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Education, cognition, health knowledge, and health behavior


Using data from NLSY97, we analyze the impact of education on health behavior. Controlling for health knowledge does not influence the impact of education on health behavior, supporting the productive efficiency hypothesis. Accounting for cognitive ability does not significantly alter the relationship between education and health behavior. Similarly, the impact of education on health behavior is the same between those with and without a learning disability, suggesting that cognition is not likely to be a significant factor in explaining the impact of education on health behavior.

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  1. 1.

    Also, the NLSY97 allows us to employ the number of Months Attended to school by the individual as a measure of education. As explained in more detail in the Data section below, the number of Months Attended to school is measured with a high degree of precision, and it better captures the individual’s exposure to schooling. The conventional measure of education (years of completed schooling) contains substantial measurement error, generated by the timing of the survey, in a sample of young adults who are still in school.

  2. 2.

    Kenkel also runs instrumental variable regressions where health knowledge questions are instrumented with whether the individual received advice from a physician on lifestyle-related topics and for smoking, years of schooling completed after 1964 (the year of surgeon general’s report on smoking), as well as indicator variables for occupation and industry and whether the person is employed in a health field. He obtains results similar to OLS (with larger standard errors) and concludes that the OLS results are not biased because of endogeneity.

  3. 3.

    It is plausible that the ASVAB score is not a reliable indicator of cognitive ability. For example, Heckman et al. [18] and Hansen et al. [17] stress that a person's schooling and family background at the time tests are taken affect test scores. Although we control for some family background characteristics in the regressions reported in Table 5, it is likely that important family attributes are omitted.

  4. 4.

    We also run specifications that entertain nonlinear effect of cognition [19]. In almost all specifications the quadratic term of cognition was insignificant, and these specifications provided the same results as those with linear cognition.


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We thank three anonymous referees for helpful comments and suggestions, and Deokrye Baek and Luiza Pogorelova for research assistance.

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Correspondence to Duha T. Altindag.

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Mocan, N., Altindag, D.T. Education, cognition, health knowledge, and health behavior. Eur J Health Econ 15, 265–279 (2014).

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  • Health inputs
  • Cognition
  • Learning
  • Productive efficiency

JEL Classification

  • I12
  • I20