Education as Leading Social Determinant of Health

Introduction: Education and Our Society

The role of education in society has proven to service the people through the spreading of information, teaching of lessons and simply giving the gift of knowledge. With the gift of knowledge, we ultimately give the other the right and the ability, more importantly, to make their own informed choices. An educated mind can go beyond the limits set out by society and can make wise decisions regarding their health, success and general well being by simply using rationale. The level of education one obtains is directly related to the health of that individual, whereby it determines the person’s quality of life and life expectancy. Further more, one may be lead to believe that education is the most significant determinant of health due to its impact on behavioural and lifestyle factors. In other words, the health of an individual is dependant on being informed and educated about the simple lifestyle choices that play a significant role in benefiting or deteriorating the body. Such lifestyle factors include tobacco use, food choices, stress management and physical activity. As the obesity epidemic continues to spread across our western society the overall health of the people worsens and these factors, along with others, contribute significantly. “The prevalence of obesity increased by 40% between 1980 and 1990. Obesity is a chronic disease with a multifactorial etiology including genetics, environment, metabolism, lifestyle, and behavioral components” (Rippe, 1998, p13). Therefore, if lifestyle factors could be controlled and maintained by society through methods of education, it can be assumed that the prevalence of obesity, and even other preventable illnesses, would begin to decrease.

Education: the Leading Socioeconomic Status Measure

The overall health of a person, or more specifically their morbidity and mortality experience, is most strongly predicted by their socioeconomic status (Winkleby, 1992, p816). Ones socioeconomic status (SES) is comprised of the individual’s education, income, occupation or the collection of all these factors (Winkleby, 1992, p816). While it is important to take all these factors into consideration when predicting an individual’s quality of life, when compared however, education seems to be the fundamental and easiest factor to mold and control. For instance, job placement requires a basis of knowledge, experience and an understanding of the job at hand, while income requires a place of occupation with good working conditions, food security and education (Raphael, Bryant & Rioux, 2005, p118). As one can see, the determinants of SES all seem to lead back to education as the fundamental measure. As Ross states in her journal article, “Health advantages of high income and disadvantages of low income also diverge with age, but household income does not explain education's positive effect” (Ross, 1996, p104). This in turn suggests that if the education of a group of people is improved that it will ultimately lead to an improvement in SES and eventually to an improvement in their health. In 1998 a study was published entitled Is Educational Attainment Associated with Shared Determinants of Health in the Elderly? which found “That an education gradient functions over an array of factors that structure daily life, even in later life in a healthy population, may suggest how socioeconomic status influences health” (Kubzansky, 1998, 578). Furthermore, a study conducted in the UK found that:

at baseline, similar gradients between socioeconomic position and blood pressure, height, lung function, and smoking behavior were seen, regardless of whether the education or social class measure was used. Manual social class and early termination of full time education were associated with higher blood pressure, shorter height, poorer lung function, and a higher prevalence of smoking. Within education strata, the graded association between smoking and social class remains strong, whereas within social class groups the relation between education and smoking is attenuated (Davey Smith, 1998, p5).

The correlations between level of education and socioeconomic status, and therefore the general health of an individual, are repeatedly proven to be evident across the globe.

Educated Choices for our Health?

Lifestyle choices and behaviours are amongst the factors that are most easily controlled by the individual themselves. It is our choice to smoke, eat foods that are high in sugar and fat and not exercise. These are three of the leading factors that can cause coronary heart disease (N.Gledhill, personal communication, 2004) and yet thousands of people continue to do it because they are not aware,