Less Education May Mean Poorer Health

WEDNESDAY May 6, 2009 -- American adults with the least education have the worst health, a new study finds.

Almost half of U.S. adults ages 25 to 74 reported being in less than very good health, and levels of health differ depending on level of education, according to a report released Wednesday by the Robert Wood Johnson Foundation Commission to Build a Healthier America.

For example, adults who didn't graduate from high school were more than 2.5 times as likely to be in less than very good health as college graduates. Those who graduated high school but didn't go to college were nearly twice as likely to be in less than very good health as college graduates.

The new report added to the commission's growing body of evidence that factors outside of the medical system play an important role in determining how healthy people are and even how long they will live.

"Access to affordable, high-quality medical care is essential, but that alone will not improve the health of Americans," commission co-chair Alice M. Rivlin said in a Johnson Foundation news release.

"What this report tells us is that education has a tremendous impact on how long and how well we live. Policymakers need to focus on schools and education, as well as promoting healthier homes, communities and workplaces, to improve the health of our nation," Rivlin said.

The report's authors said it is the first to look at health and education on a state-by-state basis. Among its other findings:

  • 45 percent of U.S. adults reported being in less than very good health. Rates vary widely between states, from a low of 35 percent in Vermont to a high of 53 percent in Mississippi.
  • Education-related differences in health can be seen within states. In Mississippi, nearly 75 percent of adults who hadn't graduated from high school reported being in less than very good health, compared with 37 percent of college graduates. In Vermont, which had the best overall health in adults, 68 percent of adults who hadn't finished high school said they were in less than very good health, compared with 22 percent of college graduates.
  • Overall, racial and ethnic minorities were more likely than whites to report being in less than very good health. Education-related differences in health were seen within every racial or ethnic group. For example, 44 percent of black college graduates in the United States said they were in less than very good health, compared with 55 percent of those with some college education, 62 percent of high school graduates, and 73 percent of those who didn't finish high school.
  • California had the largest gap between the overall rate of less than very good health and the rate for college graduates. The study found that 48 percent of all adults in California said they were in less than very good health, compared with 28 percent of college graduates in the state. Delaware had the smallest difference, with 41 percent of all adults reporting being in less than very good health, compared with 32 percent of college graduates.

"Regardless of where your state falls in these rankings, the news isn't good," commission co-chair Mark McClellan said in the news release. "Education is an important marker for an array of opportunities that can lead to better health. One of the most important things we can do for our nation's health is to improve education quality and educational attainment."

The report authors also established a benchmark rate for adult health by looking at the best level of health achieved in any state among college graduates who also have healthy behaviors. The benchmark was found in Vermont, where less than very good health was reported by only 19 percent of college graduates who exercised and didn't smoke.

A comparison of rates in every state against this benchmark shows that American adults at every education level and in every racial or ethnic group aren't as healthy as they could be, the report authors said.

More information

The U.S. Centers for Disease Control and Prevention has more about health disparities.

Posted: May 2009


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