Introduction Education, chronic disease, and other factors such as occupation play a role in how one perceives and reports their health. The interrelationships of these factors are not well understood; specifically it is unclear how much of the education contribution can be explained through other factors such as chronic disease and whether this varies by world region and by gender. In this paper we quantified the total and mediated associations between educational attainment and multi-dimensional health score spanning eight health domains, across the world stratified by world region, national income, and gender.
Methods Using hierarchical regression methods to analyse World Health Survey data on 146 561 individuals in 51 countries, we estimated the influence of education on a multidimensional health score that is calculated using self-reported assessments of eight global states of general health. We quantified both the total effects and effects not mediated by chronic disease status and occupation, with(out) stratification by world region, national income, and participant gender.
Results We found that individuals with no formal schooling consistently reported the lowest levels of health. How occupation and chronic disease mediated this association varied widely by world region and national income. Chronic disease status and occupation accounted for much more of this relationship in developed regions and higher income countries. On average, the results for women reflected an increased importance of education on health score compared with men.
Conclusion Western and wealthy countries and regions and women appear to be more successful at converting their educational attainment into better health.
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