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الاثنين، 25 يناير 2016

Why Education Matters to Health: Exploring the Causes


Income and Resources

“Being educated now means getting better employment, teaching our kids to be successful and just making a difference in, just in everyday life.” —Brenda
Better jobs: In today’s knowledge economy, an applicant with more education is more likely to be employed and land a job that provides health-promoting benefits such as health insurance, paid leave, and retirement.5 Conversely, people with less education are more likely to work in high-risk occupations with few benefits.
Higher earnings: Income has a major effect on health and workers with more education tend to earn more money.2 In 2012, the median wage for college graduates was more than twice that of high school dropouts and more than one and a half times higher than that of high school graduates.6 Read More +/-
“Definitely having a good education and a good paying job can relieve a lot of mental stress.”
—Chimere
Resources for good health: Families with higher incomes can more easily purchase healthy foods, have time to exercise regularly, and pay for health services and transportation. Conversely, the job insecurity, low wages, and lack of assets associated with less education can make individuals and families more vulnerable during hard times—which can lead to poor nutrition, unstable housing, and unmet medical needs. Read More +/-

Figure 1
Figure 2
FIgure 4
Figure 1

Social and Psychological Benefits

“So through school, we learn how to socially engage with other classmates. We learn how to engage with our teachers. How we speak to others and how we allow that to grow as we get older allows us to learn how to ask those questions when we're working within the healthcare system, when we're working with our doctor to understand what is going on with us.”
—Chanel
Reduced stress: People with more education—and thus higher incomes—are often spared the health-harming stresses that accompany prolonged social and economic hardship. Those with less education often have fewer resources (e.g., social support, sense of control over life, and high self-esteem) to buffer the effects of stress. Read More +/-
Social and psychological skills: Education in school and other learning opportunities outside the classroom build skills and foster traits that are important throughout life and may be important to health, such as conscientiousness, perseverance, a sense of personal control, flexibility, the capacity for negotiation, and the ability to form relationships and establish social networks. These skills can help with a variety of life’s challenges—from work to family life—and with managing one’s health and navigating the health care system. Read More +/-
Social networks: Educated adults tend to have larger social networks—and these connections bring access to financial, psychological, and emotional resources that may help reduce hardship and stress and improve health. Read More +/-
“Being able to advocate and ask for what you want, helps to facilitate a healthier lifestyle. … If it's needing your community to have green spaces, have a park, a playground, have better trails within the community, advocating for that will help.”
—Chanel

Health Behaviors

Knowledge and skills: In addition to being prepared for better jobs, people with more education are more likely to learn about healthy behaviors. Educated patients may be more able to understand their health needs, follow instructions, advocate for themselves and their families, and communicate effectively with health providers.21 Read More +/-

Healthier Neighborhoods

“Poor neighborhoods oftentimes lead to poor schools. Poor schools lead to poor education. Poor education oftentimes leads to poor work. Poor work puts you right back into the poor neighborhood. It's a vicious cycle that happens in communities, especially inner cities.” —Albert
Lower income and fewer resources mean that people with less education are more likely to live in low-income neighborhoods that lack the resources for good health. These neighborhoods are often economically marginalized and segregated and have more risk factors for poor health such as:
  • Less access to supermarkets or other sources of healthy food and an oversupply of fast food restaurants and outlets that promote unhealthy foods.25
Read More +/-
“If the best thing that you see in the neighborhood is a drug dealer, then that becomes your goal. If the best thing you see in your neighborhood is working a 9 to 5, then that becomes your goal. But if you see the doctors and the lawyers, if you see the teachers and the professors, then that becomes your goal.” —Marco
“It's a lot of things going on [in this community], a lot of challenges. It's just hard sometimes to try and get people to come together, as one, just so we can solve the problem.” —Toni
  • Less green space, such as sidewalks and parks to encourage outdoor physical activity and walking or cycling to work or school.
  • Rural and low-income areas, which are more populated by people with less education, often suffer from shortages of primary care physicians and other health care providers and facilities.
  • Higher crime rates, exposing residents to greater risk of trauma and deaths from violence and the stress of living in unsafe neighborhoods. People with less education, particularly males, are more likely to be incarcerated, which carries its own public health risks.
  • Fewer high-quality schools, often because public schools are poorly resourced by low property taxes. Low-resourced schools have greater difficulty offering attractive teacher salaries or properly maintaining buildings and supplies.
  • Fewer jobs, which can exacerbate the economic hardship and poor health that is common for people with less education.
  • Higher levels of toxins, such as air and water pollution, hazardous waste, pesticides, andindustrial chemicals.27
  • Less effective political influence to advocate for community needs, resulting in a persistent cycle of disadvantage.

