Sunday, November 20, 2011

Education = Longer Life

Last week the Census Bureau released the first analysis of the nation's very old--the 1.9 million Americans aged 90 or older. "An increasingly important feature of population aging in the United States is that the older population itself is getting older," the Census Bureau explains in 90+ in the United States: 2006-2008. The growing percentage of the very old among the elderly makes it increasingly important to understand their characteristics, one of which is particularly striking: Among people aged 90 or older, 61 percent have a high school diploma. That may not sound like a big deal, since a much larger percentage of Americans have a high school diploma today. But for teenagers in the 1930s and earlier decades, graduating from high school was a big deal. The Census Bureau notes that only 39 percent of 20-to-30-year-olds had a high school diploma in 1940. The far higher level of education among those who survived into their 90s is more proof that educational attainment plays a decisive role in determining how long you live.

So what else is new? Most of us would wager, correctly, that high school dropouts are not as healthy as those with more education. We can see with our own eyes what the research shows: The less educated fare poorly on almost every measure of health, including self-reported health status, disability, obesity, and chronic conditions such as arthritis, heart conditions, and asthma. That's what you get when you behave badly. The less educated are more likely to smoke, drink, use illegal drugs, and forego seat belts. It all seems so obvious, except for one thing: bad behavior does not explain the gap. Even after controlling for risky behavior, differences in health by education persist. They persist even when controlling for income, health insurance status, age, race, and gender. There seems to be some mystery factor--call it the X factor--linking education to better health and higher life expectancy. 

When social scientists David M. Cutler and Adriana Lleras-Muney pursued the X factor with a one-two punch of data analysis and a massive literature review, (see NBER Working Paper 12352), they came up with no definitive answer but an intriguing possibility--the educated think differently. "Education might matter for health not just because of the specific knowledge one obtains in school," they said, "but rather because education improves general skills, including critical thinking skills and decision-making abilities." 

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