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Annual Review of Sociology

Volume 50, 2024

Widening Educational Disparities in Health and Longevity

Abstract

Educational attainment level has long been a strong predictor of adult health and longevity in the United States. Interestingly, the association between education and these outcomes has strengthened in recent decades. Since the 1980s, higher-educated adults have experienced favorable trends in health and longevity, while lower-educated adults have experienced stagnation or unfavorable trends. Studies have provided important clues about why the association between education and health and longevity has strengthened over time. However, explanations remain incomplete and contested. This article discusses key findings and debates about why the association has become stronger and offers recommendations to advance robust explanations. Two key recommendations call for a fundamental shift in how researchers conceptualize and study the increasingly strong association. These include () reconsidering which education groups should be viewed as normative in analyses of the trends and () elevating attention on contexts, institutions, and actors that have had an outsized influence on the trends.

Keyword(s): disparities, education, health, inequalities, life expectancy, mortality
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2024-08-12
2025-02-09
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Literature Cited

  1. Baker DP, Smith WC, Muñoz IG, Jeon H, Fu T, et al. 2017.. The population education transition curve: education gradients across population exposure to new health risks. . Demography 54::1873–95
     [Crossref] [Google Scholar]
  2. Bauldry S. 2015.. Variation in the protective effect of higher education against depression. . Soc. Ment. Health 5::145–61
     [Crossref] [Google Scholar]
  3. Becker GS. 2009.. Human Capital: A Theoretical and Empirical Analysis With Special Reference to Education. Chicago:: Univ. Chicago Press. , 3rd ed..
     [Google Scholar]
  4. Boardman JD, Domingue BW, Daw J. 2015.. What can genes tell us about the relationship between education and health?. Soc. Sci. Med. 127::171–80
     [Crossref] [Google Scholar]
  5. Boardman JD, Fletcher JM. 2015.. To cause or not to cause? That is the question, but identical twins may not have all the answers. . Soc. Sci. Med. 127::198–200
     [Crossref] [Google Scholar]
  6. Boller B, Mellah S, Ducharme-Laliberté G, Belleville S. 2017.. Relationships between years of education, regional grey matter volumes, and working memory-related brain activity in healthy older adults. . Brain Imaging Behav. 11::304–17
     [Crossref] [Google Scholar]
  7. Bosworth B. 2018.. Increasing disparities in mortality by socioeconomic status. . Annu. Rev. Public Health 39::237–51
     [Crossref] [Google Scholar]
  8. Bound J, Geronimus AT, Rodriguez JM, Waldman TA. 2015.. Measuring recent apparent declines in longevity: the role of increasing educational attainment. . Health Aff. 34::2167–73
     [Crossref] [Google Scholar]
  9. Case A, Deaton A. 2015.. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. . PNAS 112::15078–83
     [Crossref] [Google Scholar]
  10. Case A, Deaton A. 2020.. Deaths of Despair and the Future of Capitalism. Princeton, NJ:: Princeton Univ. Press
     [Google Scholar]
  11. Case A, Deaton A. 2021.. Life expectancy in adulthood is falling for those without a BA degree, but as educational gaps have widened, racial gaps have narrowed. . PNAS 118::e2024777118
     [Crossref] [Google Scholar]
  12. CDC (Cent. Dis. Control Prev.). 2020.. Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. Fact Sheet, Cent. Dis. Control Prev., Washington, DC:. https://www.cdc.gov/nchs/products/databriefs/db364.htm
    [Google Scholar]
  13. CDC (Cent. Dis. Control Prev.). 2022.. National diabetes statistics report: estimates of diabetes and its burden in the United States. Rep., Cent. Dis. Control Prev., Washington, DC:. https://www.cdc.gov/diabetes/data/statistics-report/index.html
    [Google Scholar]
  14. Clouston SAP, Kuh D, Herd P, Elliott J, Richards M, Hofer SM. 2012.. Benefits of educational attainment on adult fluid cognition: international evidence from three birth cohorts. . Int. J. Epidemiol. 41::1729–36
     [Crossref] [Google Scholar]
  15. Clouston SAP, Link BG. 2021.. A retrospective on fundamental cause theory: state of the literature and goals for the future. . Annu. Rev. Sociol. 47::131–56
     [Crossref] [Google Scholar]
  16. Crimmins EM, Saito Y, Kim JK, Zhang YS, Sasson I, Hayward MD. 2018.. Educational differences in the prevalence of dementia and life expectancy with dementia: changes from 2000 to 2010. . J. Gerontol. B 73::S20–28
     [Crossref] [Google Scholar]
  17. Cutler DM, Huang W, Lleras-Muney A. 2015.. When does education matter? The protective effect of education for cohorts graduating in bad times. . Soc. Sci. Med. 127::63–73
     [Crossref] [Google Scholar]
  18. Cutler DM, Lleras-Muney A. 2008.. Education and health: evaluating theories and evidence. . In Making Americans Healthier: Social and Economic Policy as Health Policy, ed. RF Schoeni, JS House, GA Kaplan, H Pollak , pp. 29–60. New York:: Russell Sage Found.
