{"id":83374,"date":"2016-05-08T05:00:20","date_gmt":"2016-05-08T09:00:20","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?p=83374"},"modified":"2021-02-08T16:45:44","modified_gmt":"2021-02-08T21:45:44","slug":"a-good-education-the-best-prevention","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2016\/a-good-education-the-best-prevention\/","title":{"rendered":"A Good Education\u2014The Best Prevention?"},"content":{"rendered":"\n
\n\t
\n\t\t\t\t\t
May 8, 2016<\/div>\n\t\t\n\t\t\t\t
\n\t\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\tTwitter<\/span><\/span>\n\t\t\tFacebook<\/span><\/span>\n\t\t\t<\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n

\"deansnote1\"<\/strong><\/p>\n

As a school of public health it is our mission to improve the health of populations. We do so through generating new knowledge and through advancing a public health conversation towards creating the conditions that make people healthy.\u00a0We also do so through teaching\u2014educating a generation of students who will be the actors who aspire to improve population health in the years to come. This, then, gives us a particular responsibility to consider the role of education in everything we do, including in the generation of population health.<\/p>\n

How does education relate to health? In almost every way imaginable. Study<\/a> after study has shown<\/a> that the higher our education level, the longer we will potentially live and the healthier those years are likely to be. College graduates live at least five years longer<\/a> than those who do not graduate high school. Those four years of higher education can also lead to a range of health benefits, including a lower risk of diabetes, heart disease, and obesity. The health effects of education are also intergenerational\u2014the infant mortality rate per 1,000 live births for mothers who did not graduate from high school is close to double<\/a> that of women who earned college degrees. Figure 1 illustrates how years of educational attainment can shape an individual\u2019s vulnerability to a wide variety of health risks.<\/p>\n

\"Figure
Figure 1.<\/strong>
Hahn RA, Truman BI. Age-adjusted death rates among persons ages 25\u201364 years for several condition groupings, by sex and educational attainment. Selected US states, 1994\u20132005. International Journal of Health Services. 2015 0(0) 1\u201422.<\/figcaption><\/figure>\n

Even if a young person does manage to stay in school, poor academic performance can have health implications regardless of whether that student graduates or not. When high school students have lower grades, they are, for example, less likely to exercise and moderate their television viewing, and more likely to engage in unsafe behaviors like carrying a weapon (Figure 2).<\/p>\n

\"Figure
Figure 2.<\/strong>
Health-risk behaviors and school grades, United States, 2009. Source: http:\/\/www.cdc.gov\/healthyyouth\/health_and_academics\/pdf\/health_risk_behaviors.pdf<\/a>.<\/figcaption><\/figure>\n

<\/strong>There are several<\/a> mechanisms that explain why the amount of education a person receives is such an important determinant of well-being. Take, for example, why better grades seem to lead to better life choices. Robert Hahn and Benedict Truman speculate<\/a> that several influences could be at play, including the possibility that students who avoid risky behavior perform better as a result of their choices, as such hazardous activities could impede academic improvement. Hahn and Truman also suggest the influence of \u201cother factors, such as strong values, [which] promote both academic achievement and self-protective behaviors.\u201d<\/p>\n

The health benefits<\/a> of education are compounded by the health benefits of income<\/a>, with the two being highly correlated. More education means greater access to economic resources; people with a college degree can expect to earn nearly $1 million\u00a0more<\/a> over the course of a lifetime than those without one, and people with graduate degrees can expect to see an even greater increase in earnings. Figure 3 reflects this advantage on the level of weekly income and unemployment rates. The relation between higher income and health is, in turn, probably one of the best established<\/a> relations in population health.<\/strong><\/p>\n

\"Figure
Figure 3.<\/strong>
Earning and unemployment rates by educational attainment, 2015. \u2028Source: http:\/\/www.bls.gov.\/emp\/ep_chart_001.htm<\/a>.<\/figcaption><\/figure>\n

With so much at stake, it is encouraging to be able to report that the state of education in the United States, troubled for so long, is actually improving<\/a>. Slowly<\/a>. The US graduation rate recently hit 82 percent<\/a>, an all-time high, and American students are performing better<\/a> in math and science, though they remain in the middle of the pack internationally. The problem is that these positive outcomes are not being shared<\/a> by everyone. The achievement gap between racial groups<\/a>, particularly between white and black students<\/a>, remains wide. This is reflected in recent ACT scores, where black students performed at a significantly lower level than many of their peers, often failing to earn minimum, benchmark scores (Figure 4).<\/p>\n

\"Figure
Figure 4.<\/strong>
Percent of 2010\u20132014 ACT-Tested High School Graduates Meeting Three or More Benchmarks by Race\/Ethnicity. Source: https:\/\/www.insidehighered.com\/news\/2014\/08\/20\/acts-annual-score-report-shows-languishing-racial-gaps-mediocre-scores<\/a>.<\/figcaption><\/figure>\n

The achievement gap is further illustrated in everything<\/a> from high school dropout rates\u2014with 16 percent of black students dropping out, compared with 8\u00a0percent of white students\u2014to the racial divide in college enrollment. In 2014, 56 percent of black students enrolled, while the number for whites was 66 percent. When black students do enroll in college, they are less likely<\/a> to graduate than their white peers. There are several ways to account for these troubling disparities. The first is economic. Data have shown a correlation<\/a> between racial achievement gaps and the racial socioeconomic divide; gaps between white and black students tend to be wider<\/a> in wealthier communities. A new analysis<\/a> found that sixth graders in wealthier school districts are four grade levels above children in poorer districts. There are also social reasons for these gaps. Black children are more likely<\/a> to have difficult childhoods; the attendant challenges are compounded by the fact that the mothers and fathers of these children are less likely than white parents to have degrees themselves (Figure 5).<\/p>\n

\"Figure
Figure 5.<\/strong>
Parents With Bachelor\u2019s or Higher, by Child\u2019s Race. Source: http:\/\/www.usnews.com\/news\/blogs\/data-mine\/2015\/01\/28\/us-education-still-separate-and-unequal<\/a>.<\/figcaption><\/figure>\n

The data<\/a> are conclusive: A better-educated population is a healthier population. Hahn and Truman argue compellingly that education is not only crucial to promoting health, it is actually an important part of health itself. \u201cBasic educational expertise and skills,\u201d they write, \u201cincluding fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health.\u201d This is very much in keeping with the World Health Organization\u2019s definition<\/a> of health as \u201ca state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.\u201d That is then a reminder of the centrality of education to our work\u2014both as a core part of our mission as a School, and as a fundamental goal of the work of population health.<\/p>\n

I hope everyone has a terrific week. Until next week.<\/p>\n

Warm regards,<\/p>\n

Sandro<\/p>\n

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea<\/a><\/p>\n

Acknowledgement: I am grateful to Eric DelGizzo and Catherine Ettman for their contributions to this Dean\u2019s Note.<\/em><\/p>\n

Previous Dean\u2019s Notes are archived at: https:\/\/www.bu.edu\/sph\/tag\/deans-note\/<\/a><\/p>\n