ISSUE BRIEF 6: EDUCATION AND
HEALTHSEPTEMBER 2009

A large body ofevidence links
education with health,even when otherfactors like income
are taken into
account.

Education Matters for HealthEveryone knows that without a good education, prospects for a good job with goodearnings are slim. Few people think of education as a crucial path to health,however. Yet a large body of evidence strongly—and, with very rare exceptions,consistently—links education with health, even when other factors like income are
1-6
By “education” we mean educational attainment, or the years
taken into account.
or level of overall schooling a person has, rather than instruction on specific health
topics like hygiene, diet or exercise; while the quality of education also is importantfor health outcomes, this information is more difficult to measure and thus typicallyunavailable. People with more education are likely to live longer, to experience
better health outcomes (Figures 1 & 2), and to practice health-promoting behaviors
such as exercising regularly, refraining from smoking, and obtaining timely health4, 7-9
Educational attainment among adults is linked
care check-ups and screenings.
with children’s health as well, beginning early in life: babies of more-educatedmothers are less likely to die before their first birthdays, and children of moreeducated parents experience better health (Figures 3 & 4).
Education can influence health in many ways. This issue brief examines three majorinterrelated pathways through which educational attainment is linked with health:health knowledge and behaviors; employment and income; and social andpsychological factors, including sense of control, social standing and social support.
In addition, this brief explores how educational attainment affects health acrossgenerations, examining the links between parents’ education—and the social andeconomic advantages it represents—and their children’s health and social
advantages, including opportunities for educational attainment.

Figure 1. For both men and women, more education typically means longer life.†
College graduates can expect to live at least 5 years longer than individuals who have notfinished high school.
Educational Attainment
Less than high-school graduate

60
LIFE EXPECTANCY AT AGE 25

High-school graduate

56.4

College graduate

54.7

55

53.4

52.2
50.6
50
47.9

45

40

MEN

WOMEN

MEN

WOMEN

Source: National Longitudinal Mortality Study, 1988-1998.
† This chart describes the number of years that adults in different education groups can expect to live
beyond age 25. For example, a 25-year-old man with only a high-school diploma can expect to live 50.6
more years and reach an age of 75.6 years.

Figure 2. Less education is linked with worse health.†
Across racial or ethnic groups, adults with greater educational attainment are less likely torate their health as less than very good.
Educational Attainment

PERCENT OF ADULTS, AGES 25-74 YEARS,IN LESS THAN VERY GOOD HEALTH*

People with moreeducation are likely
to live longer andexperience better
health outcomes.

58.5

57.4

Some college

Less than high-school graduate

100

High-school graduate
Some college

84.1

80

70.6

70.4

67.2

62.2

60

College graduate

72.7

54.7

54.1

43.6

69.4

60.9
57.5

59.4

50.0

48.6

41.0

41.8

39.5

40

41.4
26.7

20

0
Black,
Non-Hispanic
BLACK,NON-HISPANIC

Hispanic

HISPANIC

Asian

ASIAN

American Indian or Alaska

AMERICAN INDIAN
NativeOR ALASKA NATIVE

Other‡WHITE,NON-HISPANIC

Source: Behavioral Risk Factor Surveillance System Survey Data, 2005-2007.
† Based on self-report and measured as poor, fair, good, very good or excellent.
* Age-adjusted.

Page 2

Figure 3. Infant mortality rates vary by mother’s education.

Mother’s Educational Attainment

100-11 years
12 years
13-15 years

8.1
8

16 or more years

7.6

6.2
6

4.2
4

2

0
1

Source: Matthews TJ, MacDorman MF. Infant Mortality Statistics from the 2004 Period Linked Birth/Infant Death
Dataset. National Vital Statistics Reports, vol 55 no 15. Hyattsville, MD: National Center for Health Statistics, 2007.

Figure 4. Parents’ education is linked with children’s health.†
Children whose parents have not finished high school are more than six times as likely
to be in poor or fair health as children of college graduates.

6

PERCENT OF CHILDREN, AGES ≤ 17 YEARS,WITH POOR/FAIR HEALTH*

Educational
attainment among
adults is linked withchildren’s health aswell, beginning earlyin life.

INFANT MORTALITY RATES (PER 100,000 LIVE BIRTHS)

Babies born to mothers who have not finished high school are nearly twice as likely to die
before their first birthdays as babies born to college graduates.

