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      The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach

      1 , 2
      Annual Review of Public Health
      Annual Reviews

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          Abstract

          Adults with higher educational attainment live healthier and longer lives compared with their less educated peers. The disparities are large and widening. We posit that understanding the educational and macrolevel contexts in which this association occurs is key to reducing health disparities and improving population health. In this article, we briefly review and critically assess the current state of research on the relationship between education and health in the United States. We then outline three directions for further research: We extend the conceptualization of education beyond attainment and demonstrate the centrality of the schooling process to health; we highlight the dual role of education as a driver of opportunity but also as a reproducer of inequality; and we explain the central role of specific historical sociopolitical contexts in which the education–health association is embedded. Findings from this research agenda can inform policies and effective interventions to reduce health disparities and improve health for all Americans.

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            Socioeconomic Disparities in Health Behaviors.

            The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms.
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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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                Author and article information

                Journal
                Annual Review of Public Health
                Annu. Rev. Public Health
                Annual Reviews
                0163-7525
                1545-2093
                April 2018
                April 2018
                : 39
                : 1
                : 273-289
                Affiliations
                [1 ]Department of Sociology, Western University, London, Ontario N6A 5C2, Canada;
                [2 ]Department of Sociology, University of Nevada, Las Vegas, Nevada 89154, USA;
                Article
                10.1146/annurev-publhealth-031816-044628
                5880718
                29328865
                964d787b-7e2c-4634-94db-cf1f1b8dd850
                © 2018
                History

                Education,Medicine,Social & Behavioral Sciences,Economics
                Education, Medicine, Social & Behavioral Sciences, Economics

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