The Rising Significance of Education for Health?

Abstract

Research on inequality in America shows evidence of a growing social and economic divide between college graduates and people without college degrees. This article examines whether disparities in health between education groups have also recently increased. Pooled crosssectional regression analyses of data from the National Health Interview Survey (NHIS) show that educational disparities in self-reported health status increased from 1982 to 2004 among older adults but held relatively steady or narrowed amongyounger adults. Sensitivity analyses show that the trends do not totally or primarily reflect change in the demographic composition of education groups. The trend of increasing disparities amongolder adults might reflectlarge and growingeducational disparities in economic resources, health-promoting behaviors, or the use of health services and medical technology.The last two decades of the 20th century saw a sharp upswing in levels of social and economic inequality in the United States. As predicted by Bell (1973) and other social theorists, much of this trend reflects increasing inequality on the basis of education levels, particularly between college-educated men and women and those without college degrees. Increasing disparities in narnings between education groups account for about one-third of the increase in overall wage inequality since the early 1980s (Bernhardt et al. 2001). Educational disparities in work conditions, employment benefits and job satisfaction have also increased (Fligstein and Shin 2004). Freeman (1999:4) warns that this "new inequality" is leading toward a "two-tiered society... in which the successful and uppermiddle classes live fundamentally different from the working classes and poor." If Freeman is correct, then education is arguably the main dividing line by which these tiers are split.In this article, 1 add to recent inequality research by examining whether disparities in health between education groups have also recently increased. Health, like wealth, is a main dimension of individual welt-being, yet researchers know much less about trends in health disparities between education groups than about trends in earnings or income disparities. Evidence of increasing disparities in health would bolster claims of a growing social divide on the basis

Education and Health Across Lives and Cohorts: A Study of Cumulative Advantage in Germany

“…Recent U.S. studies have supported the rising importance hypothesis (Lynch 2003;Mirowsky and Ross 2008). Furthermore, the data were consistent with the main explanations that have been proposed for this trend, suggesting that widening health gaps emerge from distributional change in health-related resources (Lynch 2006), as well as compositional change of educational groups (Goesling 2007).…”

“…By considering cohort effects, recent investigations have produced consistent results: Educational gaps in health increase over the life course, supporting the cumulative advantage hypothesis, which predicts initial health-related advantages and disadvantages to accumulate with age (Willson et al 2007). Moreover, this divergence was found to intensify across cohorts, a result that has been termed "rising importance of education for health" (Goesling 2007;Mirowsky and Ross 2008). …”

Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis

“…Recent studies on time-related changes in the education-health association have drawn attention to intersection processes (Goesling, 2007;Lauderdale, 2001;Lynch, 2003;Mirowsky & Ross, 2008). Firstly, age and cohort patterns can either enhance or suppress each other.…”

“…Apart from their additional effects, life course and cohort experiences can be interwoven (Goesling, 2007;Mirowsky & Ross, 2008). Age and historical context intersect, so the cumulative relationship between educational returns and health might differ from one cohort to another (Chen et al, 2010;Willson et al, 2007).…”

“…The body of social epidemiological literature is currently one-sided in this regard. There is fragmentary evidence for the rising importance hypothesis (Goesling, 2007;Mirowsky & Ross, 2008), which predicts that the cumulative advantage pattern will become stronger with each successive birth cohort. This hypothesis presumes an interaction between the cumulative advantage theory and the cohort accretion theory.…”