State School Policies as Predictors of Physical and Mental Health: A Natural Experiment in the REGARDS Cohort
State School Policies as Predictors of Physical and Mental Health: A Natural Experiment in the REGARDS Cohort
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DOI：
10.1093/aje/kwz221
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发表时间：
2020-05-01
影响因子：
5
通讯作者：
Howard, Virginia J.
中科院分区：
文献类型：
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作者：
Brenowitz, Willa D.;Manly, Jennifer J.;Howard, Virginia J.
我们使用州立学校政策的差异作为自然实验，以评估教育数量和质量对晚年身心健康的共同影响。使用美国人口普查微观样本数据，国家义务教育和学校质量的历史措施（学期长度，学生-教师比例和出勤率）通过回归建模相结合的规模对应的教育年数（政策预测年教育（PPYEd））。PPYEd值与卒中地理和种族差异原因研究（2003-2007）中年龄≥ 45岁的8,920名黑人和14,605名白色参与者的个人水平记录相关。线性和分位数回归模型估计PPYEd与简明健康调查表中的身体健康总评（PCS）和心理健康总评（MCS）之间的关联。我们研究了种族之间的相互作用，并对性别、出生年份、6岁时的居住州和研究入组年份进行了调整。较高的PPYEd与较好的中位PCS（β = 1.28，95%置信区间（CI）：0.40，1.49）和可能较好的中位MCS（β = 0.46，95% CI：-0.01，0.94）相关。黑人（与白色相比）的效应估计值更高（PCS x种族相互作用，β = 0.22，95% CI：-0.62，1.05，MCS x种族相互作用，β = 0.18; 95% CI：-0.08，0.44）。当把学校的质量和持续时间结合起来时，这种准实验分析发现了几十年后教育对健康的因果影响的混合证据。
We used differences in state school policies as natural experiments to evaluate the joint influence of educational quantity and quality on late-life physical and mental health. Using US Census microsample data, historical measures of state compulsory schooling and school quality (term length, student-teacher ratio, and attendance rates) were combined via regression modeling on a scale corresponding to years of education (policy-predicted years of education (PPYEd)). PPYEd values were linked to individual-level records for 8,920 black and 14,605 white participants aged >= 45 years in the Reasons for Geographic and Racial Differences in Stroke study (2003-2007). Linear and quantile regression models estimated the association between PPYEd and Physical Component Summary (PCS) and Mental Component Summary (MCS) from the Short Form Health Survey. We examined interactions by race and adjusted for sex, birth year, state of residence at age 6 years, and year of study enrollment. Higher PPYEd was associated with better median PCS (beta = 1.28, 95% confidence interval (CI): 0.40, 1.49) and possibly better median MCS (beta = 0.46, 95% CI: -0.01, 0.94). Effect estimates were higher among black (vs. white) persons (PCS x race interaction, beta = 0.22, 95% CI: -0.62, 1.05, and MCS x race interaction, beta = 0.18; 95% CI: -0.08, 0.44). When incorporating both school quality and duration, this quasiexperimental analysis found mixed evidence for a causal effect of education on health decades later.