The education divide in mortality
By Andrew and Mario
Economists have long documented two interrelated phenomena: the earnings premium for a bachelor's degree (the wealth premium is disputed) and disparities in health outcomes based on education and economic status.
A new study explores the “mortality premium,” or how a four-year college degree as an input is associated with outputs (e.g., higher income, greater wealth, better living environments, a healthy diet, etc.) that correlate with better health outcomes, specifically in this case, the number of expected years lived between ages 25 and 75.
The researchers examined 48M death certificates filed between 1990 and 2018. The most novel finding is that a four-year college education is now a sharper differentiator of expected years of life between 25 and 75 than is race, a reversal of the situation from just three decades ago.
The chart below delineates expected years of life from 25 to 75 by sex, race, and four-year degree status (from “Life expectancy in adulthood is falling for those without a BA degree, but as educational gaps have widened, racial gaps have narrowed,” Anne Case, Angus Deaton).
A few things to note:
Life expectancy is only decreasing for those without a four-year degree.
Black men and women with a four-year college degree, who used to have fewer expected years from 25 to 75 than White men without a BA, now have more expected years.
Over the entire period (28 years), Black and Hispanic people gained relative to White people, but increases in life expectancy leveled off for all groups at some point around 2010.
This data is only through 2018, the divide is likely to widen as people without a four-year college degree are more likely to be employed in industries with more exposure to Covid-19 infection and in close proximity to others.
There are significant policy implications here, but lots more unpacking to do:
What don’t we understand about how labor market changes have impacted the job landscape for those without a four-year degree?
What non-traditional post-secondary pathways have led to outputs that correlate with long-term health outcomes?
Are deaths of despair (e.g., opioid-related deaths) the primary driver in the widening of the educational life expectancy gap?
To what extent has cost-disease in health insurance disproportionately impacted those without a four-year college degree?
What about the design of the healthcare system makes it easier to navigate if you are better educated?
Is this a P-12 problem (e.g., do low-performing public schools in low-income communities increase very risky health behaviors among low-income adolescents thus increasing health disparities across the life span)?
Why are people with a four-year degree less likely to engage in risky behavior (e.g., drug use)?
As we grapple with how to catalyze opportunity in the wake of colliding crises—Covid-19 and structural racism—opportunities to pressure test our thinking on the mechanisms that lead to healthier lives, regardless of education level, race, or economic status, are critical.