Health returns to education by family socioeconomic origins, 1980–2008: Testing the importance of gender, cohort, and age

Abstract

Recent studies find that health returns to education are elevated among those who come from disadvantaged families. These findings suggest that education may be a health resource that compensates or “substitutes” for lower parental socioeconomic status. Alternatively, some studies find support for a cumulative (dis)advantage perspective, such that educational health returns are higher among those who already were advantaged, widening initial health (dis)advantages across the life course. However, it remains unclear whether these findings are dependent on gender or cohort, and this is a fundamental oversight given marked differences between men and women in educational and health inequalities across the twentieth century. Drawing on national US data (1980–2002 General Social Survey with 2008 National Death Index Link), I indeed find that the presence or strength of resource substitution or cumulative (dis)advantage depends upon health measure as well as gender and cohort. For self-rated health, cumulative (dis)advantage explains educational health disparities, but among men only. Cumulative (dis)advantage in avoiding fair or poor health is partly explained by cohort and age variation in health returns to education, and cumulative (dis)advantage in excellent health is more robust in earlier cohorts and at older ages. For mortality, resource substitution is instead supported, but for women only. Among those from disadvantaged families, educational mortality buffering increases with cohort but diminishes with age. Taken together, these findings confirm prior research showing that adult health inequalities linked to education depend on family background, and extend this work by demonstrating that the nature and extent of these dynamics differ considerably depending on the health outcome being assessed and on an individual's historical context, life course stage, and gender.

The gender gap in self-rated health and education in Spain. A multilevel analysis

“…Some recent papers have focused on the influence of individuals’ socioeconomic background [ 42 , 43 ] and have pointed out that health returns to education depend on socioeconomic origin. They show that the social position of the family with whom individuals live when they are young is crucial vis-à-vis determining their current education level, their health habits and their socioeconomic position.…”

Adult health returns to education by key childhood social and economic indicators: Results from representative European data

“…Other studies obtain results consistent with an opposing mechanism, in which education favors those with advantaged childhood backgrounds. Namely, a “resource multiplication” perspective usually posits that educational systems tend to favor individuals from privileged childhood backgrounds, thus amplifying rather than reducing health inequality present during childhood ( Andersson, 2016 , Bauldry, 2014 , Schafer et al, 2013 ). This perspective highlights how pre-educational resources and active parental guidance dramatically increase the odds of educational engagement, success, and attainment, beginning as early as preschool and carrying through high school and college graduation ( Conti & Heckman, 2010 ).…”

“…Relevant studies of national US data usually find adult health disparities that are consistent with resource substitution across educational attainment and childhood and adolescent resources ( Bauldry, 2015 , Ross and Mirowsky, 2011 , Schaan, 2014 , Schafer et al, 2013 ), though occasionally they find patterns consistent with resource multiplication ( Andersson, 2016 , Bauldry, 2014 ). However, existing work leaves unclear how specific key childhood and adolescent factors contribute to these patterns, and this work also does not resolve whether similar patterns hold outside the United States – or across diverse physical health measures in adulthood.…”

“…Evidence is accumulating in the United States that educational health returns are heterogeneous across family socioeconomic origins, with higher education being substantially less predictive of adult health among those who come from advantaged families ( Andersson, 2016 , Bauldry, 2015 , Ross and Mirowsky, 2011 , Schafer et al, 2013 ). Some US studies find the opposite, such that observed educational health returns are higher among those with greater parental socioeconomic resources ( Andersson, 2016 , Bauldry, 2014 ). However, existing work has not made clear how distinct key childhood and adolescent life exposures contribute to these heterogeneous returns.…”

“…However, existing work has not made clear how distinct key childhood and adolescent life exposures contribute to these heterogeneous returns. Specifically, by focusing either on singular childhood factors like parental education or social class ( Andersson, 2016 ; Ross & Mirowsky, 2016 ; Schaan, 2014 ) or on complex vectors of educational determinants ( Bauldry, 2014 , Bauldry, 2015 , Conti and Heckman, 2010 , Schafer et al, 2013 ), work on educational health disparities in the United States leaves unclear intermediate mechanisms, by which key childhood or adolescent factors might jointly shape these disparities. Namely, parental social class, childhood financial strain, and abuse or maltreatment growing up all make distinct and well-established contributions to both final educational attainment and adult health ( Carroll et al, 2013 , Ross and Mirowsky, 2011 , Schafer and Ferraro, 2012 , Schafer et al, 2013 , Wagmiller et al, 2006 , Ziol-Guest et al, 2012 ).…”