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Study authors David M. Cutler (left) and Edward L. Glaser.Credit: Kris Snibbe/Harvard University Staff Photographer
Having more education has long been linked to improved personal health. But these benefits are also contagious, say the co-authors of a new study.
“It's not just that people with more years of education have better health,” said David M. Cutler, the Otto Eckstein Professor of Applied Economics. “Even people with fewer years of education, such as those who only graduated from high school, will have better health if they live near people with more years of education.”
This paper examines why cities with more college graduates have lower overall mortality rates. It is not due to spatial classification or the habit of relocating to live among people with similar customs. The researchers also didn't find any particularly strong correlations with factors such as clean air, low crime, or high-quality health care infrastructure. Instead, most of the explanations have to do with smoking rates, physical activity rates, and obesity.
This pattern has everything to do with a community's common culture, said co-author Edward L. Glaser, Fred and Eleanor Glimp Professor of Economics and chair of the economics department. “Smoking, for example, is a social activity,” he says. “Basically, if you smoke, it's fine to be around other smokers, but if you don't smoke, it's usually pretty uncomfortable.”
Glaser, an urban economist and author of The Triumph of the City (2011), has spent decades studying how differences in educational attainment affect American society as a whole. One of his established findings concerns economic resilience. “If you ask yourself which American cities were successful in rebuilding themselves after a very difficult period in the 1970s and 1980s, the highly educated cities like Seattle and Boston were successful. Low cities didn’t make it,” Glaser said.
For the past several decades, Dr. Cutler, a health economist, has analyzed the strong link between education and individual health outcomes. All the while, he continued to work with Glaser to investigate obesity, smoking, and other health-related behaviors at the community level. Economists revisited these questions in their 2021 book, Urban Survival: The Future of Urban Life in an Age of Isolation.
Jacob H. Baugh, associate professor of global health at Boston University, and Ljubica Ristowska, a postdoctoral researcher at Yale University, also contributed to the new paper. Together, the researchers rejected the spatial classification explanation, which used data from the University of Michigan's Health and Retirement Study.
A similar analysis was conducted using data from the National Longitudinal Survey of Young Women and Men. They found that across all age groups, people with poor health moved more frequently than healthy people. However, both groups settle in areas with approximately the same level of human capital (defined here as the population's years of education).
To see whether differences in mortality rates were due to neighborhood amenities, the research team used a variety of data, from county-level homicide statistics to regional estimates of air quality to federal standards for hospital quality. Analyzed information sources. “We estimate that up to 17% of human capital externalities to health are due to these external factors, primarily driven by increased access to preventive health care,” the co-authors wrote. writing.
Rather, the researchers found that a large portion (at least 60 percent) of the correlation between human capital and community health was explained by differences in health-related behaviors. Combining data from both the U.S. Census Bureau and the Centers for Disease Control and Prevention, researchers found that for every 10 percent increase in the share of college graduates in an area, all-cause mortality rates decrease by 7 percent per year.
Utilizing additional data from the CDC's Behavioral Risk Factor Surveillance System and the Census Bureau's Current Population Survey (CPS), researchers were able to examine the relationship between human capital and various health-related behaviors . For every 10% increase in college graduates in a region, there was a 13% decrease in smoking, a 7% decrease in physical inactivity, and a 12% decrease in the odds of being extremely obese.
“This really opens up all these questions about how people form beliefs,” Cutler said.
This paper provides the most in-depth look at smoking, considering the rich historical figures on tobacco initiation, cessation, and beliefs. According to CPS data, people in cities with more years of education, such as New York City, Boston, and Seattle, are more likely to believe that smoking is bad for them.
Residents of these cities are also more likely to support smoking restrictions. For every 10% increase in a bachelor's degree, the probability of working in a smoke-free location increases by 2 percentage points.
Cutler and Glaser were particularly interested in finding that the relationship between human capital and community health increased over time, particularly from 1990 to 2010. They explained that as the correlation between an individual's education and behavior increases, so too does the relationship between a community's level of education and its community's health. Mortality rates slowly followed suit.
“Look at people who were 70 years old in 2000,” says Glaser, who observed a similar movement between human capital and earnings over the same period. “These people were 30 years old in 1960. A lot of people were smoking in 1960, but the educational gradient was not as strong as we saw 30 years later.”
For more information:
Jacob Bor et al, Human Capital Spillovers and Health: Does Living Around College Graduates Increase Lifespan? (2024). DOI: 10.3386/w32346
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