Education is widely associated with better physical and mental health, but isolating its causal effect is difficult because education is linked with many socioeconomic advantages. One way to isolate education’s effect is to consider environments where similar students are assigned to different educational experiences based on objective criteria. Here we measure the health effects of assignment to selective schooling based on test score, a widely debated educational policy. In 1960s Britain, children were assigned to secondary schools via a test taken at age 11. We used regression discontinuity analysis to measure health differences in 5039 people who were separated into selective and non-selective schools this way. We measured selective schooling’s effect on six outcomes: mid-life self-reports of health, mental health, and life limitation due to health, as well as chronic disease burden derived from hospital records in mid-life and later life, and the likelihood of dying prematurely. The analysis plan was accepted as a registered report while we were blind to the health outcome data. Effect estimates for selective schooling were as follows: self-reported health, 0.1 worse on a 4-point scale (95%CI − 0.2 to 0); mental health, 0.2 worse on a 16-point scale (− 0.5 to 0.1); likelihood of life limitation due to health, 5 percentage points higher (− 1 to 10); mid-life chronic disease diagnoses, 3 fewer/100 people (− 9 to + 4); late-life chronic disease diagnoses, 9 more/100 people (− 3 to + 20); and risk of dying before age 60, no difference (− 2 to 3 percentage points). Extensive sensitivity analyses gave estimates consistent with these results. In summary, effects ranged from 0.10–0.15 standard deviations worse for self-reported health, and from 0.02 standard deviations better to 0.07 worse for records-derived health. However, they were too imprecise to allow the conclusion that selective schooling was detrimental. We found that people who attended selective secondary school had more advantaged economic backgrounds, higher IQs, higher likelihood of getting a university degree, and better health. However, we did not find that selective schooling itself improved health. This lack of a positive influence of selective secondary schooling on health was consistent despite varying a wide range of model assumptions.

中文翻译：

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就读精英学校的长期健康影响：一项自然实验。

教育与更好的身心健康广泛相关，但很难分离出其因果效应，因为教育与许多社会经济优势相关。隔离教育影响的一种方法是考虑根据客观标准将相似的学生分配到不同的教育经历的环境。在这里，我们根据考试成绩来衡量分配到选择性学校教育对健康的影响，这是一项引起广泛争议的教育政策。在 20 世纪 60 年代的英国，孩子们在 11 岁时通过考试被分配到中学。我们使用断点回归分析来测量 5039 名通过这种方式分为精英学校和非精英学校的人的健康差异。我们衡量了选择性教育对六种结果的影响：中年健康自我报告、心理健康和健康造成的寿命限制，以及中年和晚年医院记录中得出的慢性疾病负担，以及患上慢性疾病的可能性。过早地死去。分析计划被接受为注册报告，而我们对健康结果数据却视而不见。选择性教育的效果估计如下：自我报告的健康状况，4 点量表上较差 0.1（95%CI - 0.2 至 0）；心理健康状况，16 分制中较差 0.2（− 0.5 至 0.1）；由于健康原因导致生命有限的可能性高出 5 个百分点（− 1 至 10）；中年慢性病诊断，每 100 人减少 3 人（− 9 至 + 4）；晚年慢性病诊断，每 100 人中有 9 人以上（− 3 至 + 20）；和 60 岁之前死亡的风险，没有差异（−2 至 3 个百分点）。广泛的敏感性分析给出了与这些结果一致的估计。总之，对于自我报告的健康状况，影响范围为较差 0.10-0.15 个标准差，对于记录衍生的健康状况，影响范围为较好 0.02 个标准差到较差 0.07 个标准差。然而，他们过于不精确，无法得出选择性教育有害的结论。我们发现，就读精英中学的人拥有更优越的经济背景、更高的智商、更高的获得大学学位的可能性以及更好的健康状况。然而，我们并没有发现选择性教育本身可以改善健康。尽管模型假设存在很大差异，但选择性中学教育对健康缺乏积极影响的情况是一致的。