Associations of schooling type, qualification type, and subsequent health in mid-adulthood: Evidence from the 1970 British Cohort Study

Background Education is thought to benefit subsequent health. However, existing studies have predominantly focused on educational attainment while the type of educational institution attended has been overlooked, despite being important indictors of education resource, quality, and influencing subsequent socioeconomic outcomes. In this study, we investigated associations between type of high school or university attended and multiple subsequent health outcomes in mid-adulthood. Methods Data from the 1970 British Cohort Study were used (N=8 107). Type of high school attended (comprehensive; grammar; private) was ascertained at age 16 and type of university (classified as higher (Russell Group) or normal-status) was reported at age 42. We investigated ten health measures that capture cardiometabolic risks, physical capabilities, and cognitive function measured at age 46. Multivariable regression models were used, adjusting for sex and childhood socioeconomic, health and cognitive factors. Results In unadjusted models, private school and higher-status university attendance were favourably associated with most health outcomes. After adjusting for potential confounders, associations between private school attendance and cardiometabolic risks remained; associations for higher-status university attendance and cognitive function remained, while the association with other health outcomes were largely attenuated. For example, private school attendance was associated with 0.14 standard deviation (SD) (95% confidence interval (CI): 0.04, 0.23) lower body mass index (BMI) while higher-status university attendance was associated with a 0.16 SD (0.07, 0.26) better performance in memory (word list recall task) compared with normal-status university attendance. Conclusions The type of educational institution attended was associated with multiple health outcomes—it could therefore be an important under-researched component of health inequalities. Further research is warranted to test the causal nature of this relationship and its generalisability to more recently born cohorts given changes in secondary education and the expansion of higher education.