May 15, 2008
Educational Gap Widening For Longevity

The advantage of being smart is getting bigger when it comes to longevity.

ATLANTA—May 13, 2008—A new study finds a gap in overall death rates between Americans with less than high school education and college graduates increased rapidly from 1993 to 2001. The study, which appears in the May 14 issue of PLoS ONE, says the widening gap was due to significant decreases in mortality from all causes, heart disease, cancer, stroke, and other conditions, in the most educated while death rates among the least educated remained relatively unchanged. The study is the first to examine recent trends in socioeconomic inequalities in mortality from all causes as well as several leading causes of death in the United States using national individual-level socioeconomic measures.

American Cancer Society epidemiologists led by Ahmedin Jemal, Ph.D., working with scientists from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) used data from the National Vital Statistics System (NVSS) and death certificate information to analyze more than 3.5 million deaths recorded from 1993 to 2001. They found the overall death rate from all causes decreased significantly during the time period among the most educated (≥16 years) men and women, with the largest decrease in black men. In contrast, the all cause death rate actually increased in those with less than a high school education. The annual percent increase was largest among white women with less than 12 years of education (3.2 percent per year), but was also statistically significant (0.7 percent per year) in white women who had completed high school. The authors say the growing gap was caused largely by an unprecedented decrease in the all-cause death rate among the most educated men (totaling 36 percent in black men and 25 percent in white men over the nine-year interval) largely due to decreases in death rates from HIV infection, cancer, and heart disease.

Here from the Plos One paper:

We calculated annual age-standardized death rates from 1993–2001 for 25–64 year old non-Hispanic whites and blacks by level of education for all causes and for the seven most common causes of death using death certificate information from 43 states and Washington, D.C. Regression analysis was used to estimate annual percent change. The inequalities in all cause death rates between Americans with less than high school education and college graduates increased rapidly from 1993 to 2001 due to both significant decreases in mortality from all causes, heart disease, cancer, stroke, and other conditions in the most educated and lack of change or increases among the least educated. For white women, the all cause death rate increased significantly by 3.2 percent per year in the least educated and by 0.7 percent per year in high school graduates. The rate ratio (RR) comparing the least versus most educated increased from 2.9 (95% CI, 2.8–3.1) in 1993 to 4.4 (4.1–4.6) in 2001 among white men, from 2.1 (1.8–2.5) to 3.4 (2.9–3–9) in black men, and from 2.6 (2.4–2.7) to 3.8 (3.6–4.0) in white women.

Why do I make the claim that this result is due more to intelligence than to education? Linda Gottfredson and Ian Deary have demonstrated intelligence is a powerful variable for influencing longevity (PDF format).

ABSTRACT—Large epidemiological studies of almost an entire population in Scotland have found that intelligence (as measured by an IQ-type test) in childhood predicts substantial differences in adult morbidity and mortality, including deaths from cancers and cardiovascular diseases. These relations remain significant after controlling for socioeconomic variables. One possible, partial explanation of these results is that intelligence enhances individuals’ care of their own health because it represents learning, reasoning, and problem-solving skills useful in preventing chronic disease and accidental injury and in adhering to complex treatment regimens.

Also see Gottfredson's paper Intelligence: Is it the epidemiologists' elusive "fundamental cause" of social class inequalities in health? (PDF format).

My guess is that as the amount of useful knowledge available to influence longevity has increased (e.g. results from dietary and lifestyle research and new types of treatments that require patients to do much self-administration of drugs and therapies) the advantage of being smart has been amplified. If you get sick and you are smart you have more clinical trials to investigate, diets to try, and treatments to follow carefully. You are better able to understand why a treatment should benefit you and therefore more motivated to stick with it. Rather than follow the advice of one doctor you can seek out multiple experts, ask tough questions, and compare notes with other smart people chasing better treatments. You are better able to see through self-serving advice of specialists who are trying to boost their income. You are more likely to recognize serious side effects of treatments and challenge the wisdom of continued use of a treatment.

In the much longer run rejuvenation treatment delivery will become so automated and the treatments so incredibly effective that even the dumbest among us will benefit. But in the shorter run having brains and utilizing those brains to make diet, lifestyle, and other choices to maximize health can provide a big edge.

Share |      Randall Parker, 2008 May 15 09:58 PM  Aging Studies

HellKaiserRyo said at May 15, 2008 11:20 PM:

Any speculation to how much working conditions, stress of having little money, access to information (not the ability to process it, but poor people in developed countries are not likely to have computers as even the conservative Robert Rector acknowledges), and health care access might contribute to the differences that are independent of intelligence.

You cannot grant them the ability to process the necessary information, but I do think it is possible to reduce some of the current longevity gaps although I doubt one could eliminate it.

Audacious Epigone said at May 16, 2008 9:49 AM:

I think you nailed it on the head. The correlation between estimated IQ and life expectancy is .85 at the national level. That's the strongest correlation I've been able to find--stronger than PPP, corruption (inverse), infant mortality rates (inverse), crime (inverse), distance from the equator.

Mike Johnson said at May 16, 2008 9:58 AM:

Interesting. I'd like to see some sort of attempt at quantifying how much of IQ's correlation with longevity is due to more intelligent behavior through life, and how much is due just to having a better-put-together, more healthy and capable physiology. Seems pretty hard to tease apart, though.

Jake said at May 16, 2008 10:47 AM:

You must have the life skills of dedication, discipline and self-denial to keep healthy especially if you have a chronic medical condition. You must also have those life skills to keep you out of poverty.

It would be more valuable to treat these health disparates as a life skill problem rather than a class or culture problem.

David Gobel said at May 16, 2008 5:48 PM:

How much does self-discipline factor in here? Is there any study anywhere on the impact of self-discipline on longevity? I think of self-discipline as the equivalent of an opposable consciousness like an opposable thumb. Can't make any progress if you heart and head don't work together - even worse if heart or head dominates...oy.

M said at May 17, 2008 9:35 PM:

More Inteligence & Motivation may lead to more education (assuming equal educational access) & that may lead to higher incomes.

Higher Education leads to healthier Diet & Exercise habbits:
"... In 2005, 61 percent of four-year college graduates ages 25-34 exercised vigorously at least once a week. Only 31 percent of high school graduates did so. ... "
"... Americans are eating healthier diets than they did in 1965, but college-educated people are doing better than high school dropouts, new research indicates. ..."

Higher Education Helps people compensate or avoid dementia:
"Those with at least a high school education spend more of their older years without cognitive loss -- including the effects of Alzheimer's, Parkinson's and dementia -- but die sooner after the loss becomes apparent..."

Bad Health Habits more common among less educated:
"The decreased use of cocaine in the United States over the last 20 years mostly occurred among the highly educated, while cocaine use among non-high school graduates remained constant, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. ..."
"... educated women have a healthier average weight than less educated women ..."

If Interested in Longevity & Aging there's Virginia Museum of Natural History exhibit:
' .. "Amazing Feats of Aging", a 2,500-square-foot interactive exhibit, explores the science of aging, with special emphasis on healthy aging, how animals age, and the aging brain. '

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