What is more important determinant of health: education or income? Introduction
According to World Health Organisation, ‘health is a state of complete physical and mental well-being and not merely the absence of disease or infirmity (WHO, 1948).’ Several factors merge to affect the health of people and communities such as the place we live in, the environment, income and education level, all these factors influence the health of an individual. The health status of people is immense crucial as it ensures increased productivity in the community which helps internal stability and the nation’s economic growth. For past decades, some people proved that income and education are the main determinant of health. However, past studies showed that education is more important than income in determinant of health. This paper evidences that this statement is correct. Education
Education is a substantial contributor to health. Past studies supported that ‘schooling could increase knowledge about health effects of behaviour and medical-care options, change preferences, or train a person to better process and act upon information (Victor R. Fuchs 1986, p.243).’ Grossman also stated that ‘better-educated persons tend to be economically more efficient producers of health status (Grossman, 1973).’ This evidences that an educated person can keep healthy due to additional years of schooling and indicates that education is a vital determinant of health. Moreover, the education level of an individual is directly related to his/her health, whereby it determines his/her value of life and life expectancy.
According to Koji and Chevalier, ‘education can help improve health by raising cognitive and socio-emotional skills and developing health related habits and attitudes (Koji and Chevalier, 2010).’ Through education, an individual can have better lifestyle choices which can benefit to his/her health. Lifestyle choices comprise cigarette use, drinking, food choices, exercises and stress management. According to Rosin, ‘obesity rates have increased dramatically over the last 30 years (Rosin, 2008).’ Obesity can raise a lot of health problems such as serious chronic diseases and disability. Also, people who have an obesity problem are more likely to have a lower quality of life, lower life expectancy as well as lower labour productivity. Rosin proved that ‘education can be health promoting through knowledge (Rosin, 2008).’ Koji and Chevalier also supported that ‘schools may provide an ideal environment in which children can develop healthier habits and lifestyles (Koji and Chevalier, 2010).’ It is crystal clear that a better and healthier lifestyle can be maintained through education and therefore the frequency of obesity and other preventable diseases can be reduced. This indicated that education is an important determinant of health. Furthermore, education has a more direct influence on health, according to the data from OECD; it evidenced that ‘education helps individuals obtain better job, higher earning, partners, safer residential areas and useful social networks which improve their living environment and access to health care (Koji and Chevalier, 2010).’ This showed that education affects an individual’s capability to navigate the health care system, interpret health information and converse effectively with care providers. Health literacy is the ability of the patient to comprehend health information and follow prescription regarding their treatment. From the standpoint of physicians, they are harder to explain the details of the illness together with prescriptions to an illiterate person compared to an educated person. This showed that an educated person has a better manage on illness and recover faster than an uneducated person.
Also, past studies supported that ‘the level of education influences employment opportunities, earnings and social networks which can have a better way to relieve stress and receive more information on healthful behaviors and health purchases from more contacts (Folland, Goodman and Stano, 2012).’ This indicated that education is an essential determinant of health. Parental education also has a direct effect on health. When an educated mother is pregnant, she used to have a healthier practise which directly influences the birth weight and the children’s health. Past studies evidenced that ‘educated parents are able to take good care of children’s health conditions (Koji and Chevalier, 2010).’ The learning and literacy of children is supported by parents. Parents with higher education can provide a better living and school environment for their children. Their children are more likely to be healthier since they are protected against several health issues such as drug abuse and alcohol. In addition, research proved that ‘parents have enormous potential to shape children’s health-related values by themselves being (healthy) role models and encouraging children to follow healthy lifestyles (Koji and Chevalier, 2010).’ Therefore, we can conclude that children from an education family and good quality of school environment are easily to have healthy habits, diet and lifestyle. This demonstrated that education is an important determinant of health. Various studies showed that individuals with adverse health status have low levels of education which lead to malnutrition, poverty and ill health and particularly the high rates of mortality in infants and children.
Conversely, individuals with low education levels are likely to have lifestyles (such as less exercise) that lead to chronic diseases. This low health literacy makes it difficult to learn and adopt healthy options. Hence, people who are less educated are more difficult to be employed. Many causes of education inequality in education are seen in health inequalities. Health inequality is a term used to explain the unfair distribution of health in a community. It is evident that health is not experienced evenly by all individuals; there is a disparity between the appropriate health enjoyed by those in the socio-economic group and those in disadvantaged groups. Past studies supported that ‘improving education levels among the disadvantaged group will ultimately make a positive impact on the health inequalities (Koji and Chevalier, 2010).’ Therefore, it is no doubt that education has a causal and strong positive effect on health.
