The DOI matches its Crossref record; 68 of the 72 references it cites were found in a registry or an index.
Understanding differences in health behaviors by education
Open accessAbstract
Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and health behaviors, known as the education gradient. We show that income, health insurance, and family background can account for about 30 percent of the gradient. Knowledge and measures of cognitive ability explain an additional 30 percent. Social networks account for another 10 percent. Our proxies for discounting, risk aversion, or the value of future do not account for any of the education gradient, and neither do personality factors such as a sense of control of oneself or over one's life.
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“this finding is supported by many studies showing that social determinants of health are key drivers of mortality,50, 51, 52, 53, 54”
From Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021 (2024) · cites this paper as [51]
In the citing paper
“the prevalence of several risk behaviors is generally higher among those with fewer than nine years of formal education, begins to decline among those who have nine to 12 years of formal education, and continues to decline with additional years of education”
From Education improves public health and promotes health equity (2015) · cites this paper as [28]
In the citing paper
“There is also strong evidence of a dose response between years of education and many health-related risk and protective behaviors among US adults.”
From Education improves public health and promotes health equity (2015) · cites this paper as [28]
In the citing paper
“Similar results are found by Cutler and Lleras-Muney,28 who use different sources to assess associations between educational attainment, health behaviors, and mortality in the United States and Great Britain.”
From Education improves public health and promotes health equity (2015) · cites this paper as [28]
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Citations
Cites
The Handbook of Social Psychology
Gravatt, A. E., Lindzey, G. E., & Aronson, F. (1969) · The Family Coordinator · doi:10.2307/582242 · Cited by 12,518
On the Concept of Health Capital and the Demand for Health
Grossman, M. (1972) · Journal of Political Economy · doi:10.1086/259880 · Cited by 5,951 · cited 2×
“Grossman (1972) ; in his formulation, education allows inputs to be combined more productively.”
BackgroundActual causes of death in the United States
McGinnis, J. M. (1993) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1993.03510180077038 · Cited by 5,480
Actual Causes of Death in the United States, 2000
Mokdad, A. H. (2004) · JAMA · doi:10.1001/jama.291.10.1238 · Cited by 5,211 · cited 4×
“Mokdad et al. (2004) estimate that nearly half of all deaths in the United States are attributable to behavioral factors, most importantly smoking, excessive weight, and heavy alcohol intake.”
BackgroundInfluential1. On the Concept of Health Capital and the Demand for Health
Grossman, M. B. (2017) · Columbia University Press eBooks · doi:10.7312/gros17812-004 · Cited by 3,999
Education, health, and behaviour
Rutter, M. E. (1970) · Medical Entomology and Zoology · Cited by 3,236
Experimental Analysis of Neighborhood Effects
Kling, J. R., Liebman, J. B., & Katz, L. F. (2007) · Econometrica · doi:10.1111/j.1468-0262.2007.00733.x · Cited by 2,719 · cited 7×
“Unweighted regressions use the methodology in Kling et al. (2007) .”
InfluentialBarsky, R. B., Juster, F. T., Kimball, M. S., & Shapiro, M. D. (1997) · The Quarterly Journal of Economics · doi:10.1162/003355397555280 · Cited by 2,400 · cited 1×
“The HRS in 2002 asked hypothetical questions that allow for categorization of individuals into 4 risk aversion categories (Barsky et al., 1997).”
BackgroundINVESTMENT IN HUMANS, TECHNOLOGICAL DIFFUSION, AND ECONOMIC GROWTH
Phelps, E. S. (1980) · Elsevier eBooks · doi:10.1016/b978-0-12-554002-5.50015-7 · Cited by 2,226 · cited 1×
“Nelson and Phelps (1966) first hypothesized that “education is especially important to those functions requiring adaptation to change” and that “the rate of return to education is greater the more technologically progressive is the economy.” This was echoed by Schultz (1975), who proposed that education enhances indiv…”
BackgroundEconomic Status and Health in Childhood: The Origins of the Gradient
Case, A. C., Lubotsky, D. H., & Paxson, C. H. (2002) · American Economic Review · doi:10.1257/000282802762024520 · Cited by 1,753
The lasting impact of childhood health and circumstance
Case, A., Fertig, A., & Paxson, C. (2005) · Journal of Health Economics · doi:10.1016/j.jhealeco.2004.09.008 · Cited by 1,738
Investment in Humans, Technological Diffusion and Economic Growth
Nelson, R. R., & Phelps, E. S. (1965) · Chula Digiverse · doi:10.58837/chula.taic.522 · Cited by 1,713
Education and Health: Evaluating Theories and Evidence
Cutler, D., & Lleras-Muney, A. (2006) · doi:10.3386/w12352 · Cited by 1,507 · cited 1×
“Although we do not know the reason, our finding that education gradients are smaller for older individuals has been noted elsewhere (see Cutler and Lleras-Muney, 2008a for references).”
