Better health, but growing social and health inequalities among young adults in Germany due to educational expansion? A counterfactual mediation analysis

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-09-19 DOI:10.1016/j.socscimed.2025.118604

Stefanie Sperlich, Batoul Safieddine, Johannes Beller

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引用次数: 0

Abstract

Purpose

Based on theoretical and empirical work on the significance of school education for health, this study examines the influence of educational expansion on self-rated health (SRH) and the development of social and health inequalities between educational groups among young adults in Germany.

Methods

We used data from the German Socio-Economic Panel study from 1995 to 2020, focusing on individuals aged 25–39 years. Health was measured using the single item ‘self-rated health’. Social inequalities between educational groups were examined in terms of professional position, unemployment rates and household income. Logistic regression analyses were applied to examine health trends. The Relative and Slope Index of Inequality (RII/SII) were calculated to examine the development of social and health inequalities. The influence of school education, professional position, unemployment rates and income on the health trends was analysed using causal mediation analysis.

Results

We found a beneficial effect of educational expansion on SRH of young adults. At the same time, social and health inequalities have increased between educational groups in terms of relative and absolute measures of inequalities. The deterioration in health of young adults with low education could be partly explained by the increase in low-skilled jobs and low incomes.

Conclusions

Our findings suggest that a high educational attainment is becoming increasingly important for success in the labor market and good SRH. Young adults with a low level of education are becoming a smaller but increasingly vulnerable group, which poses challenges for future prevention.

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更好的健康状况，但由于教育扩张，德国年轻人的社会和健康不平等日益加剧？反事实调解分析

目的基于学校教育对健康重要性的理论和实证研究，本研究探讨了教育扩张对德国青年自评健康（SRH）的影响以及教育群体之间社会和健康不平等的发展。方法：我们使用了1995年至2020年德国社会经济小组研究的数据，重点关注25-39岁的个体。健康是用单项“自评健康”来衡量的。从专业职位、失业率和家庭收入方面考察了教育群体之间的社会不平等。采用Logistic回归分析检验健康趋势。计算不平等的相对指数和斜率指数（RII/SII）来检查社会和健康不平等的发展。采用因果中介分析，分析学校教育、专业职位、失业率和收入对健康趋势的影响。结果教育扩展对青壮年性健康有显著的促进作用。与此同时，就不平等的相对和绝对衡量标准而言，教育群体之间的社会和保健不平等有所增加。受教育程度低的年轻人健康状况恶化的部分原因可能是低技能工作和低收入的增加。结论我们的研究结果表明，高教育程度对劳动力市场的成功和良好的健康状况变得越来越重要。受教育程度低的年轻人正在成为一个规模较小但日益脆弱的群体，这对未来的预防构成了挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.