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4704.0 - The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, Oct 2010  
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Contents >> Education >> Links between education and health

05/04/2013 Note: 2002 and 2008 NATSISS alcohol data by risk level have been revised. For more information, see the Information Paper (Catalogue No. 4714.0.55.005).


EDUCATION AND HEALTH: LINKS BETWEEN EDUCATION AND HEALTH
This article is part of a comprehensive series released as The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples.



KEY MESSAGES

Higher levels of educational attainment are associated with improved health outcomes:
  • In 2008, 59% of Aboriginal and Torres Strait Islander people aged 15–34 years who had completed Year 12 reported excellent/very good health compared with 49% of those who had left school early (Year 9 or below). For people aged 35 years and over, the rates were 43% and 25% respectively.
  • The likelihood of smoking also decreased with higher levels of schooling, 34% of Aboriginal and Torres Strait Islander people aged 15–34 years who had completed Year 12 were current daily smokers compared with 68% of those who had left school early. For people aged 35 years and over, the rates were 36% and 48% respectively.

Education can influence health through a range of complex mechanisms like income and access to health care, and participation in the labour market (employment) (Endnote 1). Educational attainment can be associated with developing information and cognitive skills, choices, and participation in social networks (Endnote 1). Education has also been found to be strongly linked to determinants of health such as risky health behaviours and preventative service use (Endnote 2).

Despite a growing body of research that suggests a correlation between education and health, the relationship is far from straightforward – there is no consensus on, and quite limited research into establishing a causal link between the two. Besides, research suggests that education acts in close relation with other factors (like employment), and not in isolation.

This topic explores the relationship between selected health measures and educational attainment for Aboriginal and Torres Strait Islander people aged 15 years and over, using results from 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). Topics presented include:
It is important to note that the links between educational attainment and health outcomes are complex and difficult to measure in social surveys. Whereas NATSISS data can offer insights into the association between school completion and health, and non-school qualifications and health, they cannot be used to determine causality.


EDUCATIONAL ATTAINMENT AND HEALTH

Both educational attainment and health are strongly related to age, meaning that younger people are much more likely than older people to be better educated and in good health. For example, in 2008, Aboriginal and Torres Strait Islander people in the 15–34 year age group were more likely to have completed Year 12, or to have attained a non-school qualification than those aged 35 years and over, and the proportions reporting excellent/very good health were also higher. The following analysis compares two broad age groups: young adults aged 15–34 years, and older adults aged 35 years and over.

Results from the 2008 NATSISS show that higher levels of schooling were positively associated with health status. Younger Aboriginal and Torres Strait Islander people aged 15–34 years who had completed Year 12 were more likely than those who had left school at Year 9 or below to rate their health as excellent/very good (59% compared with 49%) and were less likely to rate their health as fair or poor (9% compared with 16%) (see table 5.1). Among Aboriginal and Torres Strait Islander people aged 35 years and over, the proportions with excellent/good self-assessed health were 43% and 25% respectively, and with fair/poor health were 23% and 43%.

A similar pattern of association was evident between higher levels of school completion and levels of psychological distress for both broad age groups. When compared with younger Aboriginal and Torres Strait Islander people who had left school at Year 9 or below, those who had completed Year 12 were less likely to have reported high/very high levels of psychological distress in the last four weeks (29% compared with 35%). Among Aboriginal and Torres Strait Islander people aged 35 years and over, the corresponding proportions were 20% and 37% respectively.

The likelihood of engaging in certain health risk behaviours also decreased with higher levels of schooling. Younger Aboriginal and Torres Strait Islander people (aged 15–34 years) who had completed Year 12 were less likely to be current daily smokers than those who had completed Year 9 or below (34% compared with 68%), and were also less likely to have used an illicit substance in the last 12 months (23% compared with 32%).


5.1 SELECTED HEALTH CHARACTERISTICS OF ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE(a), by highest year of school completed—2008

15–34 years
35 years and over

Year 9 or
Year 9 or
Year 12
Year 10/11
below(b)
Total
Year 12
Year 10/11
below(b)
Total

