Comment – education as a social determinant of male health
Researchers at the University of Colorado have highlighted that having a low standard of educational attainment may have consequences for health comparable in significance to the affect of smoking. The research, which looked at educational disparity in adult mortality in the U.S. across the lifespan found that educational attainment has ‘a graded, inverse association with the risk of death’. For example, for males born in 1925 the researchers found that males who had no high school diploma had a 23% higher risk of death compared to males possessing a high school diploma; males with some college education were found to have a 6% lower risk of death, males educated to baccalaureate degree level a 25% lower risk of death, and males with post-baccalaureate education a 33% lower risk of death.
Education is identified as one of the social determinants of health by the World Health Organization (WHO); if we consider gender and education in the collective West, boys and young men are consistently outperformed by girls and young women in schools and universities. Reasons for this can be debated – the ‘boy problem and literacy’, a ‘too cool for school’ culture, educational assessment systems that favour girls, a feminised educational workforce, social change allowing more young women to enter university – the reasons are as plentiful as the solutions proposed to engage boys with education. Reduced employment opportunities for uneducated males in a changing workplace and the impact on health of a lack of income is also a concern; employment is another of the social determinants of health recognised by WHO.
Addressing the social determinants of health is a driver of health work with men in countries where male health policy has been implemented – the Republic of Ireland and Australia; highlighting the importance of a good education beyond its impact on income opportunities is part of Australian policy on male health. In the UK, where no such policy exists and Public Health work largely concentrates on single-silo preventative health work, and where an academic focus on masculinities and the social pathologies of men is currently the dominant paradigm, it may be time to call not for yet more research into masculinities and hand-wringing narratives into men as a problem, but to look at the impact of social determinants on male health in a UK context, what can be done to address these – and if we really want to improve male health, put into place policy, programmes and services that are designed to meet the needs of boys and men – and not try to fit males into services – health or educational that fail them.
The original research article, Mortality Attributable to Low Levels of Education in the United States can be accessed via the online journal Plos One
The Economist offers a recent article The weaker sex exploring boys and young men’s lack of engagement with education.