title: A meta-analysis of education effects on chronic disease: the causal dynamics of the Population Education Transition Curve.
abstract: As the Epidemiological Transition progresses worldwide, chronic diseases account for the majority of deaths in developed countries and a rising proportion in developing countries indicating a new global pattern of mortality and health challenges into the future. Attainment of formal education is widely reported to have a negative gradient with risk factors and onset of chronic disease, yet there has not been a formal assessment of this research. A random-effects meta-analysis finds that across 414 published effects more education significantly reduces the likelihood of chronic disease, except for neoplastic diseases with substantial genetic causes. Some studies, however, report null effects and other research on infectious disease report positive education gradients. Instead of assuming these contradictory results are spurious, it is suggested that they are part of a predictable systemic interaction between multiple mediating effects of education and the Epidemiological Transition stage of the population; and thus represent one case of the Population Education Transition Curve modeling changes in the association between education and health as dependent on population context.
authors.affiliation: The Pennsylvania State University, Education Theory and Policy, 300 Rackley Building, University Park, PA 16802, USA; Higher School of Economics, Institute of Education, Moscow 101000, Russia. Electronic address: wcs152@psu.edu.
authors.forename: William C
authors.initials: WC
authors.lastname: Smith
authors.affiliation: The Pennsylvania State University, Education Theory and Policy, 300 Rackley Building, University Park, PA 16802, USA. Electronic address: ewa111@psu.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Anderson
authors.affiliation: The Pennsylvania State University, Education Theory and Policy, 300 Rackley Building, University Park, PA 16802, USA; Organization for Economic Co-operation and Development, Paris 75116, France. Electronic address: drs347@psu.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Salinas
authors.affiliation: The Pennsylvania State University, Education Theory and Policy, 300 Rackley Building, University Park, PA 16802, USA. Electronic address: ruh158@psu.edu.
authors.forename: Renata
authors.initials: R
authors.lastname: Horvatek
authors.affiliation: The Pennsylvania State University, Education Theory and Policy, 300 Rackley Building, University Park, PA 16802, USA; The Pennsylvania State University, Population Research Institute, University Park, PA 16802, USA. Electronic address: dpb4@psu.edu.
authors.forename: David P
authors.initials: DP
authors.lastname: Baker
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology*; D004522:Educational Status; D020022:Genetic Predisposition to Disease / Q000453:epidemiology; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008017:Life Expectancy; D008603:Mental Health; D009369:Neoplasms / Q000453:epidemiology; D012307:Risk Factors; D064890:Social Determinants of Health; D012959:Socioeconomic Factors
keywords: Chronic disease; Education; Epidemiological Transition; Heterogeneous effects; Meta analysis; Population Education Transition Curve