Key result
Low public school expenditure at birth linked to ~7.5 mg/dL higher non-HDL-C in young adulthood.
Why the study?
Area-level investment in education may influence individual health, but whether county-level public school expenditure around birth associates with cardiovascular health in young adulthood is unknown.
Does county-level public school expenditure per student around time of birth improve cardiovascular health in young adulthood?
Cohort (n=1,089)
Does county-level public school expenditure per student around time of birth improve cardiovascular health in young adulthood?
Effect estimate: 7.5 mg/dL higher non-HDL-C (95% CI 2.9, 12.0)
Lower county-level school expenditure around the time of birth is associated with worse cardiovascular health factors, such as higher non-HDL cholesterol, in young adulthood.
Birth in low-expenditure counties was associated with higher non-HDL-C; hypothesis-generating for early-life economic influences on adult lipids.
Area-level investment in education may influence individual health. We evaluated whether county-level public school expenditure per student around time of birth was associated with cardiovascular health (CVH) in young adulthood. Among Future of Families and Child Wellbeing Study participants enrolled at birth and followed through year 22, we used multivariable linear regression to evaluate the associations of annual school expenditure per student in the county of residence at birth (low: z-score ≤-0.5; intermediate: z-score -0.5 to 0.5; high: z-score ≥0.5) with cardiovascular risk factors and Life’s Essential 8 (LE8) scores at year 22, adjusting for sociodemographic characteristics. Among 1,089 participants (54% female), annual county-level expenditure per student was: low, $4,020-6,245; intermediate, $6,317-7,392; high, $7,561-9,902. By year 22, 9% of participants graduated college, 41% had some college education, and 39% graduated high school; mean LE8 score was 69 (SD 14). Compared with living in a high expenditure county at birth, living in a low expenditure county was associated with 7.5 mg/dL higher non-HDL-C (95% CI 2.9, 12.0) and 3.4-point lower LE8 cholesterol score (95% CI -6.6, -0.23) in young adulthood; and living in an intermediate expenditure county was associated with a 2.3-point lower LE8 glucose score in young adulthood (95% CI -4.6, -0.04). There was no significant difference in overall LE8 score. Living in a county with lower school expenditure per student around time of birth was associated some worse CVH factors in young adulthood. County-level school expenditure is likely a reflection of a county’s socioeconomic standing. Policies that increase funding for children’s education may improve CVH in young adulthood.
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Ardehali et al. (2026) conducted a cohort in Cardiovascular health (n=1,089). Low county-level public school expenditure per student at birth vs. High county-level public school expenditure per student at birth was evaluated on Cardiovascular risk factors and Life's Essential 8 (LE8) scores at year 22 (7.5 mg/dL higher non-HDL-C, 95% CI 2.9, 12.0). Living in a county with low public school expenditure at birth was associated with 7.5 mg/dL higher non-HDL-C (95% CI 2.9-12.0) in young adulthood compared to high expenditure counties.
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