More education equals a longer life

Photo: Erik Prozes

A paper published in the British Medical Journal by a team led by Estonian scientist Taavi Tillmann shows that pursuing education directly reduces risk of heart attack.

The results of the study are indeed unexpectedly far-reaching. Using complex gene analysis, the authors demonstrate that 3.6 years of extra education lowers the likelihood of heart disease by no fewer than 33 percent.

While the connection between education and longer life has been known for decades, it is seldom mentioned as a risk factor of heart disease in medical textbooks. At the same time, the dangers of smoking and high cholesterol are almost universally known.

“The subject of education and heart disease has fascinated me for years. We know that education is one of the more important future health indicators, if not the most important one,” author of the paper, doctoral student at University College London Taavi Tillmann (32) said. “For example, men with higher education live eight years longer on average than those with a lower level of education in Estonia. It is an insane difference!”

Even though the first research papers on the connections between education and heart disease were published some 50 years ago, the nature of the connection has largely remained a mystery. Can education really reduce the risk of heart disease, or is it a random connection due to third factors we cannot yet assess?

Ideally, a complicated study that would compare medical histories of two groups of people – those with higher education and those without – where all other factors are random over decades should be carried out to confirm or overturn causal relations. Such a study would be extremely complicated and time-consuming.

Scientists have invented a new method for studying these kinds of phenomena that makes use of randomized gene variation before a child is born. The so-called Mendelian randomization method is used to take gene samples and compare connections between occurrence of gene sections tied to behavioral phenomena and diseases. There was another major problem in studying the connection between education and disease before last year’s study: scientific literature in its entirety provided no clues as to gene markers that could be associated directly with education.

“I knew there was a method; however, literature simply did not have data to suggest specific gene markers could be tied to education,” Tillmann said. The eureka moment dawned during a meeting with Estonian Genome Center scientists.

“A year ago, I attended an unrelated meeting at the genome center where it turned out they were about to publish a paper in Nature in which they describe 162 gene markers that push people to obtain a little more education. I had to jump out of my seat – it was such an important breakthrough!” Tillmann said.

A fundamental research project Estonians were a part of gave way to new, far more applied research.

True, the gene markers described by scientists explain the length of education of only a small part of people – approximately 2 percent – which is why credible data requires masses of data. Tillmann and his colleagues looked at the data of 543,733 men and women and tried to answer the question of whether people with more education-favoring markers, and therefore higher level of education, are less likely to develop heart disease later in life.

The results suggested a connection exists. Because the markers are not connected to other risk factors, like eating habits or physical activity, the paper constitutes a breakthrough as it can now be said with certainty that education translates into a longer life.

“It seems that a low level of education is as important in terms of heart disease as high blood pressure or cholesterol. Doctors and public health experts have been making headway in keeping those two indicators in check for nearly 50 years. Our research adds an entirely new aspect – to avoid heart attacks, we should try and make sure people spend more time in the education system,” Tillmann said.

The exact mechanisms of the connection are far from clear today. Scientists said their results suggested that a lower level of education comes with a higher risk of smoking and obesity. Researchers are still far from exhaustingly explaining education’s effect in reducing heart disease. There is, however, enough grounds for including level of education as a significant factor in public health debates, whether on the level of the individual or larger groups of people.