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The positive association between education and health is well established, but explanations for this association are not. Well educated people experience better health than the poorly educated, as indicated by high levels of self-reported health and physical functioning and low levels of morbidity, mortality, and disability. In contrast, low educational attainment is associated with high rates of infectious disease, many chronic noninfectious diseases, self-reported poor health, shorter survival when sick, and shorter life expectancy (Feldman, Makuc, Kleinman, and Cornoni-Huntley 1989; Guralnik, Land, Fillenbaum, and Branch 1993; Gutzwiller, LaVecchia, Levi, Negri, and Wietlisbach 1989; Kaplan, Haan, and Syme 1987; Kitagawa and Hauser 1973; Liu, Cedres, and Stamler 1982; Morris 1990; Pappas, Queen, Hadden, and Fisher 1993; Syme and Berkman 1986; Williams 1990; Winkleby, Jatulis, Frank, and Fortmann 1992; Woodward, Shewry, Smith and Tunstall-Pedoe 1992).(1) The positive association between health and socioeconomic status, whether measured by education, occupation, or income, is largely due to the effects of SES on health, not vice versa, and downward mobility among persons in poor health cannot explain the association (Doornbos and Kromhout 1990; Fox, Goldblatt, and Jones 1985; Power, Manor, and Fogelman 1990; Wilkinson 1986).
INEQUALITY AND HEALTH
Why is education associated with good health? Our theoretical explanations fall into three categories: (1) work and economic conditions, (2) social-psychological resources, and (3) health lifestyle. According to the first explanation, well educated people are less likely to be unemployed, and more likely to have full-time jobs, fulfilling work, high incomes, and low economic hardship. According to the second, the well educated have social-psychological resources, including a high sense of personal control and social support, in addition to economic resources. According to the third, the well educated have healthier lifestyles; compared to the poorly educated, the well educated are more likely to exercise, to drink moderately, to receive preventive medical care, and less likely to smoke.
We focus on education as the aspect of socioeconomic status most important to health--not to the exclusion of work and income, but as the variable that structures the other two.(2) Education is the key to one's position in the stratification system; it shapes the likelihood of being unemployed, the kind of job a person can get, and income.
Sociologists study stratification out of interest in systematic differences...