As a Cornell student, it can be easy to lose oneself in the intellectual ivory tower. It is sometimes hard to fathom that not everyone in America has a college degree, knows about DNA polymerase II, and can choose their favorite subject to study in school; but venture beyond campus and this illusion quickly fades. Even in the town of Ithaca, one can begin to see public health crises that mar much of the American populace: substance abuse, inadequate nutrition, and more. Of course, many of these problems are inherently tied to socio-economic status, there is no avoiding that. Nevertheless, these health issues also stem from educational disparities.
The education situation in America is much different from most people’s preconceived notions. Indeed, the numbers are staggering. In 2019, only 39% of American adults held a bachelor’s degree [1]. As America pushes towards a one-size-fits-all approach to education with the desire for universal college, it’s important to ask: how does an individual’s education affect health outcomes?
Education and socioeconomic status are extremely intertwined which makes it difficult to pinpoint whether education has a causal effect. Yet, an increasing number of statistics reveal the dramatic influence of education on health.
First, one must consider how a patient’s educational background can create difficulties during a visit to the doctor’s office and understanding of a treatment plan. The fact is that “fewer than half of US patients have the necessary skills to read and follow drug label instructions, respond to insurance forms, provide a patient history or communicate effectively with a physician, according to an NIH study” [2]. This is perhaps the bleakest of all statistics, as it suggests that no matter how much doctors try to improve patient health outcomes, a patient’s poor education situation may prevent them from obtaining the best health care.
How is someone supposed to receive treatment if they cannot explain their problem to the physician, fill out the paperwork to pick up their medicine, and follow its instructions?
Then, there is the matter of difference in how physicians treat patients based on their education level. Studies have shown that patients with high school education and below spend more time being examined and counseled on nutrition, and less time on having their questions answered, health knowledge assessed, and being counseled on the importance of exercise. What’s more, less educated patients receive fewer screening tests [3]. Surprisingly, these patients have similar overall visit satisfaction. These studies convey a concerning trend: lesser educated patients may not realize the care that they are missing out on.
Perhaps the most shocking finding is that those with lesser education are not only receiving different care at the doctor’s office, but they are also leading shorter lives. Studies have shown that for individuals born in the U.S between 1914 and 1939, only one additional year of schooling decreases the chance of dying by 3.6% [4].
Not only are they living shorter lives, but in the time they do have, they are also less healthy. [1] Studies show that, in general, individuals who completed higher education have a greater chance of being in good health than those who did not [5]. This can be due to a host of personal factors. For example, bettereducated people are more likely to hold better jobs with fewer health risks and superior health insurance coverage [6]. Similarly, they are more likely to have less stress and fewer resources to fight off stressful situations like financial means, strong social support, and self-esteem, etc. Then, there are the clear socio-economic matters, like the fact that the higher income that corresponds with higher education means individuals can more easily purchase healthy food, afford a doctor’s visit, and have time to exercise regularly [6].
Unfortunately, these issues are not only limited to this generation [2]. Studies have shown that for women at the brink of college enrollment, being able to attend for two years decreases the risk of smoking during pregnancy from 7.8% to 2% [4]. These deleterious health outcomes will be passed onto the next generation when individuals are unable to pursue higher education.
In short: more Americans need higher education. Beyond the obvious socio-economic benefits, the studies highlight the improved health outcomes we can expect. As to how the higher education rates can be improved, it is not for me or anyone else in academia to decide. Our concern should be bringing awareness to this issue via advocacy and supporting studies that continue to underscore the importance of ensuring everyone receives a college degree because its effects extend beyond the job market and into a healthier America both now and later.
References:
1) Education Attainment Statistics. (2019). Educationdata.org. https://educationdata.org/education-attainment-statistics
2) Orgain, J. (2013, July 26). Understanding Patients’ Literacy Level is Crucial Step in Care. AAFP.Org. https://www.aafp.org/news/blogs/leadervoices/entry/understanding_ patients_literacy_level_is.html
3) K.F. (2002, March). Does patient educational level affect office visits to family physicians? NIH.Gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594098/
4) Feinstein, L. (2006). What are the Effects of Education on Health? OECD.Org. https://www.oecd.org/education/innovationeducation/37425753.pdf
5) Jansen, T. (2018, May 31). The role of health literacy in explaining the association between educational attainment and the use of out-ofhours primary care services in chronically ill people: a survey study. Https://Bmchealthservres.Biomedcentral.Com. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913- 018-3197-4
6) Why Education Matters to Health: Exploring the Causes. (2015, February 13). Https://Societyhealth.Vcu.Edu. https://societyhealth.vcu.edu/work/the-projects/why-educationmatters-to-health-exploring-the-causes.html