Health & Human Services

Diplomas Keep the Doctor Away

When it comes to surviving the swine flu, Texans, Californians and folks in other states along our southern border have fared better than their neighbors...
by | May 31, 2009

When it comes to surviving the swine flu, Texans, Californians and folks in other states along our southern border have fared better than their neighbors in Mexico. One theory for this phenomenon looks to cultural habits: In Mexico, when people get sick--and this seems to be true for the middle class as well as the poor--they tend to self-medicate. Mexicans, in short, don't run to the doctor or clinic at the first sign of a cough. They put it off until they are almost too sick to function. For some of those who contracted the flu in the early part of the pandemic, that decision turned out to be deadly.

Americans generally don't have that particular barrier to seeking professional help when there's a threat to our health--as anyone who's been to an emergency room on a Saturday afternoon can testify. But we have plenty of other non-medical impediments that keep us from being healthy. Last September, I wrote a column about a handful of academics who used a series of charts, graphs and yield curves to show that education plays a key role in one's ability to make use of health care. What the academics found was that a longer life span was connected to a college degree.

Now, the Robert Wood Johnson Foundation is taking the academic theories one step further. It has looked at research data and found that there's a direct link between a person's health and the level of education attained. In short, the higher your degree, the healthier you are. And the conclusions don't rest on a national snapshot. They look at the link between education and health in every state.

Take the numbers from Vermont. In the land of green mountains and clean air, 67 percent of those with less than a high school diploma say they are in less than good health; only 22 percent of college graduates make that downbeat assessment. The numbers from Mississippi are a variation on that theme. Among those who did not graduate from high school, 74 percent are in less than optimal health; among college grads, it's 37 percent.

There is even a noticeable health gap between college dropouts and college grads. In Maryland, for instance, 40 percent of those with some college education reported less than good health; only 28 percent of college graduates did.

The researchers also found that the link to education is strong regardless of racial or ethnic background. That said, there are racial and ethnic differences. At nearly every level of education, non-Hispanic whites fare better than adults in any other racial or ethnic group.

The findings are based on a Centers for Disease Control survey that asks adults to self-report their state of health. These self-reported assessments are, RWJF researchers say, quite accurate. According to Dr. Paula Braveman, co-author of the study and director of the University of California's Center on Social Disparities in Health, "The self-reported health status responds closely to objective clinical findings."

The most discouraging part of the report is its implication for children. Undereducated parents tend to be poor and to rear their children in households with limited access to grocery stores that carry fresh fruits and vegetables; to live in less safe housing; to have insufficient access to safe places to exercise--all of which affect a family's health. "For the first time in our history, we are raising a generation of children that may live shorter, sicker lives than their parents," says Dennis Rivera, a commissioner of RWJF's Commission to Build a Healthier America. "Once a child is on this track, the curve doesn't bend. It's important to remember this. Health care reform alone won't improve the health of most Americans."

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