Income is a crucial determinant of health. The graph below showed the relationship between life expectancy and income.
The Preston Curve showed that people live in rich countries such as U.S.A. and U.K., on average, can have a longer life expectancy compare to those who live in poor countries such as Nigeria and South Africa. Past studies evidence that ‘the inhabitants of poor countries not only have lower real incomes, but they are also more often sick, and they live shorter lives (Deaton, 2006).’ We can see that the curve for rich countries is flatter than the poor countries. This indicated that poor countries with low levels of income, when there are further increases in income, it leads to large increases in life expectancy while the rich countries with high levels of income, further increase in income can only lead to small gains in life expectancy. High incomes mean to have better living conditions, higher
social capital and access to health care which are more likely to maintain a healthy body. Therefore, there exists a wide disparity in health between the rich and poor people. Individual who earn low incomes bear a large burden of disease and usually have low life expectancy. They are less likely to act in disease prevention or access to health care than the rich people. Also, living in poverty has an effect as a fundamental social determinant of health. Poverty leads to social exclusion, which in turn, leads to unhealthy lifestyle choices and more stressful. Most of the people who earn low levels of income are less educated, this also affect the health. They can only do the jobs that require less knowledge and skills such as porter and cleaner that the working conditions are worse than those who earn high levels of income. An unpleasant working condition may lead to poor health status as the working hours are longer and the jobs are more risky. Recent research evidences that ‘education may lead to better health as it leads to greater income and access to health care (Cutler and Muney, 2006).’ This indicated the education has positive effect on income. Moreover, we need to think about the income distribution in the rich countries. It is true that in the rich countries such as United Stated and United Kingdom, there still have many people’s income levels are low. Various past studies evidence that ‘the relationship between income and life expectancy has tended to disappear but still observed a strong relationship at lowest income levels (Fuchs, 1986).’ Grossman also argued that increasing income in rich countries may result in a rising in death rate. The reason is that ‘rich people may consume more health-harming goods such as alcohol and cigarettes that may adversely affect health (Grossman, 1972).’ The result showed that increasing in income can have a negative effect to health. Various researches show that income is a factor that can lead to a better health but it also depends on the income distribution in rich and poor countries. Recent studies indicated that increase in income can result in decrease in life expectancy in rich countries since rich people are more likely to consume health-harming products that may adversely affect health. However, people who have low levels of income in rich countries, it is still showed a strong effect in increasing income and also for the poor countries. In order to reduce the income and health disparity, increase education levels is the most efficient way. With higher education, individuals can improve their skills and
knowledge which increase their job opportunity and salary and capability to process different health information and thereby increase their health status. Thus, we can conclude that income has positive and negative effect on health. Conclusion
All in all, income and education are the key determinants of health. Various studies have showed that better educated parents are able to obtain better paying jobs and enable them to afford better living quality and healthy diet. Hence, higher incomes mean less stress to the families as well as the children. Regardless of these, education proves to be a more important determinant of health than income. The reasons why that people know obesity, cigarette use, binge drinking and drug abuses are harmful to their health, all this knowledge is come from education. Without education, we will not absorb different kinds of healthy information in order to maintain a healthy body. Information regarding health and health care is vital to the health status of an individual. As a result, an educated person can have a healthy lifestyle and able to follow the advice of physician. An educated person is easier to get a proper job with good income and take good care of their health status. A sustainable income is as a result of a proper job which in turn is a result of education. This evidences that income only is not enough to ensure the health of an individual. With this, education is a far more fundamental determinant of health compared to income. Moreover, recent researches evidence that raising income can have a negative effect on health. Rich people are likely to consumer health-harmful goods that lead to a decrease in life expectancy. Hence, it is crystal clear that education has a positive and causal effect on health and plays a stronger role in health than income.
A. Aizer and L. Stroud, 2010, ‘Education, Knowledge and the Evolution of Disparities in Health’, NBER Working Paper 15840.
Angus Deaton, 2006, ‘Global Patterns of Income and Health: Facts, Interpretations, and Policies’, NBER Working Paper 12735.
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S. Folland, Allen C. Goodman and M. Stano, 2012, ‘The Economics of Health and Health Care’, 7th Edition, Pearson Education, Inc.
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