Parent’s Educational Attainment
Less than high-school graduate
High-school graduate

5Some college
College graduate

4.4
4

3
2.4
2

1.7

1

0.7

0
1

Source: National Health Interview Survey, 2001-2005.
† Based on parental assessment and measured as poor, fair, good, very good or excellent.
* Age-adjusted.

Page 3

Low educational attainment is a major problem in this country.
In the United States overall, nearly 16 percent of adults ages 25 years and older
have not completed high school, 30 percent have no schooling beyond high school,
27 percent have attended but not completed college, and 28 percent are college
graduates (Figure 5). These overall percentages mask dramatic differences acrossracial or ethnic groups, however: for example, 50 percent of Asian and 31 percent of
non-Hispanic white adults are college graduates, compared with 17 percent of nonHispanic black and 13 percent of Hispanic and American Indian or Alaska Native
adults.

The United States isthe onlyindustrialized nation
where young people
currently are lesslikely than membersof their parents’generation to behigh-school
graduates.

Approximately 30 percent of high-school freshmen in this country—and nearly half ofall freshmen in school systems in the 50 largest U.S. cities—fail to graduate within
10four years. The likelihood of dropping out increases with decreasing income. In
2007, for example, 17 percent of 16 to 24 year-olds from families in the lowest
income quartile were not enrolled in high school and had not received a high-school
credential, compared with 3 percent of those from families in the highest income
11
quartile. At the same time, college has become increasingly unaffordable for lowand middle-income families. For the 2007-2008 school year, net college costs for afamily in the lowest income quintile represented 55 percent of median family income,compared with 33 percent, 25 percent, 16 percent and 9 percent, respectively, for12families in successively higher income quintiles. In response to budget constraints,
at least 28 states have cut funding for public colleges and universities and/or
13
substantially increased college tuitions in their 2009 fiscal year budgets.
The United States is the only industrialized nation where young people currently are
14less likely than members of their parents’ generation to be high-school graduates.
Given the changing demography of the country and the escalating costs of college,bold action will be needed to meet President Obama’s goal of having the highest
proportion of college graduates in the world by 2020.

Page 4

How does education influence health?

Educational
Educational
attainment
attainment

Education is linked
with health throughthree majorinterrelated
pathways: healthknowledge andbehaviors,
employment andincome, and socialand psychologicalfactors.

Educational
Educational
attainment
attainment

Educational
Educational
attainment
attainment

Health knowledge,
literacy & behaviorsWork Nutrition
 Exercise
 Drugs & alcohol Health & disease management

Working
conditions

 Exposure to hazards
 Control / demand imbalance Stress

Workrelatedresources Health insurance Sick leave Retirement benefits
 Other benefits

Income Housing Neighborhood environment
 Nutrition
 Stress

Sense of control

 Work-related factors
 Health-related behaviors
 Stress

Social standing Social & economic resources Stress

Social support

 Social & economic resources Health-related behaviors
 Family stability
 Stress

HEALTHHEALTHHEALTHHEALTHHEALTHHEALTHHEALTHHEALTH

Figure 6. Interrelated pathways through which educational attainment affects health.

Researchers have found supporting evidence for each of the following interrelated
pathways (Figure 6):
1)

Education can lead to improved health by increasing health knowledge
and healthy behaviors.

This is the pathway that many people think of first to explain the strong links
between education and health. Education can increase people’s knowledge andcognitive skills, enabling them to make better-informed choices among the healthrelated options available for themselves and their families, including those related to4, 15-18
Greater educational attainment has
obtaining and managing medical care.
been associated with health-promoting behaviors including increasing consumptionof fruits and vegetables and other aspects of healthy eating, engaging in regularphysical activity, and refraining from excessive consumption of alcohol and from
19-22
In addition, changes in health-related behaviors in response
smoking (Figure 7).
to new evidence, health advice and public health campaigns (about the risks of
4, 23
smoking, for example) tend to occur earlier among more-educated people.
As discussed in the section below on employment, more education is typically linked
with higher-paying jobs providing the necessary income to live in neighborhoods thatare less stressful, have stores with affordable healthy foods, and provide access torecreational facilities. In other words, people with more education are more likely tolive in health-promoting environments that encourage and enable them to adopt andmaintain healthy behaviors.

Page 5

Figure 7. Persistent education gaps in smoking.