     [Google Scholar]
  19. Dijkstra I, Horstman K. 2021.. “ Known to be unhealthy”: exploring how social epidemiological research constructs the category of low socioeconomic status. . Soc. Sci. Med. 285::114263
     [Crossref] [Google Scholar]
  20. Ding X, Barban N, Mills MC. 2019.. Educational attainment and allostatic load in later life: evidence using genetic markers. . Prev. Med. 129::105866
     [Crossref] [Google Scholar]
  21. Dowd JB, Hamoudi A. 2014.. Is life expectancy really falling for groups of low socio-economic status? Lagged selection bias and artefactual trends in mortality. . Int. J. Epidemiol. 43::983–88
     [Crossref] [Google Scholar]
  22. Dudel C, van Raalte AA. 2023.. Educational inequalities in life expectancy: measures, mapping, meaning. . J. Epidemiol. Commun. Health 77::417–18
     [Crossref] [Google Scholar]
  23. Frase RT, Bauldry S. 2022.. The expansion of higher education and the education-health gradient in the United States. . Soc. Curr. 9::70–86
     [Crossref] [Google Scholar]
  24. Galea S, Tracy M, Hoggatt KJ, DiMaggio C, Karpati A. 2011.. Estimated deaths attributable to social factors in the United States. . Am. J. Public Health 101::1456–65
     [Crossref] [Google Scholar]
  25. Geronimus AT, Bound J, Waidmann TA, Rodriguez JM, Timpe B. 2019.. Weathering, drugs, and whack-a-mole: fundamental and proximate causes of widening educational inequity in U.S. life expectancy by sex and race, 1990–2015. . J. Health Soc. Behav. 60::222–39
     [Crossref] [Google Scholar]
  26. Gleid S, Lleras-Muney A. 2008.. Technological innovation and inequality in health. . Demography 45::741–61
     [Crossref] [Google Scholar]
  27. Goldring T, Lange F, Richards-Shubik S. 2016.. Testing for changes in the SES-mortality gradient when the distribution of education changes too. . J. Health. Econ. 46::120–30
     [Crossref] [Google Scholar]
  28. Halpern-Manners A, Helgertz J, Warren JR, Roberts E. 2020.. The effects of education on mortality: evidence from linked U.S. Census and administrative mortality data. . Demography 57::1513–41
     [Crossref] [Google Scholar]
  29. Hayward MD, Farina MP. 2023.. Dynamic changes in the association between education and health in the United States. . Milbank Q. 101::396–418
     [Crossref] [Google Scholar]
  30. Hayward MD, Hummer RA, Sasson I. 2015.. Trends and group differences in the association between educational attainment and U.S. adult mortality: implications for understanding education's causal influence. . Soc. Sci. Med. 127::8–18
     [Crossref] [Google Scholar]
  31. Hendi AS. 2015.. Trends in U.S. life expectancy gradients: the role of changing educational composition. . Int. J. Epidemiol. 44::946–55
     [Crossref] [Google Scholar]
  32. Hendi AS. 2017.. Trends in education-specific life expectancy, data quality, and shifting education distributions: a note on recent research. . Demography 54::1203–13
     [Crossref] [Google Scholar]
  33. Hendi AS, Elo IT, Martikainen P. 2021.. The implications of changing education distributions for life expectancy gradients. . Soc. Sci. Med. 272::113712
     [Crossref] [Google Scholar]
  34. Hertel-Fernandez A. 2019.. State Capture. Oxford, UK:: Oxford Univ. Press
     [Google Scholar]
  35. Ho J. 2017.. The contribution of drug overdose to educational gradients in life expectancy in the United States, 1992–2011. . Demography 54::1175–202
     [Crossref] [Google Scholar]
  36. Ho JY, Fenelon A. 2015.. The contribution of smoking to educational gradients in U.S. life expectancy. . J. Health Soc. Behav. 56::307–22
     [Crossref] [Google Scholar]
