Education and Longevity

From the New York Times, By GINA KOLATA

Published: January 3, 2007

James Smith, a health economist at the RAND Corporation, has heard a variety of hypotheses about what it takes to live a long life — money, lack of stress, a loving family, lots of friends. But he has been a skeptic.

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Yes, he says, it is clear that on average some groups in every society live longer than others. The rich live longer than the poor, whites live longer than blacks in the United States. Longevity, in general, is not evenly distributed in the population. But what, he asks, is cause and what is effect? And how can they be disentangled?

He is venturing, of course, into one of the prevailing mysteries of aging, the persistent differences seen in the life spans of large groups. In every country, there is an average life span for the nation as a whole and there are average life spans for different subsets, based on race, geography, education and even churchgoing.

But the questions for researchers like Dr. Smith are why? And what really matters?

The answers, he and others say, have been a surprise. The one social factor that researchers agree is consistently linked to longer lives in every country where it has been studied is education. It is more important than race; it obliterates any effects of income.

Year after year, in study after study, says Richard Hodes, director of the National Institute on Aging, education “keeps coming up.”

And, health economists say, those factors that are popularly believed to be crucial — money and health insurance, for example, pale in comparison.

Dr. Smith explains: “Giving people more Social Security income, or less for that matter, will not really affect people’s health. It is a good thing to do for other reasons but not for health.”

Health insurance, too, he says, “is vastly overrated in the policy debate.”

Instead, Dr. Smith and others say, what may make the biggest difference is keeping young people in school. A few extra years of school is associated with extra years of life and vastly improved health decades later, in old age.

It is not the only factor, of course.

There is smoking, which sharply curtails life span. There is a connection between having a network of friends and family and living a long and healthy life. And there is evidence that people with more powerful jobs and, presumably, with more control over their work lives, are healthier and longer lived.

But there is little dispute about the primacy of education.

“If you were to ask me what affects health and longevity,” says Michael Grossman, a health economist at the City University of New York, “I would put education at the top of my list.”