Understanding Impact of Education on Health: A Processual Solution to an Enigma-Insights from India

Health is considered as a critical input for long term economic growth of a population. Education has been identified as the most important variable impacting health indices including mortality. Despite considerable research in attempting to understand the role of education in improving health indices, the mechanisms through which it influences health seeking behaviour in individuals is still a subject of intense debate. Consequently, considerable resources are continuing to be spent on education and health literacy without achieving the desired impact. Two questions arise — how does education impact health behaviour and how education should should be operationalised. This paper is an attempt to find answers to these questions. It is based on a study of secondary data collated from national health surveys in India. The study shows that populations with poor or nil formal literacy rates show equivalent or even better health indices. These target populations were seen to have better attitudes towards health seeking behaviours and also were having better access to health interventions. This is visible in terms of better utilisation of such interventions. It is also seen that specific awareness indicators representing specific knowledge leading to specific desired health behaviour impact the utilisation of corresponding health interventions. General awareness indicators such as formal education or literacy levels have greater impact on distal aggregate health indicators in a population. Thus the paper posits that Health awareness is crucial for actual utilisation of interventions in populations, but they require access to these interventions if impact on indices is to be achieved. Health awareness needs to be measured not only in terms of general indicators such as formal schooling or education but also in terms of specific awareness indicators in a population to understand the impact of health education messages. Crucially measurement of intervening variables is critical to understanding of impact of health education messages. This has immense policy implications in health care, both in terms of content of message and emphasis on education and specific health behaviour campaigns. It also crucially changes the mechanism of evaluation of health behaviour interventions.