Money, schooling, and health: Mechanisms and causal evidence
Money, schooling, and health: Mechanisms and causal evidence
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DOI：
10.1111/j.1749-6632.2009.05340.x
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Dow, William H.
中科院分区：
文献类型：
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作者：
Kawachi, Ichiro;Adler, Nancy E.;Dow, William H.
更高的教育程度和更好的健康状况之间的联系在文献中一再被报道。同样，数以千计的研究也发现了更高的收入和更好的健康之间的关系。然而，这些重复的观察是否构成因果关系仍然是一个挑战，尤其是因为随机选择接受不同金额的金钱或教育的人存在实际限制。在这篇文章中，我们回顾了将教育和收入与健康联系起来的潜在因果机制，并讨论了观察性研究中因果推理面临的双重挑战，即反向因果关系和省略变量偏差。我们提供了一项关于确定教育和收入对健康的因果影响的实证尝试的调查，包括自然实验。有证据表明，学校教育与改善健康状况之间存在因果关系。有证据还表明，增加穷人的收入会改善他们的健康状况。然而，除了这些粗略的发现之外，还有很多事情是未知的；例如，什么类型的教育对健康至关重要，或者临时收入冲击对健康的影响与长期收入变化之间是否存在差异。
An association between higher educational attainment and better health status has been repeatedly reported in the literature. Similarly, thousands of studies have found a relationship between higher income and better health. However, whether these repeated observations amount to causality remains a challenge, not least because of the practical limitations of randomizing people to receive different amounts of money or schooling. In this essay, we review the potential causal mechanisms linking schooling and income to health, and discuss the twin challenges to causal inference in observational studies, in other words, reverse causation and omitted variable bias. We provide a survey of the empirical attempts to identify the causal effects of schooling and income on health, including natural experiments. There is evidence to suggest that schooling is causally related to improvements in health outcomes. Evidence also suggests that raising the incomes of the poor leads to improvement in their health outcomes. Much remains unknown beyond these crude findings, however; for example, what type of education matters for health, or whether there is a difference between the health impacts of temporary income shocks versus changes in long-term income.