College Access and Adult Health

Benjamin Cowan and Nathan Tefft

American Journal of Health Economics, 2025, vol. 11, issue 3, 335 - 374

Abstract: We investigate the relationship between college openings, college attainment, and health behaviors and outcomes later in life. Though a large prior literature attempts to isolate the causal effect of education on health via instrumental variables, few papers use instruments that are directly related to college enrollment. Our paper examines whether an increase in institutions per capita (“college accessibility”) in a state contributes to higher college attainment and better health later in life. Using 1980–2015 census and American Community Survey data, we find consistent evidence that accessibility of public two-year institutions positively affects schooling attainment, employment, and earnings among Whites but not among people of color. We then examine how public two-year accessibility affects health outcomes and behaviors in adulthood by employing 1984–2015 National Health Interview Survey data. Self-reported health is significantly positively affected by public two-year accessibility among White individuals, but other outcomes are not. Among White individuals ages 50 and up, we find stronger effects on self-reported health, a reduction in the likelihood of mortality, and protective effects on several intermediate health outcomes. These effects are generally concentrated among older men, for whom the effect of two-year college access on schooling is strongest in the cohorts we study.

Date: 2025
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