  37. Hummer RA, Lariscy JT. 2011.. Educational attainment and adult mortality. . In International Handbook of Adult Mortality, ed. RG Rogers, EM Crimmins , pp. 241–61. New York:: Springer
     [Google Scholar]
  38. Johnson-Lawrence V, Zajacova A, Sneed R. 2017.. Education, race/ethnicity, and multimorbidity among adults aged 30–64 in the National Health Interview Survey. . SSM Popul. Health 3::366–72
     [Crossref] [Google Scholar]
  39. Kahn SR. 2012.. The sociology of elites. . Annu. Rev. Sociol. 38::361–77
     [Crossref] [Google Scholar]
  40. Karamcheva N, Perez-Zetune V. 2023.. Defined benefit and defined contribution plans and the distribution of family wealth. Work. Pap. 2023–02 , Congr. Budg. Off., Washington, DC:
     [Google Scholar]
  41. Katikireddi SV, Higgins M, Smith KE, Williams G. 2013.. Health inequalities: the need to move beyond bad behaviours. . J. Epidemiol. Commun. Health 67::715–16
     [Crossref] [Google Scholar]
  42. Krieger N. 1994.. Epidemiology and the web of causation: Has anyone seen the spider?. Soc. Sci. Med. 39::887–903
     [Crossref] [Google Scholar]
  43. Kubota Y, Heiss G, MacLehose RF, Roetker NS, Folsom AR. 2017.. Association of educational attainment with lifetime risk of cardiovascular disease the Atherosclerosis Risk in Communities Study. . JAMA Intern. Med. 177::1165–72
     [Crossref] [Google Scholar]
  44. Lafer G. 2017.. The One Percent Solution. How Corporations Are Remaking America, One State at a Time. Ithaca, NY:: ILR
     [Google Scholar]
  45. Link BG. 2008.. Epidemiological sociology and the social shaping of population health. . J. Health Soc. Behav. 49::367–84
     [Crossref] [Google Scholar]
  46. Link BG, Garcia SJ. 2021.. Diversions: how the underrepresentation of research on advantaged groups leaves explanations for health inequalities incomplete. . J. Health Soc. Behav. 62::334–49
     [Crossref] [Google Scholar]
  47. Link BG, Phelan J. 1995.. Social conditions as fundamental causes of disease. . J. Health Soc. Behav. (Extra Issue):80–94
     [Crossref] [Google Scholar]
  48. Lleras-Muney A. 2005.. The relationship between education and adult mortality in the United States. . Rev. Econ. Stud. 72::189–221
     [Crossref] [Google Scholar]
  49. Lleras-Muney A, Price J, Yue D. 2022.. The association between educational attainment and longevity using individual-level data from the 1940 Census. . J. Health Econ. 84::102649
     [Crossref] [Google Scholar]
  50. Lutz W. 2010.. Education will be at the heart of 21st century demography. . Vienna Yearbook Popul. Res. 8::9–16
     [Crossref] [Google Scholar]
  51. Mackenbach JP, Valverdea JR, Artnik B, Bopp M, Brønnum-Hansen H, et al. 2018.. Trends in health inequalities in 27 European countries. . PNAS 115::6440–45
     [Crossref] [Google Scholar]
  52. Masters RK, Link BG, Phelan JC. 2015.. Trends in education gradients of “preventable” mortality: a test of fundamental cause theory. . Soc. Sci. Med. 127::19–28
     [Crossref] [Google Scholar]
  53. Meara ER, Richards S, Cutler DM. 2008.. The gap gets bigger: changes in mortality and life expectancy, by education, 1981–2000. . Health Aff. 27::350–60
     [Crossref] [Google Scholar]
  54. Miech R, Pampel F, Kim J, Rogers RG. 2011.. The enduring association between education and mortality: the role of widening and narrowing disparities. . Am. Sociol. Rev. 76::913–34
     [Crossref] [Google Scholar]
  55. Mirowsky J, Ross CE. 2003.. Education, Social Status, and Health. New York:: Aldine de Gruyter
     [Google Scholar]
  56. Montez JK, Brooks JD. 2020.. Educational attainment and adult health. . In Handbook of Aging and the Social Sciences, ed. KF Ferraro, D Carr , pp. 83–98. Amsterdam:: Elsevier. , 9th ed..