PERCENT OF ADULTS, AGES ≥ 25 YEARS, WHO
ARE CURRENT SMOKERS*

Education disparities in cigarette smoking have persisted over decades. While rates ofsmoking have declined in every education group, the gaps between college graduates andthose with less education appear to have widened.
Educational Attainment

50

Less than high-school graduate
High-school graduate
Some college

40

College graduate

30

20

10

0

1980

1984

1988

1992

1996

2000

2004

19
74
19
75
19
76
19
77
19
78
19
79
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05

1976

Source: National Center on Health Statistics. Health, United States, 2006 with Chartbook on Trends in the
Health of Americans. Hyattsville, MD.
*Age-adjusted.

More education
generally means agreater likelihood of
being employed atall, and of having a
job with healthierworking conditions,better employmentbased benefits andhigher wages.

The links between education and health through health knowledge and behaviors
24, 25
Low literacy is common inare likely to be explained at least in part by literacy.
the United States (a 2003 survey found that 30 million or 14 percent of U.S. adults
had literacy levels below the level needed to perform “simple and everyday” literacy
26
activities), with higher prevalence among people with fewer years of education.
More specifically, average health literacy (i.e., the degree to which individuals havethe capacity to obtain, process and understand basic health information andservices needed to make appropriate health decisions and adhere to sometimes
complex disease management protocols) increases with educational attainment.
The proportion of American adults with “below basic” health literacy, for example,
ranges from 3 percent of college graduates to 15 percent of high-school graduates26
and 49 percent of adults who have not completed high school. Levels of healthliteracy in turn have been associated with self-reported overall health, which
27, 28compared with adults
correlates strongly with objective clinical assessments:
who have adequate functional health literacy, adults with inadequate functional
29
health literacy are more likely to rate their health as poor.

2)

Greater educational attainment leads to better employment opportunities
and higher income, which are linked with better health.

Education provides the knowledge and skills necessary for employment, which canshape health in many ways. More education generally means a greater likelihood of
being employed at all, and of having a job with healthier working conditions, better
employment-based benefits and higher wages (see Commission Issue Brief 4:“Work and Health”).
•

Education, unemployment, financial instability and health. Americans withlower educational attainment are more likely to be affected by fluctuations in the
Page 6

economy. While current unemployment rates are higher now than in more thana quarter-century, increases in unemployment rates over the past year havebeen greatest for adults who have not completed high school—6.9 percentage
30
points, compared with 2.2 percentage points for college graduates. In June
2009, unemployment rates were 15.5 percent for adults who had not graduatedfrom high school, 9.8 percent for high-school graduates, 8.0 percent for those
who had attended but not completed college, and 4.7 percent for college
30
graduates. These differences have major health implications; compared with
their employed counterparts, people who are unemployed experience poorer
31-34
health and higher mortality rates.

More education canlead to higher-paying
jobs, which enablepeople to obtainhealth care whenneeded, provide
themselves and theirfamilies with more
nutritious foods, andlive in safer andhealthier homes andneighborhoods withsupermarkets, parks
and places toexercise—all ofwhich can promote
good health bymaking it easier toadopt and maintainhealthy behaviors.

•

Education, working conditions and health. Workers with less formal educationand training are more likely to hold lower-paying jobs with more occupational
hazards, including environmental and chemical exposures (e.g., pesticides,
asbestos) and poor working conditions (e.g., shift work with few breaks,
35
potentially harmful tools) that put them at higher risk of injury and fatality.
Less-educated workers are also likely to experience more psychosocial stress
36-38—for example, to have jobs that make high demands yet offer few
at work
opportunities for control and skill utilization. Such psychosocial aspects ofwork—including perceived balance between a worker’s efforts and rewards,
perceived justice and discrimination in the workplace, and social support
among co-workers—have been shown to have both short- and longer-term
impacts on health, particularly through pathways related to stress.

•

Education, work-related benefits and health. Less-educated workers in lowerwage jobs also are less likely to have health-related benefits including paid sickand personal leave, workplace wellness programs, child and elder careresources, and retirement benefits, in addition to employer-sponsored healthinsurance. Although most Americans receive their health insurance throughtheir jobs, not all workers have access to this benefit. Employers with lowerwage workers offer health insurance less frequently, and, even if employmentsponsored benefits are available, low-wage workers may not be able to afford
39, 40the premiums, copayments or deductibles.

