Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

Abstract

Background: Past research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.

Methods: Subjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991-2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018-2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26-31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).

Results: In adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).

Conclusions: Findings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.

Keywords: Academic achievement; Cardiometabolic health; Cardiovascular risk factors; Classroom emotional quality; Classroom instructional quality; Education; Health behaviors; Health disparities; Income; Life course; Social skills; Socioeconomic status (SES); Student-teacher relationship; Study of early child care and Youth Development (SECCYD).

Fig. 1

Results are reported from analyses using hierarchical partitioning to determine the relative contributions of the student social skills indicator and the key explanatory factors

Fig. 2

Results are reported from separate regression models adjusted for socio-demographics, family income-to-needs ratio, and child BMI percentile. The solid arrows represent direct effects between the indicated early educational indicator (student social skills) and the adult CMR composite. The dotted arrows represent the indirect (mediated) effects of this indicator on the adult CMR composite via adult SES (education, income) and adult health behaviors (diet quality, activity level, sleep duration, and smoking status). Results suggest protective effects of student social skills on reduced risk for adult cardiometabolic risk are partially attributable to adult SES (greater income) and adult health behaviors (better diet quality)