In all the studies that have analyzed the relationship between health, life expectancy and socioeconomic factors, there is a clear trend: the higher the socioeconomic level, the better health and greater longevity. This relationship is known as the “social gradient in health.” Understanding the extent to which education, occupation, and income affect our physical well-being and longevity and how they interact with each other is important, but also complex. Do we really know to what extent and how all our socioeconomic circumstances influence our behavior and lifestyle?

Many of the studies on the socioeconomic gradient related to health use these determinants interchangeably. But they are not the same: education, social class, material deprivation and income influence our lifestyle and, therefore, our health in a different way.

The importance of clearly distinguishing these factors lies in their nature and particular impact . Income reflects material resources for health , while social class (measured by job occupation) reflects not only economic ability, but the person’s position in the social hierarchy.

Both are related to agents such as material resources, the availability of free time and the work environment, and can vary throughout life .

Education is the most stable factor

Educational level is an especially important determinant. In addition to providing job opportunities, it allows you to be better informed, improves critical thinking and increases the willingness to trust science  and medical advice .

It stands out among all socioeconomic factors for two main reasons: it is an aspect that we can directly influence and it is characterized by its stability. Not only does it influence income and type of work, but, in certain situations, it can also boost social mobility. This happens especially in countries with free and accessible public education systems for all levels, providing a sense of capacity and autonomy to the entire population.

Social gradient, behaviors and lifestyle

Some behaviors increase the risk of dying from cardiovascular disease, cancer, diabetes, or respiratory diseases. We know that tobacco is responsible for more than 7.2 million deaths a year worldwide, while physical inactivity, poor diet or alcohol consumption cause around 1.6, 4.1 and 3.3 million deaths annually, respectively .

These behaviors usually add to each other, and the adverse effect of their combination is worse and increases the prevalence of the main causes of death, such as cancer or cardiovascular diseases .

In the Spanish population there is a social gradient in lifestyle: people with socioeconomic difficulties have a greater number of behaviors that are harmful to health .

The population with a good educational level shows healthier habits, regardless of their social class . That is: people who have a good level of education, even if they are unemployed or have low income, have a better lifestyle.

Thus, education corrects the effect of social class on health: having a good level of education is related to behavioral profiles where the combination of negative health behaviors is less likely, even in people of low social class .

What can be done from public policies?

All people need a series of basic elements to have good health. These are access to adequate food, decent housing, adequate health care services, enjoying free time and social relationships… and also to quality, universal and accessible education at all levels.

The set of personal skills and abilities that education provides extends beyond occupation and income, promoting health through personal empowerment and encouraging healthy behaviors. Thus, education is an essential element to improve public health.

Educate not only to work

According to the OECD, Spain has the highest proportion of overqualified labor (40.7%), and young people take between 6.5 and 9 years to adapt their educational level to labor needs . For this reason, there are people who argue that the educational system is not “profitable.”

The profitability of education cannot be quantified using labor market access data alone. The non-material assets of education also have a profound effect on our well-being, on our health and on public health spending, and throughout our lives .

Promoting well-being is not only about increasing access to material goods or improving income: these are basic aspects that should be adequately guaranteed to the entire population, but by themselves they do not guarantee better health .

Public education and welfare

Investment in education is not a waste, because it contributes to the reduction of health inequalities at different stages of life (such as during those years of mismatch between educational level and job occupation, or during periods of job instability that , unfortunately, were quite common in the last decade).

Access to good public education is a key element for well-being. It guarantees dignity and sufficient training for all people to make better decisions related to their health, regardless of their social position, and contributes to equity by creating better social conditions for health.

Author Bios: Jesus Garcia Mayor is a Doctor in Physical Activity and Sports Sciences at the University of Murcia, Antonio Moreno Llamas has a PhD at University of the Basque Country / Euskal Herriko Unibertsitatea and Ernesto De la Cruz Sánchez is a Professor also at the University of Murcia