•

Education, income and health. For the vast majority of Americans, employment
is the sole or main source of income―a work-related resource that affects
7
health through multiple well-documented direct and indirect pathways. Withlimited exceptions, greater educational attainment generally corresponds withhigher-paying employment. A recent study estimated that on average each
41
additional year of schooling represents an 11 percent increase in income, andmedian yearly earnings in 2007 were $32,862 for a full-time year-round worker
with only a high-school degree, $40,769 for a worker with some college, and42$56,118 for a worker with a bachelor’s degree. These differences are
particularly dramatic when compounded over a person’s lifetime: lifetime
earnings (in 1999 dollars, and based on a 40-year, full-time work life) for adults
who have graduated from high school but not attended college have been
estimated at $1.2 million, compared with $2.1 million for those with bachelor’s
degrees and $4.4 million for those with post-baccalaureate professional
43
degrees.
Higher-paying jobs offer greater economic security and increased ability toaccumulate wealth, enabling individuals to obtain health care when needed, toprovide themselves and their families with more nutritious foods, and to live insafer and healthier homes and neighborhoods with supermarkets, parks andplaces to exercise—all of which can promote good health by making it easier toadopt and maintain healthy behaviors. Work-related income may also affecthealth through pathways involving stress. Lower-paid workers experiencegreater stress because they have fewer financial resources to cope both witheveryday challenges, including child care and other family responsibilities, and7
with unexpected challenges such as illness.

Page 7

Stress and health.
Much has been learned recently about physiologic pathways that help explain
the links between education and health. Coping with the constant challenges ofdaily living―balancing the demands of work and family, for example―can beparticularly stressful for people whose financial and social opportunities andresources have been limited by low educational attainment. Stressful
experiences have been linked repeatedly with many adverse health outcomes
across the life course, through physiological mechanisms including
neuroendocrine, immune and vascular responses to stressors. Stress cantrigger the body to release hormones and other substances that over time candamage immune defenses and vital organs. The physiologic chain of events
can accelerate aging and lead to serious chronic illnesses including
44
cardiovascular disease.

3)

Social andpsychological factors
linked with education
can influence healththrough pathways
related to stress,
health-related
behaviors, andpractical andemotional support.

Education is linked with social and psychological factors that affecthealth.

Education is linked with social and psychological factors, including sense of control,social standing and social support. These factors can improve health throughreducing stress, influencing health-related behaviors and providing practical andemotional support.
•

Sense of control. Education may influence health by shaping people’s sense ofcontrol—their perceptions of the extent to which they can influence their life
circumstances. Several studies have concluded that more education confers agreater sense of control, which perhaps is not surprising given the influence of
education on prospects for jobs and income. Higher levels of education havebeen linked with greater perception of personal control, fostering skills, habits
and attitudes—such as problem-solving, purposefulness, self-directedness,
perseverance and confidence—that contribute to people’s expectations that their
45-47
own actions and behaviors shape what happens to them.
Increased sense ofcontrol in turn has been linked with health outcomes including higher levels of
self-rated health, lower levels of physical impairment, and decreased risk ofchronic conditions; it also has been associated with health-related behaviors
45-49
including smoking, alcohol consumption, physical activity and diet.
Sense ofcontrol may also influence health through job-related pathways, by affecting a
50-52
person’s job seeking and performance, for example.
It is important to notethat an individual with a greater sense of control may also be more likely toachieve higher educational attainment, making it difficult to separate out theeffects of sense of control and education on health.

•Social standing. Many experts believe that social standing is another importantfactor linking education with health. Along with income and occupation,
educational attainment is an important determinant of where individuals rank
within social hierarchies that reflect status and influence in societies. Greater
educational attainment typically is associated with higher social standing, which
53
in turn has been linked with better health status. An individual’s perception ofwhere she or he ranks in a social hierarchy has been referred to as subjective
social status and has been shown to powerfully predict health status even after
controlling for conventional measures of socioeconomic status such as
54-56
occupation, income and education.
While the pathways linking it to health are
not well understood, subjective social status may be a more comprehensive
56
reflection of social and economic resources.
Page 8•Social support. Social support is another factor relating education to health.
Social support can be “emotional” (having someone to turn to for comfort oradvice) or “practical” (having someone to turn to for practical or material help).
Higher educational attainment, income and occupational status all have been
57-59
associated with higher levels of social support.
Higher educational
attainment increases a person’s likelihood of having close friends on whom torely and of experiencing greater family stability, including a stable and supportive3
marriage. Formal educational settings may encourage the development offriendships and interpersonal skills; people with more education and relatedsocial advantages may also have more time and resources to maintain57, 60relationships and support friends emotionally and financially.
Higher levels of social support have been linked with better physical and mental
61-64
health outcomes.
People with more social contacts have lower mortality
rates across multiple age groups and in both sexes, and disruptions in family
stability have been linked with worse health among adults and poorer health3, 65-69
behaviors and well-being among children.
Social support can buffer thehealth-damaging effects of stress by reducing negative emotional and behavioral
70, 71
responses to stressful situations.
Social relationships may also have64, 72
beneficial health effects unrelated to stress:
larger social networks canprovide access to employment, housing and other opportunities and resources
73-75
that influence health,and behavior norms within social groups can influence63
health-related behaviors such as smoking, exercise and alcohol consumption.

