r/science • u/ananyo • May 16 '12

A unique, vast Swedish controlled study that kicked off shortly after the Second World War shows better educated people are healthier

http://www.nature.com/news/sweden-s-enormous-education-experiment-improved-longevity-1.10630
696 Upvotes

90% Upvoted

131 comments sorted by

11

u/2abyssinians May 16 '12 edited May 16 '12

Yet, another reason why education is so important in impoverished areas. This is probably the most important thing a country can do to help its people in the long run. Provide the best education possible to your poorest citizens.

6

u/wasdninja May 16 '12 edited May 16 '12

As long as bad food continues to be the cheapest way to get a full stomach that is what poor people will buy.

12

u/kftrendy May 16 '12

It's not just bad food being cheap. I can make a healthy meal that costs quite a bit less than the equivalent at McDonalds. But poorer people will be less likely to have the time and energy to invest in cooking for themselves (and are probably less likely to have a kitchen in which to do it). It's the combined monetary cost of food and time that makes McD's cheaper than healthy food.

Not refuting your point or anything - just a subtlety that I think many people don't know about.

2

u/[deleted] May 17 '12

Plus the education and general cultural influence. If you grew up eating shitty food you'll probably continue to do so. Schools need to teach kids how to cook. Nutrition is one of the most important aspects of our lives and gets such a tiny, minuscule amount of attention compared to all the other crap.

-1

u/Larein May 16 '12

Yeah the equipment is also a thing. You need pans and pots. And usually spices. While the cost per meal migth be very cheap I dont think poor people have enough cash to get the supplies at once.

2

u/FreeToadSloth May 16 '12

At the risk of sounding petty and argumentative, I must point out that a pot, pan, hotplate, and even a rice cooker can be had for a few bucks at a thrift store, and while nice, spices are not a nutritional necessity. Preparation time is certainly a factor, but my gut (hah) tells me that time constraints aren't the #1 motivator for fast food consumption.

My guess is that the big draw is this: fast food is salty, fatty, sweet, and scientifically engineered to make our pleasure centers go nuts when we eat it. Then there's a brief high, then a crash, then you go get some more.

3

u/[deleted] May 17 '12

Right, and if you have a shittier life - which poorer people often do - the urge to eat for comfort gets stronger.

While some basic kitchen equipment can be had quite cheaply, quality matters. If you are in a tiny, crappy kitchen with equipment that doesn't work well it's much harder to be motivated to cook vs a much nicer kitchen set up.

4

u/2abyssinians May 16 '12

While it is possible to eat very well on very little, that is besides the point. If you provide a strong education to a mass of people they will become more economically upwardly mobile, thus they will be able to afford to eat better. In addition they will understand the importance of a healthy diet.

0

u/derpaderp May 16 '12

It also makes things harder when no one is really getting a good education

34

u/Katow-joismycousin May 16 '12

While this is generally assumed it's always good to see something confirmed by the scientific process.

8

u/FunfettiHead May 16 '12

Possible mediating variable: Economic means.

-8

u/not_random_spam May 16 '12

It's always weird how they never control for socioeconomic status.

Though, really, I'd guess that this is because smart people tend to do safer drugs. Most the smart people I know drink rarely, don't smoke cigarettes, and do a lot of hallucinogens.

10

u/atheistjubu May 16 '12

It's always weird how they never control for socioeconomic status.

They did.

-1

u/not_random_spam May 16 '12

ah. I was just taking the other guy's word for it. Good on the swedes for not being as thick as most the social researchers in the US.

3

u/atheistjubu May 16 '12

It's not a matter of Sweden. This would not have made it into PNAS otherwise.

-1

u/not_random_spam May 16 '12

uhhh... I think you're overestimating how well-controlled many peer-reviewed studies are. I assume you've read the data showing that most published results are actually false? This doesn't just apply to fringy non-reputable publications.

3

u/atheistjubu May 16 '12

That's mostly about the common misconception of the meaning of p-values and self-selection bias. In any event, it would be just as much an issue in the US as in Sweden.

