Does Further Education in Adulthood Improve Physical and Mental Health among Australian Women? A Longitudinal Study

OBJECTIVE We analyzed whether further education in young adult and mid-life [adult educational mobility] influences physical functioning and depressive symptoms in women. METHODS 14247 women born 1973-78 (younger cohort) and 13715 women born 1946-51 (mid-aged cohort) from the Australian Longitudinal Study on Women's Health were followed for 14-16 years. Measures were the Short-Form 36 Health Survey physical functioning subscale (SF-36 PF) and Centre for Epidemiologic Studies 10-item Depression Scale (CESD-10). Linear mixed modelling, accounting for time varying covariates, assessed the influence of further education on physical functioning and depressive symptoms over time. Sensitivity analysis to assess the impact of missing data was conducted using multiple imputation. RESULTS Compared to younger women with a pre-existing high level of education, women gaining further education (up to age 39 years) from low levels had lower SF-36 PF scores (poorer physical functioning) (fully adjusted beta estimates (95%CIs) -1.52 (-2.59, -0.44)) while those gaining further education from middle to high levels showed equivalent SF-36 PF scores (-0.08 (-0.61, 0.44)). A similar pattern was shown for CESD-10 scores (0.78 (0.29, 1.25); -0.02 (-0.26, 0.21), respectively) where higher scores represented more depressive symptoms. For mid-age women, further education from a middle to high level resulted in equivalent SF-36 PF scores (-0.61 (-1.93,0.71)) but higher CESD-10 scores (0.49 (0.11, 0.86)), compared to highly educated women. CONCLUSION Women who delay further education until they are aged between their 40s and 60s can improve or maintain their physical functioning but may have missed the critical time to minimise depressive symptomatology. Public health policy should focus on encouraging women to upgrade their educational qualifications earlier in life in order to potentially offset the negative associations between their initial lower socio-economic position class of origin and their mental health.