-- Study one of few to look at maternal and paternal education, finding 
protective effects of both

A new study conducted by researchers at the Institute for Health Metrics and 
Evaluation 
(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00534-1/full
text) (IHME) at the University of Washington School of Medicine and the Centre 
for Global Health Inequalities Research (CHAIN) found significant reductions in 
children's risk of death associated with more years of parental education. 

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According to the study, a single year of maternal education reduced the risk of 
death for children under 5 years of age by 3%, and children born to mothers 
with 12 years of education are more than 30% less likely to die before age 5, 
compared to those born to mothers with zero years of education. Twelve years of 
paternal education reduced the risk of under-5 mortality by 17% compared to no 
years of education. 

"This research is exciting because of the consistency of positive effects of 
education across geographies and time," said Hunter York, the study's lead 
author. "While this evidence isn't causal, it points to a relationship that 
goes beyond the influence of behaviors correlated with lower education, such as 
smoking, or policy interventions which aim to improve child survival regardless 
of parental education level, like free family planning. These are important 
mechanisms affecting the relationship between education and child health, but 
our results suggest a beneficial function of education in and of itself." 

The study authors highlighted the importance of further research on paternal 
education, which has been studied far less than maternal education. 

"Even after controlling for a mother's education, the father's education still 
matters," said Professor Emmanuela Gakidou, one of the senior authors on the 
study. "The majority of studies look only at maternal years of education, but 
it is crucial to understand and analyze the connection between the two, and not 
to discount the contribution of paternal education to child survival." 

Over 300 studies from 92 countries were included in the analysis, capturing 
over three million live births. The researchers found that the protective 
effect of parental schooling strengthened as a child's age increased, but was 
significant for all age groups under 5 years.

    -- For neonates (0-27 days), each additional year of maternal education 
       reduced mortality risk by 1.5%. Each year of paternal education 
       reduced risk by 1.1%. 
    -- For infants (1-11 months), each year of maternal education reduced 
       mortality risk by 3.7%. Each year of paternal education reduced risk 
       by 1.8%. 
    -- For young children (1-4 years), each year of maternal education 
       reduced mortality risk by 4.4%. Each year of paternal education 
       reduced risk by 2.2%. 

The relationship was present across regions and after controlling for wealth or 
income, partner's education level, and the sex of the child. 

"Further reductions in child mortality are needed, and investments in education 
may be key to achieving this," said CHAIN leader Professor Terje Andreas 
Eikemo. "It is time that education is brought onto the international policy 
agenda as a global determinant of child survival." 

Importantly, the study also found that the impact of each additional year of 
education on child survival remained the same for primary, secondary, and 
tertiary education – indicating that a focus on only primary education misses 
opportunities to reduce the number of under-5 deaths and give children the best 
chance of survival.  

"Even across generations, education and health are linked," said Kam Sripada, 
one of the study's lead authors. "Universal access to quality schooling must be 
a priority from the earliest years into higher education, both to support the 
current generation in reaching its potential and to help the next generation 
survive and thrive."

The study was funded by the Norwegian Research Council, the Bill & Melinda 
Gates Foundation, and the Rockefeller Foundation-Boston University Commission 
on Social Determinants, Data, and Decision Making (3-D Commission).

Contact: media@healthdata.org 

About the Institute for Health Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent global 
health research organization at the University of Washington School of Medicine 
that provides rigorous and comparable measurement of the world's most important 
health problems and evaluates the strategies used to address them. IHME is 
committed to transparency and makes this information widely available so that 
policymakers have the evidence they need to make informed decisions on 
allocating resources to improve population health. 

SOURCE  Institute for Health Metrics and Evaluation