Explaining educational-related inequalities in health: Mediation and moderator models

This paper studies how education and certain lifestyle factors affect people's self-reported health. In addition to the assessment of the effects of education and lifestyle, the study contrasts two models of explaining educational-related health inequalities: the mediation model and the moderator model. The mediation model posits that well-educated people's better health, as compared to the poorly educated, is caused by their more 'healthy' lifestyles. The moderator model suggests, by contrast, that the effects of the lifestyle variables on health are dependent upon educational level. Several analyses are carried out on two large data sets comprising of middle-aged men and women in two Norwegian counties, Rogaland and Nordland. Two main findings are presented: (1) Both education and lifestyle factors have the expected effects on health. (2) The results do not permit a clear-cut conclusion as to which of the two models of educational-related health inequalities should be preferred: whereas the results support the mediation model in the data from Rogaland, the moderator model is partially supported in the Nordland data.