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Source: New Perspectives in Medicine
Author: New Perspectives in Medicine
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It is well established that there is a positive correlation between higher educational attainment and improved health. Over the past 50 years, the global distribution of educational attainment has changed dramatically, and these changes have had some impact on mortality. In particular, the impact of parental education on child mortality is particularly striking, with studies showing that for each additional year of education for mothers, the under-five mortality rate is reduced by 3.0 per cent, and for each additional year of schooling for fathers, the under-five mortality rate is reduced by 1.6 per cent.
Although decades of research have led to a growing awareness of the strong relationship between education and population health, no previous studies have systematically determined the extent to which years of schooling affect adult mortality risk. A study published in The Lancet Public Health showed a dose-response relationship between educational attainment and adult all-cause mortality, with an average 1.9% lower risk of death for each additional year of education. In addition, the impact of education level on mortality in younger people (e.g., 18~49 years old) is greater than that of older people (70 years old and above). According to the researchers, this is the "first" systematic review and meta-analysis that quantifies the importance of years of schooling in reducing adult mortality.
截图来源：The Lancet Public Health
The researchers searched the literature from PubMed, Web of Science, Scopus, Embase, Global Health (CAB), EconLit, and Sociology Source Ultimate databases from January 1, 1980 ~ May 31, 2023, for studies that assessed data on years of schooling and adult mortality. In addition, the investigators excluded studies that relied on case crossover or ecological study designs to reduce the risk of bias in non-associated data, and studies that did not report a key measure (adult all-cause mortality). In the end, the researchers included 603 studies involving 59 countries and 70 regions and extracted data from them to generate a final dataset of 10,355 observations.
Overall, in the case of age, sex, and marital status, mortality was significantly reduced with longer years of schooling compared with no education:
- The mortality rate was reduced by 13.1% (95% UI 12.3~14.1) after 6 years of schooling (approximately equivalent to primary school level in most parts of the world),
- After 12 years of education (secondary education level), the mortality rate was reduced by 24.5% (95% UI 23.0~26.1),
- After 18 years of education (university and graduate level), the mortality rate was reduced by 34.3% (95% UI 32.5~36.5).
- This finding implies an average reduction of 1.9% (95% UI 1.8~2.0) in the risk of dying per year of education over 18 years.
At the same time, the researchers observed that education level had a significant impact on the risk of death in different age groups (18~49 years, 50~59 years, 60~69 years, and 70 years and above). Individuals aged 18~49 years were associated with an average reduction in mortality risk by 2.9% (95% UI 2.8~3.0) for each additional year of education, while adults aged 70 years and older had an average reduction in mortality risk of 0.8% (95% UI 0.6~1.0) for each additional year of education. In addition, the investigators did not find a difference in educational attainment on all-cause mortality by gender or sociodemographic index levels.
Overall, this study provides convincing evidence of the importance of education in increasing life expectancy. At the same time, older people can also benefit: for adults aged 70 years and older, the risk of death is reduced by an average of 0.8% for each additional year of schooling.
Resources
[1] IHME-CHAIN Collaborators. (2024). Effects of education on adult mortality: a global systematic review and meta-analysis. Lancet Public Health, doi: 10.1016/S2468-2667(23)00306-7.