A1 Refereed original research article in a scientific journal
Educational attainment and health transitions over the life course: testing the potential mechanisms
Authors: Elovainio M, Rosenstrom T, Hakulinen C, Pulkki-Raback L, Mullola S, Jokela M, Josefsson K, Raitakari OT, Keltikangas-Jarvinen L
Publisher: OXFORD UNIV PRESS
Publication year: 2016
Journal: Journal of Public Health
Journal name in source: JOURNAL OF PUBLIC HEALTH
Journal acronym: J PUBLIC HEALTH-UK
Volume: 38
Issue: 3
First page : E254
Last page: E262
Number of pages: 9
ISSN: 1741-3842
eISSN: 1741-3850
DOI: https://doi.org/10.1093/pubmed/fdv124
Abstract
Background It has been shown that higher education associates with health outcomes, but the less is known about the specific mechanisms mediating this association. We examined whether higher education would associate with long-term health transitions from childhood to adulthood and whether health behaviors, self-esteem, social support and work-related health hazards could mediate or confound this association.Methods The participants were from a population-based sample of 3596 men and women from the Young Finns study aged 3-18 years at the beginning of the study in 1980, and who responded to repeated surveys of educational attainment and self-rated health in four study phases from 1997 to 2012. The associations were tested using multistate Markov models for the health-state transition intensities.Results Our results suggested that a 1-year difference in education was related to a 16% higher transition probability from mediocre to good self-rated health over the 5-year follow-up. Depressive symptoms and job strain seemed to partly mediate or confound the association, but self-esteem and social support did not.Conclusions These results suggest that educational attainment is associated with good self-rated health transitions from childhood to adulthood, and multiple processes rather than a single underlying mechanism are likely to drive the educational differences in self-rated health.
Background It has been shown that higher education associates with health outcomes, but the less is known about the specific mechanisms mediating this association. We examined whether higher education would associate with long-term health transitions from childhood to adulthood and whether health behaviors, self-esteem, social support and work-related health hazards could mediate or confound this association.Methods The participants were from a population-based sample of 3596 men and women from the Young Finns study aged 3-18 years at the beginning of the study in 1980, and who responded to repeated surveys of educational attainment and self-rated health in four study phases from 1997 to 2012. The associations were tested using multistate Markov models for the health-state transition intensities.Results Our results suggested that a 1-year difference in education was related to a 16% higher transition probability from mediocre to good self-rated health over the 5-year follow-up. Depressive symptoms and job strain seemed to partly mediate or confound the association, but self-esteem and social support did not.Conclusions These results suggest that educational attainment is associated with good self-rated health transitions from childhood to adulthood, and multiple processes rather than a single underlying mechanism are likely to drive the educational differences in self-rated health.
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