(Un)healthy lifestylesEducation as a dividing line

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Health-related behaviour and the education gap

Authors: Stéfanie André, Roza Meuleman and Gerbert Kraaykamp

Here we explore educational differences in health-related behaviour in the Netherlands. We investigate educational dividing lines in relation to smoking, regular alcohol consumption, overweight, consumption of fruit and vegetables and physical activity in the Dutch population in 2014. Educational differences in health-related behaviour could stem from the fact that people with low and high educational levels differ in terms of their health knowledge, financial capacity, working conditions, social networks, cultural lifestyle differences and context; see also Education as a dividing line.

Large educational differences in relation to smoking

Knowledge about the harmful effects of smoking is widespread. Moreover, age restrictions and measures to limit advertising have been in place for a long time in the Netherlands, and smoking is banned at the workplace and in public buildings and spaces. Despite this, there were still a large number of people who reported that they smoked daily in 2014. These (regular) smokers are mainly found among those with a lower and higher secondary education (33.1% and 28.4%, respectively); there are far fewer (regular) smokers among those with a high education. This may be explained by the idea that less educated people might be less aware of the serious health effects of smoking, or that smoking might be considered more acceptable within their social networks (and therefore carries less stigma) than is the case for people with a high educational level. Although smoking is a very expensive habit (nowadays), financial considerations appear to not play an important role in relation to smoking.

Figure 3.1Smoking behaviour by educational level

low 33,1
higher secondary 28,4
higher professional (HBO) 17,8
university (WO) 10,3

aSmoking here includes smoking every day as well as smoking less regularly than every day. For more information on the variables, see Acknowledgements and sources

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,415)

Drinking more prevalent among highly educated

Figure 3.2 illustrates that persons who drink alcohol regularly are most often found among those with a university education (46.7% compared with 33.4% among less educated people). This is a striking finding, given the advice by the Health Council of the Netherlands to avoid excessive alcohol consumption. It would seem that regular alcohol consumption among university graduates is so socially and culturally accepted that it is part of their lifestyle; see also Education as a dividing line; this could be a reason for ignoring potentially harmful health effects.

More generally, we find that frequent alcohol consumption is more common among people with a higher education; regular use of alcohol is least common among the less educated (33.4%) and rises steadily with educational level. It may be assumed that this association can also be partly explained by the generally higher income of people with a higher educational level. Unlike regular alcohol consumption, the differences between educational groups in daily consumption are negligible.

Figure 3.2Alcohol consumption by educational level

drinks daily drinks regularly
low 13,4 33,4
higher secondary 9,9 41,9
higher professional (HBO) 8,9 42
university (WO) 9,3 46,7

aMore than once per week.

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,415)

Body weight and vegetable consumption also highly differentiated

Figure 3.3 presents the educational differences by (relative) bodyweight expressed as BMI. The average BMI among those with a low and higher secondary education is above 25, indicating overweight. Among higher professional (HBO) graduates, the average BMI is precisely on the threshold of overweight, while among university graduates it is below the overweight threshold, at 24.4. Here again knowledge and financial capacity may play a role in explaining the education gap presented here; see also Education as a dividing line.

Figure 3.3BMI by educational level

low 26,8
higher secondary 25,8
higher professional (HBO) 25
university (WO) 24,4

aThe dotted line represents the threshold for being overweight (BMI > 25).

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,415)

Educational differences are less prominent for healthy eating than for the other health-related behaviours. We do however find a clear association with education and daily consumption of fruit and vegetables: the higher a person’s educational level, the healthier their diet. Although university graduates report that they eat fruit daily more often than less educated respondents, the difference (5.6 percentage points) is negligible. This contrasts with the differences in daily consumption of vegetables, where we do find meaningful differences between these groups (15.4 percentage points). The educational differences are thus larger for daily consumption of vegetables than of fruit.

Figure 3.4Consumption of vegetables by educational level

low 71,5
higher secondary 77,2
higher professional (HBO) 84,3
university (WO) 86,9

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,415)

Physical activity most popular among university graduates

Figure 3.5 shows people with a low educational level least often engage in physical activity (72.6%). It may be that this group lack the financial resources to enable them to participate in organised sport or purchase sports equipment; see also Education as a dividing line. Physical activity in leisure time is most common among university graduates: 92.5% of them engage in sufficient physical activity. Possible explanations for this finding are that they have the most knowledge regarding the health-promoting effects of physical activity, as well as greater financial capacity to fund participation in sport.

Sufficient healthy physical activity

To establish whether people engage in sufficient healthy physical activity, respondents were asked how many days in the past week they had taken a brisk walk, played sport or spent at least 30 minutes on some other physical activity. Physical activity can thus involve cycling to work, for example, but also intensive sport. Here we define sufficient physical activity as engaging in intensive activity for more than 30 minutes at least once per week; see Acknowledgements and sources.

Figure 3.5Physical activity by educational level

low 68,2
higher secondary 69,9
higher professional (HBO) 73,3
university (WO) 73,8

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,415)

In Accumulation of risk factors we investigate to what extent the accumulation of (un)healthy behaviours is related to education.

Cite this card

André, S., R. Meuleman and G. Kraaykamp (2018). Health-related behaviour and the education gap. In: (Un)healthy lifestyles: Education as a dividing line. Retrieved [datum vandaag] from https://digital.scp.nl/lifestyles/health-related-behaviour-and-the-education-gap.

Information notes