It makes sense that people with higher education levels have lower mortality rates. Better education can improve health literacy. Higher education levels can lead to higher incomes and more health benefits for employees (with better insurance coverage). However, does living in communities with higher education levels affect mortality independently of whether a person’s family is highly educated?
According to an NBER working paper Bor and others (2024)the answer is ‘Yeah‘.
The authors use a variety of data sets to reach this conclusion, including mortality data from
National Center for Health Statistics (NCHS) Vital statistics; and educational attainment data by county in the United States Decennial Census and the American Community SurveyWith this data, they find the following:
The researchers first test the hypothesis that this correlation reflects healthier people disproportionately moving to areas with higher educational attainment. They reject this hypothesis and show that migration patterns are similar for healthier and sicker people.
Second, they examine differences in health-damaging behaviors between areas with more and less educated residents. They focus on two key behavioral risk factors: smoking and obesity. Nearly 60 percent of the correlation between area education and health is explained by differences in smoking and obesity. Adults in more educated areas are less likely to be obese, less likely to start smoking, and more likely to quit smoking by age 30 or 40 than adults with the same level of education in less educated areas. The researchers argue that local differences in attitudes, beliefs, social norms, and policies (such as workplace smoking bans) are plausible mechanisms for these patterns.
Finally, they look at the role of local services in more educated communities, such as reducing pollution, lowering crime rates, and improving the quality of health care. They conclude that these local services mediate the correlation between education and health, but explain no more than 17 percent of the correlation. While they acknowledge that there are many environmental factors not measured in their data, they argue that observable environmental factors play a smaller role than behavioral risk factors in explaining this surprising correlation.
The full article is here; The NBER Bulletin on Health summary is here.
