Ma Yuanyuan, Nolan Anne, Smith James P
Wenlan School of Business, Zhongnan University of Economics and Law, Wuhan, China; The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.
The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland; Economic and Social Research Institute, Dublin, Ireland.
Econ Hum Biol. 2018 Sep;31:14-25. doi: 10.1016/j.ehb.2018.07.006. Epub 2018 Jul 23.
Does education have a causal impact on health? The existing literature presents mixed results. More evidence is required from contexts that have not been explored in the literature, and using clinically-measured health outcomes. Using data from the Irish Longitudinal Study on Ageing (TILDA), and exploiting a policy change in the 1960s that eliminated public secondary school fees, we investigate whether additional years of schooling for those with lower socio-economic status (SES) have a causal effect on the prevalence of cardiovascular disease in later life. We find significant sizable effects of education on the prevalence of both hypertension and diabetes. An additional year of schooling decreases the probability of having hypertension by approximately 3% points, and decreases the probability of having diabetes by approximately 1% point, effects that are large given existing prevalence. Further analysis of possible mechanisms shows that additional schooling increases the probability of engaging in high levels of physical activity and refraining from smoking. In the context of an increasing focus on strategies to prevent chronic disease, evidence such as this provides important insights for policymakers tasked with designing public health interventions targeting risk factors for chronic disease.
教育对健康有因果影响吗?现有文献呈现出参差不齐的结果。需要从未在文献中探讨过的背景下获取更多证据,并使用临床测量的健康结果。利用爱尔兰老龄化纵向研究(TILDA)的数据,并利用20世纪60年代取消公立中学学费的政策变化,我们调查了社会经济地位较低(SES)的人群接受更多学年教育是否会对晚年心血管疾病的患病率产生因果影响。我们发现教育对高血压和糖尿病的患病率有显著的可观影响。多接受一年教育会使患高血压的概率降低约3个百分点,使患糖尿病的概率降低约1个百分点,鉴于现有患病率,这些影响是很大的。对可能机制的进一步分析表明,多接受教育会增加进行高水平体育活动和戒烟的概率。在越来越关注预防慢性病策略的背景下,这样的证据为负责设计针对慢性病风险因素的公共卫生干预措施的政策制定者提供了重要见解。