A smart way to health?

With a new Governor and a new legislative year, New Yorkers may be able to see some action on issues like education and health care, which combine for an interesting article here.

James Smith, a health economist at the RAND Corporation, has heard a variety of hypotheses about what it takes to live a long life — money, lack of stress, a loving family, lots of friends. But he has been a skeptic.

Yes, he says, it is clear that on average some groups in every society live longer than others. The rich live longer than the poor, whites live longer than blacks in the United States. Longevity, in general, is not evenly distributed in the population. But what, he asks, is cause and what is effect? And how can they be disentangled?

He is venturing, of course, into one of the prevailing mysteries of aging, the persistent differences seen in the life spans of large groups. In every country, there is an average life span for the nation as a whole and there are average life spans for different subsets, based on race, geography, education and even churchgoing.

But the questions for researchers like Dr. Smith are why? And what really matters?

The answers, he and others say, have been a surprise. The one social factor that researchers agree is consistently linked to longer lives in every country where it has been studied is education. It is more important than race; it obliterates any effects of income.

Year after year, in study after study, says Richard Hodes, director of the National Institute on Aging, education “keeps coming up.”

And, health economists say, those factors that are popularly believed to be crucial — money and health insurance, for example, pale in comparison.

Dr. Smith explains: “Giving people more Social Security income, or less for that matter, will not really affect people’s health. It is a good thing to do for other reasons but not for health.”

Health insurance, too, he says, “is vastly overrated in the policy debate.”

Instead, Dr. Smith and others say, what may make the biggest difference is keeping young people in school. A few extra years of school is associated with extra years of life and vastly improved health decades later, in old age