The August issue of Health Affairs, a leading journal of health policy research, has an article that starkly highlights two Americas: one that is educated and full of promise, and one that is not educated and truncated. Titled “Differences In Life Expectancy Due To Race And Educational Differences Are Widening, And Many May Not Catch Up,” the piece lays out in stark terms a gap in life expectancy that is widening in the United States. We are two Americas. The authors estimate the impact of race and education on past and present life expectancy and the numbers are shocking.
For 2008 adult men and women with fewer than twelve years of education, life expectancy was not roughly the same of that of Americans in the 1950s. Add race into the mix and it is more dramatic. For people with less than twelve years of education, the difference in life expectancy is an expected shorter life of 14 years – white men compared to black men, and ten years – white women compared to black women. The authors’ analysis is that education trumps many other factors in determining life expectancy. Their recommendations are clear: more education for all people at all races to reduce the disparities in health and longevity.
The article highlights thinking about education as a public health concern. An educated public is a healthier public, so the authors reason, for an educated public should make smarter choices over the short-term and the long-term. However, Americans regularly resist expanding their conceptions of public health. Maybe it has to do with a strand of libertarian thinking, but whatever the subject, it is a difficult pill for us to swallow. In the US, public health initiatives almost always are highly contested and debated on grounds other than health. For example, environmental regulation is a public health issue, but it is often fought on the basis of the economy and jobs. Guns are a public health issue, but we do not talk about them that way.
As for education, I have yet to see an educational leader champion education as a path to a healthier and longer life. It very well may be that getting education right is enough of a challenge.