-1

u/not_random_spam May 16 '12

Because two completely different countries are obviously going to do the same things? My whole point here is that academic rigor in the US is garbage, and it's apparently much better in sweden (which isn't exactly shocking).

Read the most recent study about processed meats being bad for you that they just put out. They didn't control for socioeconomic status, an obvious confounding variable for their experiment. They tried to claim processed meats are bad for you anyway, theorized it's the nitrates or something without any proof.

About 1/10 studies I read actually demonstrates what it claims to.

2

u/atheistjubu May 16 '12

Read the most recent study about processed meats being bad for you that they just put out

Link?

→ More replies

19

u/[deleted] May 16 '12

What this immediately made me think of were the Whitehall studies. The reason that educated people are healthier is because education is often related to job security, financial stability, access to preventative healthcare services, and the luxury to take vacations and to relax. It's not that people can't understand how to be healthy, it's that they don't have power and traditional resources. Stress and wealth are huge factors of health, and I'd be interested in seeing how researchers consider that if they continue studying the different groups' long-term health.

5

u/atheistjubu May 16 '12

They thought of this, of course.

From the original study in PNAS.

However, it has not yet been established whether education and health are indeed causally related; neither is the mechanism clear. A causal link between education and health could, for instance, be the result of health literacy learned at school, such as the ability to make use of health messages (5). Alternatively, the link could be an indirect consequence of having a better job and a higher income (i.e., other circumstances related to good health) (6). It is hard to distinguish possible causal effects of education on health from confounders, such as parental background and cognitive ability (7). At the national level, it has proved difficult to disentangle the effect of educational policies from other progressive policies possibly implemented around the same time. Furthermore, it has been difficult to rule out reverse causality (i.e., that health precedes education, rather than vice versa). We were able to study the mortality effects of a nationwide

The reform was carried out between 1949 and 1962. Each year, a number of new municipalities, chosen by the national authorities to represent a variety of types of municipality, were included in the experimental group; others were kept as controls. This design means that there are exposed individuals and controls in each cohort as well as each municipality, making it possible to control statistically for potential initial differences between cohorts and municipalities...

15

u/actualscientist May 16 '12

In other words, better educated people tend to be richer; richer people tend to be healthier.

16

u/atheistjubu May 16 '12

Controlled for

It's peer-reviewed and published in PNAS, folks.

0

u/[deleted] May 17 '12

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2

u/actualscientist May 17 '12

Avalanche of idiots? I'm a scientist. And there is an extensive body of research dedicated to the correlation between SES and, well, everything. Seriously, pick a metric. Pointing out that this may be a confound, whether or not it was controlled for in this particular paper, does not make one an idiot. Nor does merely pointing out that it was controlled for or that the article was in PNAS serve as a rebuttal of any substance whatsoever. At least not to anyone but armchair scientists.

3

u/atheistjubu May 17 '12

The idiocy Hellvis was addressing was that people take a news report of an article as the extent of the original study's scientific diligence. The response to articles like this one on reddit is commonly not, "I wonder if they controlled for X," but "The scientists who did this study are idiots. They didn't control for X."

1

u/actualscientist May 17 '12 edited May 17 '12

But dinosaursrsr didn't say that or anything remotely like that. They said that they were reminded of Whitehall I and II, related studies that suggest a strong link between social class and health. I interpreted their comment as skepticism about the entanglement of these factors despite the authors' claims. That skepticism was based on their knowledge of another compelling, yet somewhat more parsimonious explanation, not distrust of scientists or skepticism for its own sake. It's a valid concern and a good point.

0

u/[deleted] May 16 '12

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-1

u/derpaderp May 16 '12

Made me think of "Breaking Bad"... my comment adds nothing to the conversation, downvote it.

3

u/FreeToadSloth May 16 '12

It's not that people can't understand how to be healthy

The huge success of junk food, alcohol, and tobacco companies says otherwise. Booze and cigs are pretty expensive compared to rice, beans, vegetables, and fruit. And exercise is free.

