Dropping Out of School is Deadly

A large proportion of Australian students do not complete Year 12. According to the Productivity Commission’s Report on Government Services 2015, 26 per cent of the potential Year 12 population did not complete Year 12 in 2013 and 32 per cent of low SES students did not complete the final year of school. New research shows that not completing Year 12 is a deadly decision.

The research, published last week in the scientific and medical journal PLOS ONE, found that completion of high school leads to lower levels of mortality and that not completing school may be as deadly as smoking.

The study used data on over a million people from the Centres for Disease Control and Prevention’s National Health Interview Survey in the United States from 1986 to 2006 to estimate the number of deaths attributable to low levels of education among those ages 25 to 85 in 2010. It found that 145,243 deaths could have been saved in 2010 if adults who had not completed high school had gone on to achieve a high school degree or a General Educational Development (GED) degree. This is comparable to the estimated number of deaths that could be averted if all current smokers had the mortality rates of former smokers. Mortality attributable to having less than a high school degree is proportionally similar among women and men and among non-Hispanic blacks and whites.

The findings point to the importance of education in changing health-related behaviours. “In public health policy, we often focus on changing health behaviours such as diet, smoking, and drinking,” said one of the researchers, Virginia Chang from the Global Institute of Public Health and School of Medicine at New York University, in a press release. “Education – which is a more fundamental, upstream driver of health behaviours and disparities – should also be a key element of U.S. health policy.”

The study compared results for people born in 1925, 1935, and 1945 to discover how education levels affected mortality over time. It found that disparities in mortality across different levels of education widened substantially over time. The percentage of all-cause mortality attributable to having less than a high school degree rather than a high school degree or GED doubled among both men and women when considering educational disparities in mortality in the 1945 cohort rather than the 1925 cohort.

The study says that increasing educational disparities in mortality across cohorts result from a variety of changes disproportionately benefitting those with more education, including improved labour market outcomes, reduced incidence of medical conditions, better outcomes among those with acute and chronic disease, and greater reductions in smoking. “Broadly, life expectancy is increasing, but those with more education are reaping most of the benefits,” Chang said.

Deaths from cardiovascular disease played a greater role than deaths from cancer in these growing gaps in mortality and improvements in survival for well-educated people, likely due to advances in the prevention and treatment of cardiovascular disease among those with more education. The study found that 16 per cent of cardiovascular disease deaths among females and 9 per cent of cardiovascular disease deaths among males are attributable to individuals having less than a high school degree or GED. In contrast, 7 per cent of cancer deaths among females and males are attributable to individuals having less than a high school degree rather than a high school degree.

Healthy People 2020 – an initiative to improve Americans’ health decade by decade – set goals for increasing the proportion of students completing high school by 2020. The researchers said that based on their findings, meeting these goals could have a substantial impact on future survival patterns and public health efforts should consider placing a greater emphasis on promoting higher educational attainment among those who do not complete school. 

“Our results suggest that policies and interventions that improve educational attainment could substantially improve survival in the U.S. population, especially given widening educational disparities across birth cohorts. The magnitude of our estimates confirms the importance of considering education policy as a key element of US health policy…” [p.11]

“Unless these trends change, the mortality attributable to low education will continue to increase in the future,” said Patrick Krueger, from the Department of Health & Behavioural Sciences at the University of Colorado.

“In addition to education policy’s obvious relevance for improving learning and economic opportunities, its benefits to health should also be thought of as a key rationale,” said Virginia Chang.

The study’s findings are consistent with those of numerous studies from around the world that the level of education is a primary factor influencing health outcomes and health-related behaviours. More education is strongly associated with lower death rates, less risky health behaviours such as smoking, obesity and lack of exercise, and more use of preventative health services. As one review of such studies published earlier this year observes:

The positive association between an individual’s educational attainment and their health and longevity is one of the strongest, pervasive, and most robust in the social sciences. [Social Science and Medicine, 127 (February 2015), p. 1]

A study published in the same journal by academics from the Melbourne Institute of Applied Economic and Social Research at the University of Melbourne found a positive effect of education on health outcomes in Australia. It found that an additional year of schooling has a positive effect on health by improving dietary behaviour, reducing alcohol consumption and increasing physical activity.

Education is often referred to as a “social vaccine” because of the strong association between years of formal education and health and life expectancy. Increasing Year 12 completion rates will contribute to better health outcomes, especially for low SES and other disadvantaged students. It will require additional funding for schools, especially those serving disadvantaged communities. Improving health outcomes is another reason to fully implement the Gonski funding plan.

Trevor Cobbold

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