Educational attainment, deprivation-affluence and self reported health in Britain: a cross sectional study

Study objective-The level of material deprivation or affluence is strongly and independently correlated with all cause mortality at an area level, but educational attainment, after controlling for deprivation-affluence, remai ns strongly associated with coronary and infant mortality. This study inves tigated whether these relations hold at an individual level with self repor ted morbidity. Design-Analysis of the cross sectional associations of self reported longst anding illness and "not good" or "fairly good" self assessed health with in dividual educational attainment in seven levels, adjusting for deprivation measures (economic status of head of household, car ownership, housing tenu re, overcrowding). Setting-The 1993 General Household Survey, a random sample of households in Great Britain. Participants-11 634 subjects aged 22 to 69. Main results-After adjusting for household deprivation, lower educational a ttainment was significantly associated with longstanding illness in men (od ds ratio 1.05 per education category, 95% CI 1.02 to 1.08), but not in wome n (odds ratio 1.01, 95% CI 0.98 to 1.04). The associations with "not good" or "fairly good" self assessed health were stronger and significant in both men and women (men 1.13, 95% CI 1.10 to 1.17; women 1.10, 95% CI 1.07 to 1 .14). The findings were little changed by allowing for people in poor healt h becoming economically inactive. Conclusions-The associations of self reported health with deprivation-afflu ence are stronger than with educational attainment. However, educational at tainment is associated with self assessed health in adulthood, independentl y of deprivation-affluence. Longstanding illness may be associated with edu cational attainment in men only. Educational attainment may be a marker for childhood socioeconomic circumstances, its association with health may res ult from occupational characteristics, or education may influence the prope nsity to follow health education advice.