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What is the Association between Education and Health as Income Increases?

Recent research from Chile investigated whether there is an association between education and blood lipid levels as income increases over a decade.

Cardiovascular diseases are the main cause of death in Chile and worldwide. In fact, cardiovascular diseases were responsible for 27% of deaths in Chile as reported by the World Health Organization in 2015. Smoking, obesity, a sedentary lifestyle, hypertension, diabetes mellitus, and dyslipidemia are among the modifiable risk factors for cardiovascular diseases.

How are Cardiovascular Risk Factors Related to the Economy?

The prevalence of cardiovascular disease risk factors has increased along with the economic improvements, especially in developing countries. In Latin America, Chile has a fast-growing economy which reduced the poverty rate from 20% in 2000 to 15% a decade later. Chile is also becoming one of the most economically stable countries in South America. Despite all Chile’s fast economic growth, cardiovascular risk factors rate increased in Chilean adults. In addition, Chilean adults are living in an environment that is conducive to obesity, with high rates of a sedentary lifestyle and unhealthy diets that are high in sugar, fat, and salt.

Many known cardiovascular risk factors are more frequent among those with a lower education level. There seems to be a relationship between improved health outcomes and higher education levels based on the last National Health Survey. On the other hand, it was reported that people with low education, regardless of income, are more susceptible to develop less healthy eating patterns and lifestyles. This may be due an increased in their income but without corresponding improvements in their education.

Mechanisms that Explain the Relationship between Education and Health

There are three proposed mechanisms that could explain the relationship between education and health. Firstly, education increases knowledge about health behaviours directly. This has been reported in some studies, which show an association between education and the consumption of healthier food as well as increased in physical activities. Secondly, increased education might lead to better employment opportunities. This allows people to live in healthier and less stressful environments with a higher availability of food options and recreational areas. Lastly, a higher education is associated with psychosocial factors, such as a sense of control, social support, and social position. All of those psychosocial factors can help to minimize the barriers to change as well as maintain improvements in health behaviours.

In a recent article published in BMC Public Health, Lara and Amigo conducted a cohort study to analyze the effect of education on blood lipid levels as income increases over a decade in Chilean adults. The researchers included information from 3,092 births in Limache Hospital between 1974 and 1978. Of these, 998 people were randomly selected in 2000 and 650 of them were followed up in 2010. The direct effect of education level in 2000 on blood lipid levels in 2010 was estimated by using the mediation analysis.

Higher Education May Lead to Better Health for Women but Not Men

The results indicated that of the 650 adults, 24% had low education and 60% increased their income over time. Moreover, mediation analysis showed that, among women whose income was increased, those with low education had worse lipid profiles compared to women with high education. On the other hand, men with low education had better profiles than men with high education. Additionally, men had a higher frequency of elevated tryglicerides, hyperglycemia, and hypertension than women.

The overweight and obesity epidemic is an important public health issue in Chile. There was a trend that low education was associated with worse lipid profiles in women and better lipid profiles in men despite the rise in income of Chilean adults. This important study indicates that health-care practitioners and policy-makers in Chile may need to address men and women separately when implementing prevention programs.

Written by Alexa Deano, BSc(Hons)

Reference: Lara, M., & Amigo, H. (2018). Association between education and blood lipid levels as income increases over a decade: a cohort study. BMC Public Health18(1), 286.



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