, the Secretary General of the Department of Education, Ms Bridget McManus, said claims that education causes improved health needed, in her opinion, more evidence.

Ireland took its first step toward providing that evidence with the launch of the Institute’s report, which links better education to better health, drawing upon numerous international studies, and confirming them with Irish statistics.
As expected, the report found:
* Low education level is associated with increased risk of death from lung cancer, stroke, cardiovascular disease and infectious diseases.
* Associations have also been found between education and a range of illnesses including back pain, diabetes, asthma, dementia and depression.
* Improving educational outcomes amongst the most disadvantaged groups has the potential to make a positive impact on health inequalities.
* Those with higher levels of education are likely to consume more fruit, vegetables and fibre and less fat than those with less education.
* Those with higher levels of education are less likely to smoke and more likely to quit if they do.
* Those with more years of education are more likely to be employed, which is better for health than being unemployed.
These findings are largely to be expected, based on the international experience. But investment is never made without local evidence.
h4. Mediating factors
The report’s authors do not pretend that the link between health and education is easy to define, or account for, because several mediating factors influence that link. For instance, a person with a second-level degree from an impoverished, rural community will have a different health experience than someone with the same degree, who grew up in a neighbourhood of relative affluence.
But even that distinction cannot grasp a fraction of the complexity that the authors of the report try to identify. Personal issues that mediate the link between health and education include gender, ethnicity and age; health behaviour; and skills.
Social influences include level of engagement and participation with people around them; networks of friends and acquaintances; and cultural norms. Major economic influences include the socio-economic status of parents; employment; and income.
Additionally, there are different kinds of health – physical, mental and social – as well as broad social and economic policies of a region, and specific education and health policies set by the ruling government in that region.
Yet despite all these innumerable qualifying aspects to the relationship, people who have higher levels of education, across society, have higher levels of health. Good health does not appear to be primarily, or at least causally, linked with better performance in school, but simply education itself.
Studies have shown that teenagers who do not do well academically yet regularly attend school have better health as adults than truants with the same low level of qualifications.
Another striking example of the power of education on health is the fact that the health benefits to those who take part in adult education is far more significant in people who are undereducated – indicating, perhaps, significant and immediate benefits of basic educational foundations such as literacy.
h4. Pilot schemes
Some GP pilot schemes internationally have used prescriptions for education as a treatment for patients.
Education also moderates income inequality. That is, the more you know (the longer you have spent studying), the less impoverishment affects your health.
An expert on the relationship between education and health, Dr John Vorhaus, Director of the Centre of Wider Benefits of Learning at the Institute of Education, University of London, gave a convincing talk at the launch, showing not only an unambiguous link between the two, but arguing that evidence has shown that education actually causes good health.
When McManus stood to thank the Institute for its report, she said she was unconvinced by claims of causality. This is understandable. Causation is an empty premise anyway, philosophically speaking. But Dr Vorhaus still looked quite nonplussed as he listened to her speak. ‘What more evidence do you need?’ his expression seemed to ask.
That debate may be academic, since the terms used to portray the urgency are a matter of semantics. And the Institute’s report leaves no doubt that investment in education now means we may not have to put ten times that investment into health in 15 or 20 years.
The report also makes it clear that investment in education does not reach all sectors of society equally.
h4. Positive relationship
Chief Executive of the Institute, Dr Jane Wilde, said: “A strong positive relationship exists between education and health outcomes whether measured by death rates, illness, health behaviours or health knowledge.If our goal is to create equality and fairness for all members of society, then we need to invest at the earliest possible age. And funding needs to be channelled particularly to those who are most vulnerable.”
The report found that targeting literacy and early school leaving provide particularly effective ways in which education policy can improve health.
Dr Wilde continued: “While it is clear that education benefits health, such benefits do not accrue equally to all population groups in society. A growing body of evidence documents the link between education and health inequalities.
“This review shows that young people from socio-economically disadvantaged backgrounds and young people from some ethnic groups are less likely to gain health benefits from education.”