2. Poor Health That Affects Education (Reverse Causality)

“Things that happen in the home can definitely affect a child being able to even concentrate in the classroom. … If you're hungry, you can't learn with your belly growling. … If you’re worried about your mom being safe while you're at school, you're not going to be able to pay attention.” —Chimere
The relationship between education and health is never a simple one. Poor health not only results from lower educational attainment, it can also cause educational setbacks and interfere with schooling.
For example, children with asthma and other chronic illnesses may experience recurrent absences and difficulty concentrating in class.28 Disabilities can also affect school performance due to difficulties with vision, hearing, attention, behavior, absenteeism, or cognitive skills. Read More +/-

3. Conditions Throughout the Life Course—Beginning in Early Childhood—That Affect Both Health and Education

A third way that education can be linked to health is by exposure to conditions, beginning in early childhood, which can affect both education and health. Throughout life, conditions at home, socioeconomic status, and other contextual factors can create stress, cause illness, and deprive individuals and families of resources for success in school, the workplace, and healthy living. Read More +/-

What about social policy?

Social policy—decisions about jobs, the economy, education reform, etc.—is an important driver of educational outcomes AND affects all of the factors described in this brief. For example, underperforming schools and discrimination affect not only educational outcomes but also economic success, the social environment, personal behaviors, and access to quality health care. Social policy affects the education system itself but, in addition, individuals with low educational attainment and fewer resources are more vulnerable to social policy decisions that affect access to health care, eligibility for aid, and support services.
A growing body of research suggests that chronic exposure of infants and toddlers to stressors—what experts call “adverse childhood experiences”—can affect brain development and disturb the child’s endocrine and immune systems, causing biological changes that increase the risk of heart disease and other conditions later in life (see Graphic 1). For example:
“The connection that I will say between education and health would be a healthy mind produces a healthy person. A motivated mind produces a motivated person. A curious mind produces a curious person. When you have those things it drives you to want to know more, to want to have more, to want to inquire more. And when you want more, you will get more. You know where the mind goes the person follows… and that includes health.” —Marco
  • The adverse effects of stress on the developing brain and on behavior can affect performance in school and explain setbacks in education. Thus, the correlation between lower educational attainment and illness that is later observed among adults may have as much to do with the seeds of illnessand disability that are planted before children ever reach school age as witheducation itself.
  • Children exposed to stress may also be drawn to unhealthy behaviors—such as smoking or unhealthy eating—during adolescence, the age when adult habits are often first established.
Read More +/-

Graphic 1
Figure 5


Graphic 1

What about individual characteristics?

Characteristics of individuals and families are important in the relationship between education and health. Race, gender, age, disability and other personal characteristics often affect educational opportunities and success in school (see Issue Brief #1). Discrimination and racism have multiple links to education and health. Racial segregation reduces educational and job opportunities51 and is associated with worse health outcomes.52, 53

How does education impact health in your community?

The Center on Society and Health (CSH) worked with members of Engaging Richmond, a community-academic partnership that included residents of the East End, a disadvantaged neighborhood of Richmond, Virginia. This inquiry into the links between education and health was a pilot study to learn how individuals could add to our understanding of this complex issue using the lens of their own experiences.
What does your community have to say about the links between education and health – or other health disparities? Learn more about community research partnerships and community engagement:

References

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Additional Resources

Download the abridged issue brief (PDF):


Why Education Matters to Health: Exploring the Causes is part two of the Education and Health Initiative, a four-part series seeking to raise awareness about the important connections between education and health. Learn more about the initiative here, and explore the other phases below:
Education: It Matters More to Health than Ever Before: An issue brief, animated video, and expanded web content highlighting the growing divergence in health status between Americans with and without an education.
Health Care: Necessary but not Sufficient: An issue brief discussing the role of improved access to health care (and health insurance) in countering the effects of an inadequate education. Health care is necessary but not sufficient in the face of determinants like education – even in places where health care is guaranteed, people with limited education tend to be sicker.
Education and Health: The Return on Investment: A series of issue briefs arguing that spending more to educate our youth could save more on health care costs, and that the reverse is true: cuts in education to "save" money ultimately drive up health care costs
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