Cumulative Effect of Education over Time on Health after Spinal Cord Injury

Background: Every year 11,000 new cases of spinal cord injury (SCI) occur in the U.S. SCI usually leads to permanent disability, and people with SCI disability are now achieving greater longevity. Many studies had explored factors contributing to the long-term health of SCI patients, but few had focused on the effect of education. Instead, education is commonly used as a control.

Methods: This study analyzes the follow-up data collected from 26 Spinal Cord Injury Model Systems. Our sample includes 1696 participants who were 23 to 75 years old at the time of injury and completed their year 1 and year 5 follow-ups (77% men, 75% Caucasian, 52% tetraplegic, 49% complete lesion). I used fixed effect model to examine the effect of education (at injury) on self-perceived health. The time-invariant controls include age at injury, level and completeness of injury at discharge, gender, and race. The time-variant controls include number of hours at paid job, number of days rehospitalized during the past year, life satisfaction scale, and social integration scale.

Results: Controlling all variables, college educated gain 0.19 point more than others in self-perceived health (p=0.01). The effect of 1-year increase of education on health raises 0.03 point over five years period (p=0.01).

Conclusion: This study finds that education not only affects the health of SCI patients at any time, the protective effect of education also accumulates over time.