Q&A: Life expectancy and education in the United States

Dr. Laura Dwyer-Lindgren shares new research on the impact of education on longevity in the US. The study shows that those who have graduated college are expected to live 10.7 years longer on average than those who have not graduated high school.

This transcript has been lightly edited for clarity

Why did you examine educational disparities in life expectancy in the United States, and what were your key findings?

It’s pretty well established that there are educational disparities in health and longevity. And that’s something we know is true in the US. And that’s something that we know is true globally. But, as far as we could tell, nobody had ever looked at this at the county level in the US. And we were motivated to do that because when we’ve done other analysis at the county level, we find consistently across a wide range of outcomes that the situation is really different depending where in the country you are.

And it’s important to know about that variation, both so that you can identify the folks who have the greatest need, but also because sometimes the places that are doing really well provide really important clues for how we could do better for everybody.

In terms of the key findings, first of all, we confirm that there are, in fact, quite large educational disparities in life expectancy in the US. So, for example, what this plot is showing is trends in life expectancy nationally in the US for the four different educational attainment populations that we looked at. So, on the left part of the plot we see what life expectancy was for each of these four groups in the year 2000, which was the first year in our study.

And you can see that there’s quite a big gap between the two groups at the top, which are college graduates and folks who have completed some college, but not a degree. And then below that, in the green, those who have completed high school but no college. And then in the blue, the folks who have not completed high school.

So, for example, if you compare folks who have not graduated high school with folks who are college graduates, there’s a 10.7-year gap in life expectancy between those two groups. That gap has also increased over time. And the reason that it’s increased over time is because over the past few decades, all of the gains in life expectancy have really been concentrated in the most highly educated groups, while the folks who have not graduated from high school have seen essentially no increase in life expectancy over that period.

So that’s sort of the national picture. And then when we zoom down to the county level, in one sense what we find is this remarkable story of consistency. So we see educational disparities in essentially every county. We see that those disparities are growing over time in the vast majority of counties. And so, to some degree, this is sort of a universal thing that’s happening, at least within the US.

On the flip side, though, we do see that there are these huge variations in how big the disparities are. So there are some counties where the gap is relatively small, and there’s other counties where it’s quite large, even compared to the 10 years that I already mentioned at the national level.

How varied is the life expectancy across the US and between people with different levels of education?

So life expectancy is very, very different in different parts of the US and between people with different levels of education. So, if you focus just on that education slice for the minute, at the national level, life expectancy varies by over a decade between folks who have less than a high school diploma and those who have graduated from college.

But once you expand that to also look at how life expectancy varies among counties, that expands from one decade to several decades.

So this plot is showing how life expectancy varied by educational attainment – that’s the four different panels – and then also by county, in the year 2019. You see just kind of comparing the general color across the four maps, that there are these big average differences in life expectancy between the four groups.

So the college graduates and the folks with some college, you see a lot more green and blue, which indicates higher life expectancy. The high school graduates and the folks with less than a high school diploma, you see a lot more of the oranges and reds, which indicates lower life expectancy. So that is a reflection of what we see also at the national level.

But the zoomed-in view is when you start looking at the county, and you can see within every one of these maps that there’s huge variation in life expectancy among counties, even among people who have similar levels of education. And that’s most apparent for folks who have less than a high school diploma. So you see, there’s folks there, for example, in California and parts of Texas that have life expectancy in kind of that green and blue range, which we also see for the higher-educated groups.

But you also see these big regions, including much of Appalachia, parts of the northeast, where life expectancy is quite a bit lower for those groups.

We see this quite strong relationship between health and longevity on the one end, and education on the other. Because education gives people resources to pursue a healthy life; it also gives them resources to avoid health risks. And there’s a whole bunch of ways that that plays out, but one that’s really obvious is many times having more education is associated with the ability to have a higher-paying job. Having a higher-paying job is associated with all sorts of things that are good for health, like better housing, better ability to pursue good nutrition or physical activity. And also, in cases where you need health care, better ability to get high-quality health care.

The other thing we should be doing is that for people who don’t have as high a level of education, figuring out ways to break that relationship, to disentangle having lower levels of education and then the health disadvantage that comes with it.

And this is really important for reducing those disparities. So that would be huge for health and longevity, because there is such a strong relationship here.