Parents’ education influences children’s prospects for healthduring childhood and beyond.
Parents’ educational attainment is linked to their children’s health and theirchildren’s educational attainment—both of which influence their children’s health asadults.

Parents’ educational
attainment is linked
to their children’s
health and theirchildren’s
educational
attainment—both ofwhich influence theirchildren’s health asadults.

Figure 8. The impact of education on health crosses generations.

As illustrated in figures 3 and 4, parents’ education is strongly linked to their
76-79
Parents with lower educational attainment
children’s health and development.
typically face greater obstacles—including lack of knowledge, skills, time, moneyand other resources—to creating healthy home environments and modeling healthy
behaviors for their children. The quality of children’s health and development in turninfluences health later in life, through both direct and indirect pathways. A large
body of research has consistently linked adverse effects on brain, cognitive andbehavioral development early in life with important health outcomes later in life,
including cardiovascular disease and stroke, hypertension, diabetes, obesity,
smoking, drug use and depression—conditions that account for a major portion of
preventable morbidity and premature mortality in the United States. Healthy
development in childhood can also affect health later in life through its association
80
with greater academic achievement and educational attainment (see Commission
Issue Brief 1: “Early Childhood Experiences and Health”).

Page 9Figure 9. Children with less educated parents are less likely to succeed in school.
PERCENT OF 1990 HIGH-SCHOOL SOPHMORES WHOOBTAINED A BACHELOR'S DEGREE OR HIGHER BY 2000

The level of
educational
attainment children
eventually achievealso affects thehealth of their own
children—perpetuating a
viciousintergenerational
cycle of low
educational
attainment andpoorer health.

Parents’ educational attainment can also shape children’s prospects for healthy
lives through links to children’s educational attainment. Children’s academic
achievement is associated with parental education and related social and economic
advantage; children with less-educated parents and lower-income families face
greater obstacles to success in school and are less likely to go on to receive college
41, 81-86
Parents’ education levels can affect their children’s
educations (Figure 9).
education prospects both directly, through the kinds of support and resources
parents are able to provide at home, and indirectly, through the quality of schools
their children are likely to attend. Less-educated parents are less likely to have higheducational expectations and to create stimulating and nurturing environments for87
their children; in addition, they are more likely to live in lower-income
neighborhoods in which schools may have insufficient resources. The level of
educational attainment children eventually achieve affects their health as adults,
through the same pathways experienced by their parents, and it also affects thehealth of their own children in turn—perpetuating a vicious intergenerational cycle oflow educational attainment and poorer health.

100

Parent’s Educational Attainment
Less than high-school graduate
High-school graduate
Some college

80

Bachelor’s degree

73.3

Master’s degree
First-professional or doctor’s degree

65.4

60

49.4

40

25.7
20

13.3
5.9

0

Source : Snyder TD, Dillow SA, Hoffman CM. Digest of Education Statistics, 2006. National Center for Education
Statistics, Institute of Education Sciences, US Department of Education. Washington, DC: US Government Printing
Office, 2007.

Page 10

Improving health through education policies and programs

By providing theknowledge and skills
necessary to fully
participate in thelabor force,
education can be key
in promoting social
mobility and in
breaking the cycle ofintergenerational
disadvantage andrelated healthdisparities.

By providing the knowledge and skills necessary to fully participate in the labor
force, education can be key in promoting social mobility and in breaking the cycle of41, 86
intergenerational disadvantage and related health disparities.
Investments topromote and increase educational attainment could have both human and economic
benefits; for example, a recent analysis estimated that, if adult Americans who havenot completed college experienced the lower death rates and better health ofcollege graduates, the resulting improvements in health status and life expectancy
7would translate into potential gains estimated at more than $1 trillion annually.
Current knowledge described in this brief indicates that one of the most effective
strategies for reducing health disparities in this country could be to take steps toclose the gaps in educational attainment. Reviewing specific policies and programs
to increase educational attainment was beyond the scope of this brief, but more
information can be obtained from the resources listed below.

