The modifying influence of country development on the effect of individual educational attainment on self-rated health

A.L.F. Van Der Kooi, K. Stronks, C.A. Thompson, M. DerSarkissian and O.A. Arah

American Journal of Public Health, 2013, vol. 103, issue 11, e49-e54

Abstract: Objectives. We investigated how much the Human Development Index (HDI), a global measure of development, modifies the effect of education on selfreported health. Methods. We analyzed cross-sectional World Health Survey data on 217 642 individuals from 49 countries, collected in 2002 to 2005, with random-intercept multilevel linear regression models. Results. We observed greater positive associations between educational levels and self-reported good health with increasing HDI. The magnitude of this effect modification of the education-health relation tended to increase with educational attainment. For example, before adjustment for effectmodification, at comparable HDI, on average, finishing primary school was associated with better general health (b = 1.49; 95% confidence interval [CI] = 1.18, 1.80). With adjustment for effect modification by HDI, the impact became 4.63 (95% CI = 3.63, 5.62) for every 0.1 increase in HDI. Among those who completed high school, these associations were, respectively, 5.59 (95% CI = 5.20, 5.98) and 9.95 (95% CI = 8.89, 11.00). Conclusions. The health benefits of educational attainment are greater in countries with greater human development. Health inequalities attributable to education are, therefore, larger in more developed countries. Copyright © 2013 by the American Public Health Association®.

Keywords: adult; aged; cross-sectional study; developed country; developing country; educational status; female; health disparity; health status; health survey; human; male; middle aged; self report; statistics and numerical data; young adult; article; developed country; developing country; statistics, Adult; Aged; Cross-Sectional Studies; Developed Countries; Developing Countries; Educational Status; Female; Health Status; Health Status Disparities; Health Surveys; Humans; Male; Middle Aged; Self Report; Young Adult, Adult; Aged; Cross-Sectional Studies; Developed Countries; Developing Countries; Educational Status; Female; Health Status; Health Status Disparities; Health Surveys; Humans; Male; Middle Aged; Self Report; Young Adult (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301593_6

DOI: 10.2105/AJPH.2013.301593

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