Self-citationWhy Have Americans Become More Obese?
Cutler, D., Glaeser, E. L., & Shapiro, J. M. (2003) · The Journal of Economic Perspectives · doi:10.1257/089533003769204371 · Cited by 1,465
Self-citationINEQUALITIES IN DEATH—SPECIFIC EXPLANATIONS OF A GENERAL PATTERN?
Marmot, M. G., Shipley, M. J., & Rose, G. (1984) · The Lancet · doi:10.1016/s0140-6736(84)92337-7 · Cited by 1,461 · cited 1×
“This enormous difference in life expectancy by education is true for every demographic group, is persistent – if not increasing – over time (Kitagawa and Hauser, 1973; Elo and Preston, 1996; Meara et al., 2008), and is present in other countries ( Marmot et al., 1984 (the U.K.); Mustard et al., 1997 (Canada); Kunst an…”
BackgroundThe Value of the Ability to Deal with Disequilibria
Schultz, T. W. (1974) · Journal of Economic Literature · Cited by 1,418
The Role of Premarket Factors in Black-White Wage Differences
Neal, D. A., & Johnson, W. R. (1996) · Journal of Political Economy · doi:10.1086/262045 · Cited by 1,340 · cited 1×
“For example, Hansen, Heckman and Mullen (2004) find that that one year of schooling increases AFQT scores between 2 and 4 percentage points (see also Neal and Johnson, 1996, and Winship and Korenman, 1997).35 Finally cognition is associated with better health and health behaviors (Gottfredson and…”
BackgroundThe Endogenous Determination of Time Preference
Becker, G. S., & Mulligan, C. B. (1997) · The Quarterly Journal of Economics · doi:10.1162/003355397555334 · Cited by 1,336 · cited 1×
“Education may lead people to have lower discount rates ( Becker and Mulligan, 1997 ): for example, if education raises future income, individuals have an incentive to invest in lowering their discount rate.”
BackgroundThe Relationship Between Education and Adult Mortality in the United States
Lleras-Muney, A. (2005) · Review of Economic Studies · doi:10.1111/0034-6527.00329 · Cited by 1,282
Self-citationCurrie, J., & Moretti, E. (2003) · The Quarterly Journal of Economics · doi:10.1162/003355303322552856 · Cited by 1,241 · cited 1×
“Currie and Moretti (2003) show that women living in counties where college is more readily available have healthier babies than women living in other counties.”
BackgroundThe Impact of Obesity on Wages
Cawley, J. (2004) · The Journal of Human Resources · doi:10.3368/jhr.xxxix.2.451 · Cited by 1,032 · cited 1×
“Measured obesity rates are generally 3–4 percent higher than self-reported rates ( Cawley, 2004; Cawley and Burkhauser, 2006).”
BackgroundFree for All? Lessons from the RAND Health Insurance Experiment
Neuberg, L. G., Newhouse, J. P., & Insurance Experiment Group (1995) · Southern Economic Journal · doi:10.2307/1061020 · Cited by 1,008
Differential Mortality in the United States: A Study in Socioeconomic Epidemiology.
Stockwell, E. G., Kitagawa, E. M., & Hauser, P. M. (1975) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2062204 · Cited by 972
Health Behavior, Health Knowledge, and Schooling
Kenkel, D. S. (1991) · Journal of Political Economy · doi:10.1086/261751 · Cited by 956 · cited 1×
“These results are in line with those found by Meara (2001) and interestingly with those reported by Kenkel (1991) ,w ho attempted to account for the possibility that health knowledge is endogenous.17”
ResultThe Relationship Between Education and Adult Mortality in the United States
Lleras-Muney, A. (2002) · doi:10.3386/w8986 · Cited by 929
Self-citationThe Influence Of Income On Health: Views Of An Epidemiologist
Marmot, M. G. (2002) · Health Affairs · doi:10.1377/hlthaff.21.2.31 · Cited by 875
The Gap Gets Bigger: Changes In Mortality And Life Expectancy, By Education, 1981–2000
Meara, E. R., Richards, S., & Cutler, D. M. (2008) · Health Affairs · doi:10.1377/hlthaff.27.2.350 · Cited by 850 · cited 1×
“This enormous difference in life expectancy by education is true for every demographic group, is persistent – if not increasing – over time (Kitagawa and Hauser, 1973; Elo and Preston, 1996; Meara et al., 2008 ), and is present in other countries (Marmot et al., 1984 (the U.K.); Mustard et al., 1997 (Canada); Kunst an…”
BackgroundSelf-citationBeyond BMI: The value of more accurate measures of fatness and obesity in social science research
Burkhauser, R. V., & Cawley, J. (2007) · Journal of Health Economics · doi:10.1016/j.jhealeco.2007.05.005 · Cited by 849
Rational Addictive Behavior and Cigarette Smoking
Chaloupka, F. (1990) · Journal of Political Economy · doi:10.1086/261776 · Cited by 801 · cited 1×
“Chaloupka (1991) estimates elasticities of −0.6 for people with a high school degree or less and −0.15 for people with more than high school.”