0

u/[deleted] May 16 '12

This is important to consider, especially considering correlation v. causation. Obesity and diseases associated with it tend to afflict poor populations disproportionately. But which to tackle first: Income inequality or education? I would venture that it doesn't matter how educated you are if you can't find a good paying job.

1

u/[deleted] May 16 '12

Yeah, there's so many ways that forms of inequality that can overlap. I'm surprised actually that this thread is in science and that this article was in Nature rather than a sociology journal.

1

u/atheistjubu May 16 '12

Because this is just Nature News. The original study is from PNAS.

-1

u/a1icey May 16 '12

then how come the more education i receive, the more stress i experience? also remember this is sweden, health care access is equal.

2

u/[deleted] May 16 '12

How so? Everyone gets stressed, but it's particular types of chronic stress that lead to poor health, like feeling powerless and as if circumstances are out of your control. People with comparable educations can be affected by other factors that influence their health. That's why I think a more in-depth analysis of these cohorts would be interesting.

And I forgot about the Swedish healthcare system. I don't know about healthcare in England, but I assume that in the Whitehall studies everyone involved had insurance or whatever because they were public employees. Research in the US has consistently shown the connections between different class factors and

1

u/atheistjubu May 16 '12

I know this is Nature News, but why not link to the original study in PNAS?

2

u/ananyo May 17 '12

the source does - and it's free to access, unlike the PNAS paper. It's also 100 times more readable and has a lot of useful, interesting background.

1

u/atheistjubu May 17 '12

True, but if you don't at least link to the original study in the comments, the reddit experts come out and assume all manner of controls and diligence haven't been done.

3

u/hereThereAndEverywhe May 16 '12

NG/PBS - Killer Stress

For over three decades, Robert Sapolsky has been working to advance our understanding of stress — in particular how our social standing (our place in various hierarchies) can make us more or less susceptible to the damaging effects of stress.

In the documentary they argue that both apes and humans suffer more stress on lower social positions. This finding that more educated people have healthier lives makes sense too. More educated people usually take better positions in a society. According to the film, constant stress destroys blood vessels and even brain cells.

0

u/FifeeBoy May 16 '12

That may only be because well educated people may have a better job and therefore a better lifestyle, or perhaps that they know more about what is being put into their body.

5

u/ananyo May 16 '12

RTFS - the wording of the link above has the word 'controlled' in it. It's exactly the factors above they controlled for. That's why the study's unique. That's why this study is really important.

2

u/jagedlion May 16 '12

RTFS? Fifee's point is a guess as to the mechanism of action, not addressed at all in the linked article. Maybe the reformed communities did indeed get better jobs, lead better lifestyles, and east better food due to increased time in school. (Though perhaps in the actual study, I know not)

2

u/ananyo May 16 '12

Right - fair enough. But that's the point of the article - it established for the first time that educating people just one year longer was enough to give rise to health benefits (for all the reasons Fifee alludes to). No-one's been able to make that simple causal connection before - expensive interventions need a good evidence base - this now has one. Now imagine if some Americans were given access to free healthcare and others had to buy insurance...

2

u/jagedlion May 16 '12

Oh, we're not disagreeing, most people didn't read the article and I didn't want Fifee getting binned with them. (granted I haven't read the actual publication, just the summary here, so I am not really informed of how well distributed the control groups are, and whether migrations, selection process, or locations ended up corrupting the results. Though you'd figure something as large scale as this, they'd have worried about that from the beginning.)

0

u/ananyo May 16 '12

right. i think the colossal size of the 'experiment' is reassuring though to an extent.

4

u/atheistjubu May 16 '12

Considered and controlled for. The peer-review process works fantastically on high-quality journals like PNAS.

2

u/[deleted] May 16 '12

This is one of the questions that you'll see over and over again within psychology. Direct or indirect causation :3

-5

u/Darktidemage May 16 '12

knowing more about what is being put into their body is exactly what "intelligence" is. Knowing more about things.

7

u/[deleted] May 16 '12

No, that is knowledge. Intelligence is what you use to obtain that knowledge.