Self-assessed health status
Excellent/very good
%
58.7
50.5
49.2
52.6
42.9
34.3
24.8
31.3
Good
%
(c)32.3
35.0
(c)34.6
34.1
(d)34.6
38.3
(d)31.8
34.8
Fair/Poor
%
8.9
14.5
16.2
13.3
22.6
27.4
43.4
33.9
High/very high psychological distress(e)
%
(c)28.8
31.8
(c)34.5
31.5
19.9
30.2
36.9
31.6
Health risk factors
Current daily smoker
%
33.7
53.2
68.0
50.8
36.1
43.7
47.8
44.4
Long-term risky/high risk alcohol consumption(f)
%
(c)16.9
21.2
(c)22.0
20.1
(d)15.9
17.8
(d)16.7
17.0
Short-term risky/high risk alcohol consumption(f)
%
(c)50.3
42.1
(c)43.9
44.9
(d)31.2
37.9
(d)30.6
33.6
Has used illicit substance(s)(g)
%
22.8
29.3
32.3
28.1
(d)15.1
15.6
(d)14.9
15.2
Persons aged 15 years and over
no.
43 334
83 837
46 540
173 711
23 408
60 644
69 338
153 390

(a) Excludes persons still attending secondary school.
(b) Includes persons who never attended school.
(c) Difference between estimate for Year 12 and Year 9 or below is not statistically significant.
(d) Difference between estimate for Year 12 and Year 9 or below is not statistically significant.
(e) In the four weeks prior to interview.
(f) See Glossary for more information.
(g) In the last 12 months.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey. These estimates are also available for download in the Education datacube.

While results from the 2008 NATSISS show a positive association between health status and higher school completion, there were no strong associations between better self-assessed health status and achievement of non-school qualifications for Aboriginal and Torres Strait Islander people aged 15-34 years. Among people in this age group, similar proportions of those with a Certificate III or above and those without a non-school qualification assessed their health as excellent/very good (54% compared with 55%).

However, among Aboriginal and Torres Strait Islander people aged 35 years and over, there was some association between better self-assessed health and the attainment of non-school qualifications, with higher rates of excellent/very good health for people with a Certificate III or above qualification (39%) than for those without a non-school qualification (27%).
EDUCATIONAL ATTAINMENT, EMPLOYMENT AND HEALTH

Overall, a little over half (53%) of Aboriginal and Torres Strait Islander people aged 15–34 years reported excellent or very good self-assessed health in 2008. This proportion was higher among those who had completed Year 12 (59%) and among those who were employed (58%). When employment was combined with completion of Year 12, the proportion of Aboriginal and Torres Strait Islander people aged 15–34 years who reported excellent/very good health increased to 62% (see chart 5.2). Previous analysis has shown that when relatively high household income (in the third quintile and above) was combined with Year 12 completion and employment, the proportion of Indigenous people aged 15–34 years who reported excellent or very good health also increased (Endnote 3).

Among Aboriginal and Torres Strait Islander people aged 35 years and over, 48% of those who had completed Year 12, and were also employed, reported excellent/very good health, compared with 43% of those who had completed Year 12 and 41% who were employed (see chart 5.3).

SELECTED SOCIOECONOMIC INDICATORS, Aboriginal and Torres Strait Islander people(a)—2008
chart: selected socioeconomic indicators by excellent/very good health and low/moderate psychological distress, Aboriginal and Torres Strait Islander people aged 15–34 years, 2008chart: selected socioeconomic indicators by excellent/very good health and low/moderate psychological distress, Aboriginal and Torres Strait Islander people aged 35 years and over, 2008
(a) Excludes persons still attending secondary school.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey
These estimates are also available for download in the Education datacube.


Based on the modified five-item version of the Kessler Psychological Distress Scale (K5), 67% of Aboriginal and Torres Strait Islander people aged 15–34 years reported low/moderate levels of psychological distress in the four weeks prior to interview. There was a positive correlation between completion of Year 12 and/or employment and low/moderate levels of psychological distress. More than two-thirds of younger Aboriginal and Torres Strait Islander people who had completed Year 12 reported low/moderate levels of psychological distress (70%). When employment was combined with attainment of Year 12, the proportion increased to 73% (see chart 5.2 above). Previous analysis has shown that when relatively high household income (in the third quintile and above) was combined with Year 12 completion and employment, the proportion of Aboriginal and Torres Strait Islander people aged 15–34 years who reported low or moderate levels of psychological distress also increased (Endnote 3).

Among Aboriginal and Torres Strait Islander people aged 35 years and over who had completed Year 12 and were also employed, 85% reported low/moderate levels of psychological distress compared with 79% who had completed Year 12, and 76% who were employed (see chart 5.3 above).
ENDNOTES

1. Cutler, D., Lleras-Muney, A. 2007, 'Education and Health', National Poverty Center, Gerald R. Ford School of Public Policy, University of Michigan.

2. Feinstein, Leon, et al. 2006, 'What are the effects of education on health?', Report on Measuring the Effects of Education and Health and Civic Engagement, Proceedings of the Copenhagen Symposium, OECD, Copenhagen.

3. Australian Bureau of Statistics 2008, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, cat. no. 4704.0, ABS, Canberra. <www.abs.gov.au>

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