By Daniel Weintraub
It has long been known that health and life expectancy are correlated with education levels. The more education you have, the longer you are likely to live. But no one knows exactly why that relationship exists.
New research points to part of the answer: people with less education are more likely to work in jobs that make them sick.
That might seem obvious, but until now it was a hunch that had never been quantified. The latest findings could help guide employers and policymakers who seek to shrink the health gap among people with different levels of education.
Researchers at Harvard and Stanford, in a paper published in the journal Health Affairs, gathered data on education levels, workplace stresses, deaths, and life expectancy. Then they looked for connections among them.
They concluded that, for every ethnic group and gender, the workplace contributed more to annual mortality for people with less education than for people with more schooling.
For non-Hispanic white males, for example, the workplace contributed to about 5 percent of annual deaths for those with a graduate school education, 9 percent for men with at least some college, and 13 percent for males with a high school education or less.
The gap was even greater for Hispanic men. Workplace issues accounted for 6.2 percent of the deaths of those with a graduate education compared to 19 percent for Hispanic men with a high school education or less.
“People are being sorted into different jobs with different levels of stress, based on their education,” Joel Goh, an assistant professor at the Harvard Business School and the lead author on the paper, said in an interview. “That stress can account for a fair amount of the disparities we see in health.”
The most influential workplace factor, the researchers found, was a lack of health insurance. That connection seems intuitive, since we know that health is often linked to access to health care. But while health insurance is good to have, the other workplace factors the researchers studied demonstrate that things we don’t always associate with health can also have a major impact.
People with less education, for example, often work in jobs that place higher demands on them while offering low levels of social support. They have less job security and are thus more likely to be laid off and unemployed. And the poorly educated must deal more often with a crucial factor that can be nearly as influential as a lack of health insurance: low levels of control over their job.
That’s an issue health experts have pondered since the Whitehall Studies, begun in 1967, showed that the health of employees in the British civil service declined with each rung down the organization chart, even though all of the workers had access to the same health care through England’s system of socialized medicine. Researchers suspected that one reason for the disparity was that a lack of control over their jobs left lower-level workers more stressed, depressed and discouraged, burdens that eventually showed up in their health.
Goh believes that a similar study of workers’ health over time could help tease out more data about the workplace conditions that contribute to poor health and early death.
In the meantime, legislators, employers and unions would do well to examine his research for clues about workplace policies that contribute to ill health, and those practices that might help poorly educated workers in low-paying jobs live longer and healthier lives.
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