InfluentialEducational differentials in mortality: United States, 1979–1985
Elo, I. T., & Preston, S. H. (1996) · Social Science & Medicine · doi:10.1016/0277-9536(95)00062-3 · Cited by 682
Can patient self-management help explain the SES health gradient?
Goldman, D. P., & Smith, J. P. (2002) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.162086599 · Cited by 673 · cited 2×
“Goldman and Smith (2002) document that the more educated are more likely to comply with HIV and diabetes treatments, which are extremely demanding.”
BackgroundIntelligence Predicts Health and Longevity, but Why?
Gottfredson, L. S., & Deary, I. J. (2004) · Current Directions in Psychological Science · doi:10.1111/j.0963-7214.2004.01301001.x · Cited by 623
The Impact of Obesity on Wages
Cawley, J. (2004) · The Journal of Human Resources · doi:10.2307/3559022 · Cited by 615
Ross, C. E., & Mirowsky, J. (1999) · Demography · doi:10.2307/2648083 · Cited by 562 · cited 1×
“Discounting may also take the form of impulsivity and lack of self-control, as suggested by Ross and Mirowsky (1999).”
BackgroundRational Addictive Behavior and Cigarette Smoking
Chaloupka, F. J. (1990) · National Bureau of Economic Research · doi:10.3386/w3268 · Cited by 560
Neuroendocrinology of the stress-response
Sapolsky, R. (1992) · Medical Entomology and Zoology · Cited by 490
FACTORS AFFECTING THE RESPONSE OF IMMUNISED GUINEAPIGS TO ANTIGENIC STIMULUS
Hartley, P., & Hartley, O. M. (1949) · The Lancet · doi:10.1016/s0140-6736(49)92093-0 · Cited by 470
Kunst, A. E., & Mackenbach, J. P. (1994) · American Journal of Public Health · doi:10.2105/ajph.84.6.932 · Cited by 449 · cited 1×
“This enormous difference in life expectancy by education is true for every demographic group, is persistent – if not increasing – over time (Kitagawa and Hauser, 1973; Elo and Preston, 1996; Meara et al., 2008), and is present in other countries (Marmot et al., 1984 (the U.K.); Mustard et al., 1997 (Canada); Kunst and…”
BackgroundMaking Americans healthier: social and economic policy as health policy
Schoeni, R. F., House, J. S., Kaplan, G., & Pollack, H. (2009) · Choice Reviews Online · doi:10.5860/choice.46-5680 · Cited by 410
The effect of schooling and ability on achievement test scores
Hansen, K. T., Heckman, J. J., & Mullen, K. J. (2004) · Journal of Econometrics · doi:10.1016/j.jeconom.2003.10.011 · Cited by 366 · cited 1×
“For example, Hansen et al. (2004) find that that 1-year of schooling increases AFQT scores between 2 and 4 percentage points (see also Neal and Johnson, 1996, and Winship and Korenman, 1997).”
Tax incidence when individuals are time-inconsistent: the case of cigarette excise taxes
B, J. G. A., & Kőszegi, B. (2003) · Journal of Public Economics · doi:10.1016/j.jpubeco.2003.06.001 · Cited by 361 · cited 2×
“For these reasons, we do not attribute any of the education gradient in health behaviors to prices.15 14 Gruber and Koszegi (2004) estimate elasticities of -1 for people without a high school degree, -0.9 for high school grads, -0.1 for people with some college, and -0.4 for college grads.”
BackgroundInfluentialFatal Tradeoffs: Public and Private Responsibilities for Risk
Viscusi, W. K. (1992) · OUP Catalogue · Cited by 354
Differential Mortality in the United States: A Study in Socioeconomic Epidemiology.
