Educational differences in health risks and illness over the life course: A test of cumulative disadvantage theory

This study tests the cumulative disadvantage hypothesis by examining the age-varying relationships between education, health risks, and disease onset and survival duration. Results based on 20 years of longitudinal data suggest that education is related to both the individual and accumulated number of behavioral, social, and economic health-risks, which in turn, are related to increasing educational differences in rates of disease incidence and survival. For hypertension, behavioral risks fully account for education’s negative effect on disease onset whereas educational differences in survival are best explained by the accumulation of social and economic risks. For heart attack, a combination of behavioral, social, and economic risks mediate the association between education and incidence, but neither the individual nor accumulated health-risks could account for education’s positive effect on surviving after a heart attack. Similar findings for diabetes and stroke are also discussed.