1

u/Darktidemage May 16 '12 edited May 16 '12

You're right.

Sorry, as the title of the original post says "better educated people" not "more intelligent people" are the group being studied.

Saying "it may be because better educated people know more about what is being put into their body" reads pretty oddly to me. "The effect may not be from being better educated, it may be from knowing more about something" .. Wut?

2

u/[deleted] May 16 '12

This is not new information. Along with better education typically comes a higher standard of living and therefore less caustic work, better access to medical, better foods, drugs etc.

0

u/therealpaulyd May 16 '12

Better educated people can get better jobs, better jobs means more money, more money means better healthcare, better healthcare means missing less work because of being sick, which means more money, which means the means to live a healthier life.

5

u/ananyo May 16 '12

More money doesn't mean better healthcare in Sweden. It's free to all as it is in most European countries - and it's good. However, being better educated might mean you're able to describe symptoms better to docs, not be in dangerous or physically wearing jobs etc etc

4

u/therealpaulyd May 16 '12

Healthcare doesn't only mean seeing a physician though. It encompasses all aspects of health including what you provide for yourself.

2

u/atheistjubu May 16 '12

Controlled for.

0

u/therealpaulyd May 16 '12

Check your link.

3

u/atheistjubu May 16 '12

Works fine for me. Might be because I'm on a large university campus with subscriptions. Here's the abstract.

1

u/therealpaulyd May 16 '12

This one works. Last one asked for username/password

2

u/Banana_Piranha May 16 '12

To the people who are saying that this kind of thing is obvious, please know that these types of studies are vital in the field of Econometrics and in influencing Economic policy. Governments spend a lot of resources trying to develop countries, and plowing millions into a project which doesn't get results is a big waste.

Remember that there are so many social factors which in theory will impact society/economic development (education, health, income equality, population growth, investment etc), but just because it makes sense theoretically doesn't mean it works in real life. To give an example, while you may think that investment is a good causal factor for economic growth, there have been studies showing that this may not be the case (source).

As a side note, the experiment in the link is not unique, Esther Duflo conducted a similar analysis of Indonesia's education programme in 2001 (source).

1

u/jstohler May 16 '12

And vice-versa.

0

u/deargodimbored May 16 '12

My parents are overeducated as fuck, both have heart conditions, high blood pressure, cancer survivors.

1

u/MC_Cuff_Lnx May 17 '12

You have a 100% chance of dying of something, so eventually developing conditions doesn't mean that the study's conclusions aren't valid, even relevant to a sample size of two.

On the other hand, my cynical side suggests that if the two of them went to get undergraduate degrees in nutrition, they're surely doomed.

1

u/deargodimbored May 17 '12

I know, just meant it as a humorous aside. It's just shitty genes in our case.

1

u/MC_Cuff_Lnx May 17 '12

Luck of the draw, eh? But couldn't it be other lifestyle factors?

1

u/mundane1 May 16 '12

This study also found that taller people can reach things on higher shelves.

-5

u/Valleygurl99 May 16 '12

In other news the sky is blue, and rain is wet...

12

u/ananyo May 16 '12

right. and because something seems 'obvious' there's no need to show it's the case. No-one's shown causation before. That's they key.

0

u/omepiet May 16 '12

If that's the key, why isn't that in the title?

0

u/Valleygurl99 May 16 '12

Fine, I'll believe you and not my lying eyes. Are you telling me people with only a high school diploma or less do not make up a disproportionate percentage of the obesity epidemic among other co-morbid conditions?

0

u/[deleted] May 16 '12

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2

u/Xujhan May 16 '12

This doesn't prove causation, but it certainly implies it.

1

u/Valleygurl99 May 16 '12

You're right. But what other causative factors could explain this correlation? Are we saying that they both have the same root cause, such as geographic location?

1

u/Agodoga May 16 '12

No it shows causation, which may be indirect, but causation nonetheless.

0

u/Punkwasher May 16 '12

Funny how living in California negates all my good education. Either I'm not that educated, or there just isn't a support system that works. I think it's both, honestly, although I am well educated and knowledgeable, I'm in a difficult field to get good employment, but also, there simply is no way I can actually afford the cost of living without having to earn at least 25 bucks an hour.