Preston, S. H., Kitagawa, E. M., & Hauser, P. M. (1974) · Journal of the American Statistical Association · doi:10.2307/2285699 · Cited by 311 · cited 1×
“This enormous difference in life expectancy by education is true for every demographic group, is persistent – if not increasing – over time ( Kitagawa and Hauser, 1973; Elo and Preston, 1996; Meara et al., 2008), and is present in other countries (Marmot et al., 1984 (the U.K.); Mustard et al., 1997 (Canada); Kunst an…”
Background3. The Correlation between Health and Schooling
Grossman, M. B. (2017) · Columbia University Press eBooks · doi:10.7312/gros17812-008 · Cited by 292
Time Preference and Health: An Exploratory Study
Fuchs, V. R. (1980) · National Bureau of Economic Research · doi:10.3386/w0539 · Cited by 287
Beyond BMI: The Value of More Accurate Measures of Fatness and Obesity in Social Science Research
Cawley, J., & Burkhauser, R. V. (2006) · National Bureau of Economic Research · doi:10.3386/w12291 · Cited by 286
Why Are There Returns to Schooling
Rosenzweig, M. R. (1995) · American Economic Review · Cited by 241
Time preference, time discounting, and smoking decisions
Khwaja, A., Silverman, D. P., & Sloan, F. A. (2007) · Journal of Health Economics · doi:10.1016/j.jhealeco.2007.02.004 · Cited by 228
Schooling, Information and Nonmarket Productivity: Contraceptive Use and Its Effectiveness
Rosenzweig, M. R., & Schultz, T. (1989) · International Economic Review · doi:10.2307/2526657 · Cited by 206
Intelligence, genes, and success: scientists respond to the bell curve
Devlin, B. (1998) · Choice Reviews Online · doi:10.5860/choice.35-4193 · Cited by 174
Schoenbaum, M. (1997) · American Journal of Public Health · doi:10.2105/ajph.87.5.755 · Cited by 150 · cited 2×
“In the case of smoking Viscusi (1992) suggests that both smokers and nonsmokers vastly overestimate the risks of smoking (though other studies find different results, see Schoenbaum, 1997, for example).”
BackgroundSchooling, cognitive ability and health
Auld, M. C., & Sidhu, N. (2005) · Health Economics · doi:10.1002/hec.1050 · Cited by 147 · cited 2×
“Some papers have also explored interactions between education and IQ, see for example Elias (2004) or Auld and Sidhu (2005) .”
BackgroundWhat Explains Differences in Smoking, Drinking, and Other Health-Related Behaviors?
Cutler, D., & Glaeser, E. L. (2005) · American Economic Review · doi:10.1257/000282805774670464 · Cited by 143
Self-citationThe Relationship Between Education and Adult Mortality in the U. SPreprint
Lleras‐Muney, A. (2001) · RePEc: Research Papers in Economics · Cited by 140
Self-citationAge-specific education and income gradients in morbidity and mortality in a Canadian province
Mustard, C., Derksen, S. A., Berthelot, J. M., Wolfson, M., & Roos, L. L. (1997) · Social Science & Medicine · doi:10.1016/s0277-9536(96)00354-1 · Cited by 136
Tobacco At the Crossroads: The Past and Future of Smoking Regulation in the United States
Gruber, J. (2001) · The Journal of Economic Perspectives · doi:10.1257/jep.15.2.193 · Cited by 136 · cited 1×
“Gruber (2001) shows that cigarette prices more than doubled in real terms between 1954 and 1999; counting the payments from tobacco companies to state governments enacted as part of the Master Settlement Agreement, real cigarette taxes are now at their highest level in the post-war era.”
BackgroundDoes Staying in School Make You Smarter? The Effect of Education on IQ in The Bell Curve
Winship, C., & Korenman, S. (1997) · Intelligence, Genes, and Success · doi:10.1007/978-1-4612-0669-9_10 · Cited by 127 · cited 2×
“36 We follow Winship and Korenman (1997) and control for the type of test and the year that the test was taken when early IQ measures are included.”
