Abstract
Background: Attending private school or a higher-status university is thought to benefit future earnings and occupational opportunities. We examined whether these measures were beneficially related to health and selected health-related behaviours in midlife. Methods: Data were from up to 9799 participants from the 1970 British birth Cohort Study. The high school attended (private, grammar or state) was ascertained at 16 years, and the university attended reported at 42 years [categorised as either higher (Russell Group) or normal-status institutions]. Self-reported health, limiting illness and body mass index (BMI) were reported at 42 years, along with television viewing, take-away meal consumption, physical inactivity, smoking and high risk alcohol drinking. Associations were examined using multiple regression models, adjusted for gender and childhood socioeconomic, health and cognitive measures. Results: Private school and higher status university attendance were associated with favourable self-rated health and lower BMI, and beneficially associated with health-related-behaviours. For example, private school attendance was associated with 0.56 [95% confidence interval (CI): 0.48, 0.65] odds of lower self-rated health [odds ratio (OR) for higher-status university: 0.32 (0.27, 0.37)]. Associations were largely attenuated by adjustment for potential confounders, except for those of private schooling and higher-status university attendance with lower BMI and television viewing, and less frequent take-away meal consumption. Conclusions: Private school and higher-status university attendance were related to better self-rated health, lower BMI and multiple favourable health behaviours in midlife. Findings suggest that type or status of education may be an important under-researched construct to consider when documenting and understanding socioeconomic inequalities in health.
Highlights
Education is thought to benefit future health and economic outcomes,[1,2,3] but there is substantial heterogeneity in the latter depending on the type or status of education attended
Compared with attendance at comprehensive school, private school attendance was associated with better selfrated health [odds ratio (OR) of being in one category worse self-rated health 0.56; 95% confidence interval (CI): 0.48, 0.65], lower odds of limiting illness, and lower body mass index (BMI) (Table 2)
Associations with BMI remained after adjustment for future educational attainment (Supplementary Table 1, available as Supplementary data at IJE online).Grammar school attendance was associated with lower BMI before and after adjustment (Table 2)
Summary
Education is thought to benefit future health and economic outcomes,[1,2,3] but there is substantial heterogeneity in the latter depending on the type or status of education attended. A small number of studies, mostly in the economics literature, have examined how school or university characteristics relate to a limited number of adult health-related outcomes.[22,23,24] These include the investigation of the type of school and the pupil:teacher ratio,[23] and selectivity of universities in the USA.[22,24] None has examined both school and university type, and important potential confounders such as parental income[23] have in some cases not been accounted for Both school type and university status warrant investigation—university, like schooling, is likely to be a period in which patterns of health-impacting behaviours are established, which may subsequently track across life and impact on health.[25,26,27]. Findings suggest that type or status of education may be an important under-researched construct to consider when documenting and understanding socioeconomic inequalities in health
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