Sharecare Community Well-Being Index Identifies Education as Key Predictor of Health and Well-Being

Health and well-being aren’t limited to the absence or presence of disease.[1] Factors such as access to health care, income level and job security as well as having a safe and secure home all play a role in shaping people’s overall well-being over the course of their lives.  

Based on two generations of social determinants of health indices, Sharecare has found that education, historically known as “the great equalizer,” is actually creating more of a divide in the United States. 

Education’s power to ensure that all children can learn, develop and thrive is waning but not because it’s less important. In fact, education actually carries some of the greatest weight when it comes to Americans’ ability to achieve well-being, including how highly differing levels of education influence everything from healthcare access to physical inactivity. School closures during the pandemic and limited access to learning among minority and low-income populations have underscored the growing educational gap in the United States, according to global management consulting firm, McKinsey & Company.

“The impact of education on health outcomes has been proven as one of the most critical predictors of mortality and quality of life,” says Elizabeth Colyer, SVP of Sharecare’s Community Well-Being Index.

“Combining financial hardships with school closures and migration to virtual schooling broadly, we anticipate an even larger divide in education levels, nationally and globally, lending to a clear divide in health and otherwise outcomes for our next generation workforce.” 

COVID-19 highlights educational disparities

The COVID-19 pandemic forced schools across the United States to close abruptly in the spring of 2020, affecting at least 55.1 million students attending 124,000 public and private schools. Amid the ongoing pandemic, state leaders and school boards throughout the country are grappling with the decision to re-open schools in the fall of 2020 or continue with virtual, or online learning. The pandemic is primarily a health issue, but the fallout of prolonged school closures and social isolation have far reaching effects, particularly for minority children and those in low-income communities, as these students are much less likely to have access to private tutors and care, according to the Centers for Disease Control and Prevention (CDC). On the other hand, these children are much more likely to rely on critical school-supported resources, such as lunch and after school programs, special education services and counseling, the CDC points out.

Given the significance of educational factors when it comes to individual and community well-being, Sharecare’s social determiants indices suggest the impact of COVID-19 could be particularly dire for students living in areas where educational attainment is already low.  

Education influences long-term well-being  

Sharecare’s social determiants indices are designed to provide new insights on the impact that people’s environment—where they live, learn, work, and play—has on their long-term health and well-being.

Derived from more than 600 elements of social determinants of health data, one of the most critical factors included in the first-generation index is education, including educational attributes across educational status, student-teacher ratios, and private school enrollment. 

Data collected across the Community Well-Being Index (CWBI)—a combined measure that includes individual risk factors like diabetes, smoking, and lifestyle, and community risk factors, such as income and food security—found that education levels carry significant relationships with other social determinant and individual well-being factors. More specifically, higher education level was associated with the following:  

  • Access to quality healthcare. State-level education data from CWBI found that graduate degrees coincides with critical healthcare resources, such as general physicians and specialists, including pediatritians and OBGYNs per capita. 
  • Financial security. The CWBI found a strong relationship between education and wealth levels, including median household income, home-value-to-income ratios, labor force participation, and economic stability. 
  • Increased physical activity. The percentage of individuals with a college degree in a given state also coincides closely with higher levels of physical inactivity, the CWBI shows. For example, Mississippi had the highest levels of physical inactivity (31.5%) and the 2nd lowest percentage of residents with college degrees (13.4%) across all 50 states. 
  • Overall well-being. percentage of individuals with a college degree in a given state also coincides closely with greater overall well-being, expanding the relationship between higher education and lower levels of disease burden, more financial resilience and strong social ties and community connections.

Education: an investment in the future

As the pandemic wears on, small clusters of families are pooling resources to hire private tutors. An opinion piece from USA Today points out this not only help some kids learn more than their less privileged peers but also drains precious resources from local school systems.

“By hiring teachers from public schools and trained staff from after-school programs and non-profit organizations, pods siphon away community resources where they’re needed most. In California, where the pod movement has taken off, 90% of children in after-school programs are students of color and 84% are low income.”[2]

It’s important to note that California ranks in the middle of the pack, or 26th out of 50 states, for the Education domain according to Sharecare’s first-generation social determinant index. While this index does not directly address resources for low-income students, under-funding these programs could lead to lower educational attainment over time, which our data verifies is associated with positive health and wellbeing outcomes.

Access to quality education is a significant factor that helps predict children’s employment and income later in life. In turn, this may also determine where they live, if they have adequate healthcare and a safe environment in which to thrive, according to the U.S. Department of Health and Human Services

More education typically leads to jobs with higher incomes, which can help clear obstacles to good health that are associated with lower income, such as reduced access to healthier foods, green recreational spaces, quality schools, and homes in neighborhood with lower crime rates, according to the American Academy of Family Physicians (AAFP). 

In 2000 alone, approximately 245,000 deaths were attributable to low education, according to research from Sandro Galea, MD, DrPH, MPH, dean of Boston University School of Public Health.[3]

In his book WELL, Dr. Galea expands upon the importance of education, stating, “It is education that has perhaps the greatest effect on our health trajectory through the years. In 2006, a 25-year-old man without a high school diploma could expect to live more than 9 years less than a 25-year-old-man with a bachelor’s degree or higher; this life expectancy gap was more than 8 years for women. The health risks of low education have even been compared, in terms of mortality, to the dangers posed by smoking.”

In short, education is a key that unlocks doors, which can lead to better health outcomes and greater overall well-being.

“If education is intended to be the great equalizer, the Sharecare Community Well-Being Index would indicate we are falling short of the premise in the United States,” Colyer says. “Whether it be classroom size or ability to achieve higher education, there is a stark difference in access to quality education across geographies and demographics that is only becoming more profound during COVID-19, and only time will tell how this manifests into outcomes across productivity, economic security, and overall well-being.” 

[1] https://www.who.int/about/who-we-are/constitution#:~:text=Health%20is%20a%20state%20of,belief%2C%20economic%20or%20social%20condition.

[2] https://www.usatoday.com/story/opinion/voices/2020/08/15/coronavirus-covid-19-education-inequality-pandemic-pod-parents-column/3372309001/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134519/