BackgroundMethodWhy is Health Related to Socioeconomic Status
Meara, E. (2001) · National Bureau of Economic Research · doi:10.3386/w8231 · Cited by 111
Fuchs, V. R. (1983) · Health Care Management Review · doi:10.1097/00004010-198322000-00015 · Cited by 98
A Theory of Health Disparities and Medical Technology
Goldman, D. P., & Lakdawalla, D. N. (2005) · Contributions in Economic Analysis & Policy · doi:10.2202/1538-0645.1395 · Cited by 95
Silver, G. A., & Fuchs, V. R. (1982) · Journal of Policy Analysis and Management · doi:10.2307/3323677 · Cited by 93
Behrman, J. R., Hoddinott, J. F., Maluccio, J. A., Soler‐Hampejsek, E., Behrman, E. L., Martorell, R., Ramírez‐Zea, M., & Stein, A. D. (2014) · Latin American Economic Review · doi:10.1007/s40503-014-0004-4 · Cited by 78
The Economic Impacts of the Tobacco Settlement
Cutler, D., B, J. G. A., Hartman, R. S., Landrum, M. B., Newhouse, J. P., & Rosenthal, M. B. (2000) · Journal of Policy Analysis and Management · doi:10.1002/pam.1037 · Cited by 77
Self-citationThe Value of Life and the Rise in Health Spending
Hall, R. E., & Jones, C. I. (2004) · National Bureau of Economic Research · doi:10.3386/w10737 · Cited by 65
Are the More Educated More Likely to Use New Drugs?
LLERAS-MUNEY, & LICHTENBERG (2005) · Annales d Économie et de Statistique · doi:10.2307/20777592 · Cited by 36
Behrman, J. R., Hoddinott, J. F., Maluccio, J. A., Soler‐Hampejsek, E., Behrman, E. L., Martorell, R., Ramírez‐Zea, M., & Stein, A. D. (2006) · SSRN Electronic Journal · doi:10.2139/ssrn.947480 · Cited by 35
U.S. Life Tables For 1990 By Sex, Race, And Education
Richards, H., & Barry, R. P. (1998) · Journal of Forensic Economics · doi:10.5085/jfe.11.1.9 · Cited by 27
Why zebras don't get ulcers—A guide to stress, stress-related disorders and coping
Eysenck, H. J. (1996) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)90053-4 · Cited by 15
Research works printed but not linked: 1
- Elias, J.J., 2004. The Effects of Ability and Family Background on Non-Monetary Returns to Education. Ph.D. dissertation, University of Chicago.
Cited by
Sorted by citations
Socioeconomic Disparities in Health Behaviors
Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010) · Annual Review of Sociology · doi:10.1146/annurev.soc.012809.102529 · Cited by 1,944
“The tendency of low-SES groups to adopt unhealthy behaviors despite the monetary and health costs is a puzzle that many studies have examined but, with one very recent exception (Cutler & Lleras-Muney 2010), not addressed in a comprehensive way.”
BackgroundInfluentialWang, H., Abbas, K. M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abdelalim, A., Abolhassani, H., Abreu, L. G., Abrigo, M. R. M., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30977-6 · Cited by 1,971
The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach
Zajacova, A., & Lawrence, E. M. (2018) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031816-044628 · Cited by 1,205
Education Pays: The Benefits of Higher Education for Individuals and Society
Baum, S., Ma, J., & Payea, K. (2007) · Cited by 1,110
Schumacher, A. E., Kyu, H. H., Aali, A., Abbafati, C., Abbas, J., Abbasgholizadeh, R., Abbasi, M. A., Abbasian, M., Abd ElHafeez, S., Abdelmasseh, M., et al. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00476-8 · Cited by 1,045
Metadata
- Authors
- Cutler, D. M., & Lleras-Muney, A.
- Affiliations
- National Bureau of Economic Research (US)
- ORCID
- Cutler, David M.
- Venue
- Journal of Health Economics
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 29
- Issue
- 1
- Pages
- 1-28
- ISSN
- 0167-6296 (ISSN-L)
- PMC
- PMC2824018
- OpenAlex
- W2164662768
- Cited by
- 1,920
- References
- 72
- Citations by year
- 2026: 137 · 2025: 153 · 2024: 120 · 2023: 124 · 2022: 142 · 2021: 142 · 2020: 139 · 2019: 130 · 2018: 130 · 2017: 119 · 2016: 101 · 2015: 127 · 2014: 121 · 2013: 79 · 2012: 79
- FWCI
- 52.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Health Economics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute on Aging (P01AG005842)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD041022)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Intergenerational and Educational Inequality Studies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- education gradient, health behavior, income, health insurance, family background, health knowledge, cognitive ability, social networks, risk aversion, discounting, perceived control, cross-national comparison
- MeSH terms
- Adult, Educational Status, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, United States, Health Behavior, Databases, Factual, Risk Reduction Behavior
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