     [Google Scholar]
  57. Montez JK, Cheng KJ. 2022.. Educational disparities in adult health across U.S. states: Larger disparities reflect economic factors. . Front. Public Health 10::966434
     [Crossref] [Google Scholar]
  58. Montez JK, Friedman EM. 2015.. Educational attainment and health: under what conditions is the association causal?. Soc. Sci. Med. 127::1–7
     [Crossref] [Google Scholar]
  59. Montez JK, Hayward MD. 2011.. Cumulative childhood adversity, educational attainment, and active life expectancy among U.S. adults. . Demography 51::413–35
     [Crossref] [Google Scholar]
  60. Montez JK, Hayward MD, Zajacova A. 2019a.. Educational disparities in U.S. adult health: U.S. states as institutional actors on the association. . Socius 5:. https://doi.org/10.1177/2378023119835345
    [Crossref] [Google Scholar]
  61. Montez JK, Hayward MD, Zajacova A. 2021.. Trends in U.S. population health: the central role of policies, politics, and profits. . J. Health Soc. Behav. 62::286–301
     [Crossref] [Google Scholar]
  62. Montez JK, Hummer RA, Hayward MD, Woo H, Rogers RG. 2011.. Trends in the educational gradient of U.S. adult mortality from 1986 through 2006 by race, gender, and age group. . Res. Aging 33::145–71
     [Crossref] [Google Scholar]
  63. Montez JK, Sabbath E, Glymour MM, Berkman LF. 2014.. Trends in work-family context among U.S. women by education level, 1976 to 2011. . Popul. Res. Policy Rev. 33::629–48
     [Crossref] [Google Scholar]
  64. Montez JK, Sasson I, Hayward MD. 2016.. Declining US life expectancy, 1990–2010. . Health Aff. 35::550
     [Crossref] [Google Scholar]
  65. Montez JK, Zajacova A. 2013.. Trends in mortality risk by education level and cause of death among white women in the United States from 1986 to 2006. . Am. J. Public Health 103::473–79
     [Crossref] [Google Scholar]
  66. Montez JK, Zajacova A. 2014.. Why is life expectancy declining among low-educated women in the United States?. Am. J. Public Health 104::e5–7
     [Crossref] [Google Scholar]
  67. Montez JK, Zajacova A, Hayward MD. 2017.. Disparities in disability by educational attainment across U.S. states. . Am. J. Public Health 107::1101–8
     [Crossref] [Google Scholar]
  68. Montez JK, Zajacova A, Hayward MD, Woolf S, Chapman D, Beckfield J. 2019b.. Educational disparities in adult mortality across U.S. states: How do they differ and have they changed since the mid-1980s?. Demography 56::621–44
     [Crossref] [Google Scholar]
  69. Navarro V. 2019.. Why the white working-class mortality and morbidity is increasing in the United States: the importance of the political context. . Int. J. Health Serv. 49::197–203
     [Crossref] [Google Scholar]
  70. Noppert GA, Gaydosh L, Harris KM, Goodwin A, Hummer RA. 2021.. Is educational attainment associated with young adult cardiometabolic health?. SSM Popul. Health 13::100752
     [Crossref] [Google Scholar]
  71. O'Brien R, Bair EF, Venkataramani AS. 2022.. Death by robots: automation and working-age mortality in the United States. . Demography 59:(2):607–28
     [Crossref] [Google Scholar]
  72. Östergren O, Lundberg O, Artnik B, Bopp M, Borrell C, et al. 2017.. Educational expansion and inequalities in mortality—a fixed-effects analysis using longitudinal data from 18 European populations. . PLOS ONE 12::e0182526
     [Crossref] [Google Scholar]
  73. Park M, Leahey E, Funk RJ. 2023.. Papers and patents are becoming less disruptive over time. . Nature 613::138–44
     [Crossref] [Google Scholar]
  74. Phelan JC, Link BG, Diez-Roux A, Kawachi I, Levin B. 2004.. “ Fundamental causes” of social inequalities in mortality: a test of the theory. . J. Health Soc. Behav. 45::265–85