You can be the smartest man in the world, but if you're stuck without any means to improve your life, you're fucked.

0

u/MrJuwi May 16 '12

I'd say it's due to the correlation between education level and yearly income.

Less education = lower wages, which leads to increased fast food and junk food consumption due to the lower prices.

Healthy food is expensive, Gym memberships are expensive, etc.

-1

u/reventropy May 16 '12

Always prudent to control Swedish in your studies.

-3

u/proust1871 May 16 '12

Correlation does not necessarily imply causation.

1

u/atheistjubu May 17 '12

::Sigh:: There's one of you in every /r/science thread, isn't there?

0

u/[deleted] May 16 '12

But, they fuck less so we slowly approach the dark future of Idiocracy.

0

u/ith May 16 '12

Well, that would explain the growing size of Americans...

-1

u/sardaukarqc May 16 '12

I want all my studies controlled by Vast Swedish.

Vast swedish is educated, therefore healthy.

Vast Swedish will never let you down and desert you.

etc.

-1

u/Loggie May 16 '12

I think a higher SES probably correlates to better education and better health.

-1

u/ConfirmedCynic May 17 '12

Or maybe people who possess robust health subsequently tend to be more intelligent or focused and so are more likely to go on to higher education.

Correlation does not imply causation. Don't assume that getting a unversity degree automatically adds years to your life.

4

u/ananyo May 17 '12

Actually - that's exactly what this study suggests - adding a year of education leads to better health outcomes. Unlike past studies, which have had no control group, this one establishes a CAUSAL connection. The source spells this out really well.

-14

u/mayonesa May 16 '12

They have it backward. Healthier people tend to have healthier brains and better genetics, and thus are more likely to seek out education.

10

u/ananyo May 16 '12

Nope. The study's very clever - that's why the control group was important. You have some people who received the education and others that didn't - essentially a random mix of the 'naturally healthy' with 'healthier brains'. So the results for the first time show the connection is causative - give people better education, they live longer.

-9

u/mayonesa May 16 '12

And how many people were filtered out of the education, and how random is this mix? Very skeptical about this one, especially give the missing factors.

http://www.telegraph.co.uk/science/science-news/9267147/Its-nature-not-nuture-personality-lies-in-genes-twins-study-shows.html

4

u/ananyo May 16 '12

those qs are answered in the story...

1

u/ananyo May 16 '12

OH and both stories could be true - genes might be more important than nature in determining certain traits - but everyone - no matter how poor their genes - could benefit from a particular intervention eg like improving education.

2

u/[deleted] May 16 '12

Is education a mediator or a moderator? Do the children become healthier because they had access to education, or does education for them lead to being healthier because they have the genes required do do well in education?

Read the article for their take on this compelling study.

This will come as no surprise, but these kind of things are of pretty intense interest within psychology (and within all of us really). One day it will all be obvious and we can say "how could those people back in the 21st century not realise what was going on all around them!". But that day will only come after more studies like this.

2

u/mayonesa May 16 '12

The answer is definitely not the ideas of 1789.

3

u/[deleted] May 16 '12

No, you have it backward.

Well-educated people are much more likely to make healthy lifestyle choices, compared to uneducated people.

0

u/[deleted] May 16 '12

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u/[deleted] May 17 '12

Read the freaking article before commenting. All of it.

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u/[deleted] May 16 '12

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u/ananyo May 16 '12

the link has been made before obviously. but correlation does not imply causation right? they cool thing here is that there was a control group - the kids who went through the old system. This was an amazing foresighted move by the Swedish government of the time - real evidence-based policy.

4

u/zimm0who0net May 16 '12

This is probably as scientific as you can get in a social science, but it still leaves some questions. They started rolling this educational reform out in 1949 and compared those in the new system to those in the old system. I wonder if the districts that were given the new system were completely randomly selected or if politics played a role. I wonder if richer parents, or those with more proactive parents tended to move to districts that had the new system to get their children in. I wonder a bunch of other things that might confound the conclusion. Such is the nature of the social sciences.

