教育如何影響晚年健康？台灣義務教育改革的實證研究

Abstract

儘管大量證據顯示教育與健康之間存在密切關聯，但因果關係仍未有定論。 近期研究指出，教育對死亡率的影響可能有限，但其對晚年健康的影響尚未得到 充分探索。我們利用台灣 1968 年推行的九年國民義務教育改革所帶來的外生變 異，分析教育對健康的長期影響。透過使用戶籍資料和全民健保醫療紀錄，並採 用日層級的斷點迴歸分析，我們發現該改革顯著提高了受教育年數。然而，我們 的分析顯示，對於死亡率和各種健康相關結果，包括總住院醫療支出、癌症、心 血管疾病、糖尿病、精神疾病、失智症及健康檢查的使用次數，皆無顯著影響。 此外，我們的研究結果也未顯示這些健康結果在性別上的差異。這些結果顯示中 學階段增加受教育年數對健康的益處可能有限。

While substantial evidence links education and health, the causal relationship remains inconclusive. Recent studies suggest that education may have limited effects on mortal- ity, yet its influence on later-life health is less explored. We investigate the long-term impact of education on health by exploiting the exogenous variation introduced by Tai- wan’s 1968 compulsory education reform. Utilizing household registry data and universal medical records, and employing a day-level regression discontinuity design, we find that the reform significantly increased years of schooling. However, our analysis shows no sig- nificant effects on mortality or various health-related outcomes, including total healthcare spending, outpatient visits for cancer, cardiovascular diseases, diabetes, mental disorders, dementia, and health check-ups. Additionally, our results reveal no gender differences in these health outcomes. These findings suggest that the health benefits of additional schooling at the junior high school level may be limited.