     [Crossref] [Google Scholar]
  75. Phelan JC, Link BG, Tehranifar P. 2010.. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. . J. Health Soc. Behav. 51::S28–40
     [Crossref] [Google Scholar]
  76. Pierce JR, Schott PK. 2020.. Trade liberalization and mortality: evidence from US counties. . AER Insights 2:(1):47–64
     [Google Scholar]
  77. Prasad M. 2018.. Problem-solving sociology. . Contemp. Sociol. 47::393–98
     [Crossref] [Google Scholar]
  78. Sasson I. 2016a.. Diverging trends in cause-specific mortality and life years lost by educational attainment: evidence from United States vital statistics data, 1990–2010. . PLOS ONE 11::e0163412
     [Crossref] [Google Scholar]
  79. Sasson I. 2016b.. Trends in life expectancy and lifespan variation by educational attainment: United States, 1990–2010. . Demography 53::269–93
     [Crossref] [Google Scholar]
  80. Sasson I, Hayward MD. 2019.. Association between educational attainment and causes of death among white and black US adults, 2010–2017. . JAMA 322::756–63
     [Crossref] [Google Scholar]
  81. Smith H. 2012.. Who Stole the American Dream? New York:: Random House
     [Google Scholar]
  82. Smith WC, Anderson E, Salinas D, Horvatek R, Baker DP. 2015.. A meta-analysis of education effects on chronic disease: the causal dynamics of the Population Education Transition Curve. . Soc. Sci. Med. 127::29–40
     [Crossref] [Google Scholar]
  83. Sun F, Zimmer Z, Zajacova A. 2023.. Educational differences in life expectancies with and without pain. . J. Gerontol. B 78::695–704
     [Crossref] [Google Scholar]
  84. Tamborini CR, Kim C. 2016.. Education and contributory pensions at work: disadvantages of the less educated. . Soc. Forces 95::1577–605
     [Crossref] [Google Scholar]
  85. Tilly C. 1999.. Durable Inequality. Berkeley: Univ. Calif. Press
     [Google Scholar]
  86. US Census Bur. 2023.. Table A-2. Percent of people 25 years and over who have completed high school or college, by race, Hispanic origin and sex: selected years 1940 to 2021. CPS Historical Time Series Tables Dataset, US Census Bur., Washington, DC:. https://www.census.gov/data/tables/time-series/demo/educational-attainment/cps-historical-time-series.html
    [Google Scholar]
  87. Withrow DR, Freedman ND, Gibson JT, Yu M, Nápoles AM, et al. 2021.. Leading cancers contributing to educational disparities in cancer mortality in the US. , 2017.. Cancer Causes Control 32::1193–96
     [Crossref] [Google Scholar]
  88. Yang CY, Schorpp K, Boen C, Johnson M, Harris KM. 2020.. Socioeconomic status and biological risks for health and illness across the life course. . J. Gerontol. B 75::613–24
     [Crossref] [Google Scholar]
  89. Zajacova A, Lawrence EM. 2018.. The relationship between education and health: reducing disparities through a contextual approach. . Annu. Rev. Public Health 39::273–89
     [Crossref] [Google Scholar]
  90. Zajacova A, Rogers RG, Grodsky E, Grol-Prokopczyk H. 2020.. The relationship between education and pain among adults aged 30−49 in the United States. . J. Pain 21::1270–80
     [Crossref] [Google Scholar]
/content/journals/10.1146/annurev-soc-071723-080605
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Widening Educational Disparities in Health and Longevity
Annual Review of Sociology 50, 547 (2024); https://doi.org/10.1146/annurev-soc-071723-080605
/content/journals/10.1146/annurev-soc-071723-080605
/content/journals/10.1146/annurev-soc-071723-080605
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