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Americans with more education live longer, healthier lives than those with fewer years of schooling. Just as education level can affect health, health status can affect education, and conditions throughout a person's life can affect both education and health.


The amount of education a person has is often called "educational attainment" in academic literature. Just as education and educational attainment can effect health outcomes, a person's health can affect the amount of education that he or she is able to attain. For instance, health-related factors such as hunger, physical and emotional abuse, and chronic illness can lead to poor school performance.

In epidemiology, educational attainment is considered a "social determinant" of health. The World Health Organization (WHO) defines social determinants of health as "the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national, and local levels." Education, and how much education a person is able to attain, is widely recognized as one of these conditions.

Why It's Important

A large body of research has examined the relationships between the amount of education a person has and health outcomes. Low educational attainment has been identified as a problem in the U.S. The Robert Wood Johnson Foundation reports that "The United States is the only industrialized nation where young people currently are less likely than members of their parents' generation to be high-school graduates." According to the 2013 American Community Survey 5 year estimates, from 2009 to 2013 14% of Americans over the age of 25 reported not having a high-school diploma or equivalent certificate.

Like many other factors that are operationalized within the group of "social determinants of health" a "social gradient" is often seen when health outcomes are stratified by social determinants of health, such as education. According to the CDC, the term "social gradient in health" refers to the stepwise fashion health outcomes improve as socio-economic position improves.

What Is Known

While individual outcomes are dependent on a many different individual factors, ecological public health research has shown several ways that educational attainment impacts health outcomes at a population level. When looking at the entire U.S. population researchers found that:
  • For both men and women, a social gradient can be observed when life expectancy is stratified by levels of educational attainment. Data from the National Longitudinal Mortality Study found that, on average, college graduates of both sexes could expect to live 5 years longer than persons who had not graduated high school.
  • For all racial and ethnic groups, less education is linked to worse health. A review of data from the Behavior Risk Factor Surveillance System, (BRFSS) shows that groups with lower educational attainment are more likely to rate their health as less than good than groups with higher educational attainment.
  • A social gradient in health can be seen when national rates of infant mortality are stratified by mother's educational attainment.
Additionally, educational attainment has been shown to impact several other health outcomes. This is why it is important to consider educational attainment in analysis of health outcomes.

Who Is at Risk

Persons who attain less education could be at risk for negative health outcomes associated with low educational attainment. Several factors have been associated with low educational attainment.
  • Persons living in poverty. Data from the National Center for Education Statistics shows that consistently since the 1970s the high school drop-out rates have been highest for persons who are in the lowest family income groups. Additionally, a social gradient can be observed across family income groups for high school drop-out rates.
  • Persons of African American or Hispanic race/ ethnicity- According to the National Center for Education Statistics, in 2012 the national drop-out rate was highest for Hispanics, then African American Americans.

How To Reduce Risk

Like other social determinants of health, addressing low educational attainment in the United States requires a complex understanding of social, economic, cultural and historical conditions. While there are several different strategies toward educational policy, the Centers for disease Control (CDC) and the WHO recommend global approaches to addressing the Social Determinants of Health. In order to address the social determinants of health, the WHO organization created the Commission on Social Determinants of Health, which recommends the three following overarching strategies:
  • Improve the conditions of daily life-the circumstances in which people are born, grow, live, work, and age.
  • Tackle the inequitable distribution of power, money, and resources-the structural drivers of those conditions of daily life-globally, nationally, and locally.
  • Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.

How It's Tracked

Educational attainment can be tracked nationally and at state levels via several sources:

  • The United States Census American Community Survey
  • Behavioral Risk Factor Surveillance System (BRFSS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
  • Youth Risk and Resiliency Survey (YRRS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
  • Drop-out rates, graduation rates, and other measures are colleced by the New Mexico Public Education Department
Researchers can stratify survey results for health outcome questions by levels of educational attainment using the query builder tools on the IBIS website.