Listen to a podcast of Western Sociology professor Rachel Margolis as she discusses her forthcoming Journal of Health and Social Behavior article, Education Differences in Healthy Behavior Changes and Adherance among Middle-aged Americans.
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Better-educated middle-aged Americans are less likely to smoke and more apt to be physically active than their less-educated peers. They are also more inclined to make healthy changes — in general and in the face of new medical conditions — and adhere to them, according to a new study in the September issue of the Journal of Health and Social Behavior.
“This study documents that there are very large differences by education in smoking and physical activity trajectories in middle age, even though many health habits are already set by this stage of the life course,” said Western Sociology professor Rachel Margolis, the study’s author. “Health behavior changes are surprisingly common between ages 50-75, and the fact better-educated, middle-aged people are more likely to stop smoking, start physical activity and maintain both of these behaviors over time has important health ramifications.”
In her study, Educational Differences in Healthy Behavior Changes and Adherence Among Middle-aged Americans, Margolis draws on data from the Health and Retirement Study (HRS), a study of aging in the U.S. population above age 50. Her analysis considers more than 16,600 HRS participants ages 50-75 during the study period 1992-2010.
Margolis found 15 per cent of college-educated respondents smoked at some point between ages 50-75, compared to 41 per cent of college dropouts. There were also large differences by education in physical activity over the study period. For example, 14 per cent of college-educated respondents were physically active at all interviews during the study period, compared with 2 per cent of those with less than a high school education. In addition to college graduates and high school dropouts, Margolis analyzed people with only a high school degree and individuals with some college education.
According to Margolis, health problems arise throughout the life course and how people respond to new medical conditions can shape their future health.
“Having more education increased the odds that a person made a healthy behavior change when faced with a new chronic health condition,” she said. “This finding helps explain why there are educational differences in chronic disease management and health outcomes.”
Margolis also discovered education level became decreasingly important as a moderator of healthy behavior changes upon diagnosis as age increased. Having more education increased the odds of smoking cessation among people in their 50s who were diagnosed with a new condition, but not those in their 60s or early 70s.
“Well-educated smokers in their 60s and early 70s are a small and select group,” Margolis said. “They may be the most addicted or the most stubborn.”
Another possible explanation for why well-educated smokers in their 50s were more likely to quit than those in their 60s and early 70s is that the longer people expect to live when they get sick, the more likely they are to make a healthy behavior change, Margolis said.
Interestingly, although Margolis found better-educated people were much more likely to, for example, quit smoking when they got sick, her research also revealed that those with lower levels of education were also more likely to quit after receiving a negative diagnosis than when they were healthy.
“To improve overall population health, my research suggests that health practitioners and policymakers can take better advantage of the fact that people from all educational backgrounds are more inclined to make healthy changes at the point of diagnosis and focus on encouraging healthy changes at that time,” she said.