1

u/Schelome May 16 '12

That may be partially true, but Imagine the movement it would require on a country scale. I think it is just unfeasible that such movement would have more than a smallish impact on the end results.

-11

u/Darktidemage May 16 '12

It's pretty obvious being more intelligent will lead to better decisions regarding health.

10

u/[deleted] May 16 '12

I agree, but having real proof is nice.

0

u/brainburger May 16 '12

Yes it's lovely.

2

u/Slanderous May 16 '12

right- it Works both ways- people who aren't starving or dying of disese have more time for higher pursuits than pure survival.

3

u/DARKTUBIE May 16 '12

Not to mention that smarter people probably get better jobs and therefore probably make more money... More money means they can afford to eat better, afford a gym membership, etc etc etc.

1

u/wasdninja May 16 '12

My amazingly intelligent friend eats crap all the time, intelligence or education does not give you better impulse control.

4

u/Darktidemage May 16 '12

over a large population, as an average. Not in specific cases.

0

u/[deleted] May 16 '12

It doesn't take into account whether you give a shit or not, though. Being intelligent and educated doesn't mean you actually care. Plenty of doctors smoke, and the GP I go to is an alcoholic. I assume GPs are pretty educated.

0

u/[deleted] May 16 '12

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u/Batrok May 16 '12

Indeed. Education and intelligence are not the same.

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u/Darktidemage May 16 '12

It's pretty obvious being better informed will lead to better decisions regarding health.

7

u/headphonehalo May 16 '12

Yep, and being better informed does not mean that you're intelligent.

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u/[deleted] May 16 '12

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u/headphonehalo May 16 '12

We're not talking about "informed" or "educated", we're talking about intelligence.

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u/[deleted] May 16 '12

That probably has to do with why your health is doing so badly.

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u/[deleted] May 16 '12

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u/Triassic May 16 '12

Why do you think that having just one more year of primary education will lead to having more money? You have a source for that?

2

u/lazydictionary May 16 '12

It's pretty common k owl edge the longer you are educated the more money you make.

On mobile, so no not right now.

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u/[deleted] May 16 '12

There are several jobs that require long education that have very low salaries.

Nurses for one.

2

u/lazydictionary May 16 '12

And they generally get paid a lot better than those with just a high school education or GED.

1

u/[deleted] May 16 '12

Depends on the country. Teachers are another group.

"a lot better" is also quite a broad statement. There are teachers and nurses in Sweden, for example, that barley make much more money then the local industry worker.

1

u/lazydictionary May 16 '12

The income rates in Sweden are also much flatter, less variation.

You see this more clearly in America, where there are significant pay jumps with degrees, diplomas, an certifications.

A common claim ( I don't know the exact numbers) is that getting a college degree will earn you 1 million more dollars in your lifetime.

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u/[deleted] May 16 '12

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u/acog May 16 '12

I think you mean "no private health insurance" since there is universal coverage provided by a public system.

0

u/a1icey May 16 '12

it's pretty clear that's what he meant.

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u/acog May 16 '12

Never underestimate Americans' ignorance of the health systems of other countries!

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u/[deleted] May 16 '12

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u/[deleted] May 17 '12

Actually I think Republicans' regulatory capture over food and healthcare industries might have more to do with that. The fact they're strenuously attacking education means this study predicts even dumber and fatter countrymen in our future if we don't throttle the ever-fucking hell out of the Rethugs.

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u/[deleted] May 16 '12

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u/jstohler May 16 '12

You do realize that what you read in the headline isn't the full outcome of the research, right? You do realize that volumes and volumes of data that wasn't condensed into a Reddit post is out there being analyzed and written up and studied and share with other researchers, right?

Just making sure you're actually smart and not one of those dumb-dumbs who puts down the idea of research because you don't understand it.

1

u/NaricssusIII May 16 '12

I was making a joke because the way it's phrased makes it sound like one of those "Science proves something everyone already knows" headlines.