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      Education and Self-Reported Health: Evidence from 23 Countries on the Role of Years of Schooling, Cognitive Skills and Social Capital

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          Abstract

          We examine the contribution of human capital to health in 23 countries worldwide using the OECD Survey of Adult Skills, a unique large-scale international assessment of 16–65 year olds that contains information about self-reported health, schooling, cognitive skills and indicators of interpersonal trust, which represents the cognitive dimension of social capital. We identify cross-national differences in education, skill and social capital gradients in self-reported health and explore the interaction between human capital and social capital to examine if and where social capital is a mediator or a moderator of years of schooling and cognitive abilities. We find large education gaps in self-reported health across all countries in our sample and a strong positive relationship between self-reported health and both literacy and trust in the majority of countries. Education and skill gradients in self-reported health appear to be largest in the United States and smallest in Italy, France, Sweden and Finland. On average around 5.5% of both the schooling gap in self-reported health and the literacy gap in self-reported health can be explained by the higher levels of interpersonal trust that better educated/more skilled individuals have, although the mediating role of trust varies considerably across countries. We find no evidence of a moderation effect: the relationships between health and years of schooling and health and cognitive skills are similar among individuals with different levels of trust.

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          Self-rated health and mortality: a review of twenty-seven community studies.

          We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
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            Understanding differences in health behaviors by education.

            Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and health behaviors, known as the education gradient. We show that income, health insurance, and family background can account for about 30 percent of the gradient. Knowledge and measures of cognitive ability explain an additional 30 percent. Social networks account for another 10 percent. Our proxies for discounting, risk aversion, or the value of future do not account for any of the education gradient, and neither do personality factors such as a sense of control of oneself or over one's life. Copyright 2009 Elsevier B.V. All rights reserved.
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              Income inequality and population health: a review and explanation of the evidence.

              Whether or not the scale of a society's income inequality is a determinant of population health is still regarded as a controversial issue. We decided to review the evidence and see if we could find a consistent interpretation of both the positive and negative findings. We identified 168 analyses in 155 papers reporting research findings on the association between income distribution and population health, and classified them according to how far their findings supported the hypothesis that greater income differences are associated with lower standards of population health. Analyses in which all adjusted associations between greater income equality and higher standards of population health were statistically significant and positive were classified as "wholly supportive"; if none were significant and positive they were classified as "unsupportive"; and if some but not all were significant and supportive they were classified as "partially supportive". Of those classified as either wholly supportive or unsupportive, a large majority (70 per cent) suggest that health is less good in societies where income differences are bigger. There were substantial differences in the proportion of supportive findings according to whether inequality was measured in large or small areas. We suggest that the studies of income inequality are more supportive in large areas because in that context income inequality serves as a measure of the scale of social stratification, or how hierarchical a society is. We suggest three explanations for the unsupportive findings reported by a minority of studies. First, many studies measured inequality in areas too small to reflect the scale of social class differences in a society; second, a number of studies controlled for factors which, rather than being genuine confounders, are likely either to mediate between class and health or to be other reflections of the scale of social stratification; and third, the international relationship was temporarily lost (in all but the youngest age groups) during the decade from the mid-1980s when income differences were widening particularly rapidly in a number of countries. We finish by discussing possible objections to our interpretation of the findings.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                22 February 2016
                2016
                : 11
                : 2
                : e0149716
                Affiliations
                [1 ]Department for Education and Skills, Organisation for Economic Co-operation and Development (OECD), Paris, France
                [2 ]Institute of Philosophy and Sociology, Polish Academy of Science, Warsaw, Poland
                Iowa State University, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: FB. Analyzed the data: AP. Wrote the paper: FB AP.

                Article
                PONE-D-15-30532
                10.1371/journal.pone.0149716
                4763098
                26901130
                32a3ef3c-8444-4559-8511-01c565970bb3
                © 2016 Borgonovi, Pokropek

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 July 2015
                : 4 February 2016
                Page count
                Figures: 4, Tables: 0, Pages: 16
                Funding
                The authors have no support or funding to report.
                Categories
                Research Article
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Academic Skills
                Literacy
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Academic Skills
                Literacy
                Social Sciences
                Psychology
                Cognitive Psychology
                Academic Skills
                Literacy
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Medicine and Health Sciences
                Health Care
                Health Education and Awareness
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Health Care
                Health Care Policy
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognition
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Biology and Life Sciences
                Psychology
                Collective Human Behavior
                Interpersonal Relationships
                Social Sciences
                Psychology
                Collective Human Behavior
                Interpersonal Relationships
                Custom metadata
                PIAAC data can be downloaded for free at http://www.oecd.org/site/piaac/publicdataandanalysis.htm.

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