The Expansion of Higher Education and the Education-Health Gradient in the United States

The United States experienced a period of rapid higher education expansion between the mid-1940s and mid-1970s. Although this expansion likely improved the health of people able to take advantage of new education opportunities, expansion may have also intensified health inequalities between college-educated and non-college-educated people (1) through the compositional change in the relative (dis)advantage of these groups, (2) through the displacement of non-college-educated people in a more competitive post-expansion labor market, and (3) by increasing health returns to a college degree. Our analyses, rooted in a counterfactual perspective, draw on data from the Health and Retirement Study that spans birth cohorts who came of age before and after the period of expansion, allowing us to differentiate people who earned a degree because of expansion but would not otherwise (conditional-earners) from people who would or would not have earned a degree regardless of expansion (always-earners and never-earners, respectively). Comparing changes in the health of these three groups before and after education expansion permits us to individually evaluate how compositional change, displacement, and increasing returns to education exacerbated health inequalities. Our findings suggest that education expansion improved the health of conditional-earners and magnified health inequalities through the mechanism of displacement.