RESOURCES
•
•
•
•

•
•
•
•
•
•
•
•
•
•
•
•
•
•

Achievewww.achieve.org
Alliance for Excellent Education
http://www.all4ed.org/
The Annie E. Casey Foundation
http://www.aecf.org/OurWork/Education.aspx
Bill and Melinda Gates Foundation United States Program
http://www.gatesfoundation.org/united-states/Pages/united-stateseducation-strategy.aspx
Brown Center on Education Policy at Brookings
http://www.brookings.edu/brown.aspx
Center for Research on Education, Diversity and Excellence
http://crede.berkeley.edu/
Education Commission of the States
http://www.ecs.org/
The Education Trust
http://www2.edtrust.org/edtrust/default
Future of Children
www.futureofchildren.org
Lumina Foundation
http://www.luminafoundation.org/
Mathematica Policy Research, Inc.
http://www.mathematica-mpr.com/education/
National Assessment of Educational Progress
http://www.nces.ed.gov/nationsreportcard/
National Center for Education Statistics
http://www.nces.ed.gov/
National Center for Post-Secondary Improvement
http://www.stanford.edu/group/ncpi/
The National Center for Public Policy and Higher Education
http://www.highereducation.org/index.shtml
Promising Practices Network
http://www.promisingpractices.net/
RAND Education
http://www.rand.org/education/
U.S. Department of Education
http://www.ed.gov/index.jhtml
Page 11

About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and healthcare issues facing our country. As the nation's largest philanthropy devoted
exclusively to improving the health and health care of all Americans, the Foundation
works with a diverse group of organizations and individuals to identify solutions andachieve comprehensive, meaningful and timely change. For more than 35 years theFoundation has brought experience, commitment, and a rigorous, balanced
approach to the problems that affect the health and health care of those it serves.
When it comes to helping Americans lead healthier lives and get the care they need,
the Foundation expects to make a difference in your lifetime.
About the Commission to Build a Healthier America
The Robert Wood Johnson Foundation Commission to Build a Healthier America isa national, independent, non-partisan group of leaders formed in February 2008 toraise visibility of the many factors that influence health, examine innovativeinterventions that are making a real difference at the local level and in the private
sector, and identify specific, feasible steps to improve Americans’ health. The
Commission released its recommendations on April 2, 2009.
Credits
Lead Authors
University of California, San Francisco
Center on Social Disparities in Health
Susan Egerter, PhD
Paula Braveman, MD, MPH
Tabashir Sadegh-Nobari, MPH
Rebecca Grossman-Kahn
Mercedes Dekker, MPH
Photography
Elisabeth Fall, pg. 1
Robert Wood Johnson Foundation, pg. 12
Design and Layout
Alex Field
Page 12REFERENCES
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Cutler D and Lleras-Muney A. Education and Health: Evaluating Theories and Evidence. Bethesda, MD: National Bureau of Economic
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Winkleby MA, Fortmann SP and Barrett DC. "Social Class Disparities in Risk Factors for Disease: Eight-Year Prevalence Patterns by
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Braveman P and Egerter S. Overcoming Obstacles to Health: Report from the Robert Wood Johnson Foundation to the Commission to
Build a Healthier America. Washington, DC: Robert Wood Johnson Foundation Commission to Build a Healthier America, 2008.

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Richards H and Barry R. "U.S. Life Tables for 1990 by Sex, Race, and Education." J Forensic Econ, 11(1): 9-26, 1998.

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Ross CE and Wu C. "The Links between Education and Health." Am Sociol Rev, 60: 719-45, 1995.

10. Swanson CB. Cities in Crisis 2009: Closing the Graduation Gap. Bethesda, MD: Editorial Projects in Education, Inc., 2009.
11. Snyder TD, Dillow SA and Hoffman CM. Digest of Education Statistics 2008. Washington, DC: National Center for Education Statistics,
Institute of Education Statistics, U.S. Department of Education, 2009.
12. The National Center for Public Policy and Higher Education. Measuring up 2008. The National Report Card on Higher Education. San
Jose, CA, 2008. Available at: http://www.highereducation.org/
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