An economic analysis of the impact of education on health behaviours and health outcomes in South Africa: a case of Amathole District Municipality and Buffalo City Metropolitan Municipality

Background: The current study investigates the economic impact of education on health behaviour and health outcomes, specifically targeting the Raymond Mhlaba and Buffalo City municipalities in the Eastern Cape region, South Africa. 

Methods: The study employs and modifies the National Income Dynamic Study (NIDS) data by combining all five waves to create a panel data. The study investigates an analytical objective which explored the relationship between education, health behaviours and health outcomes. This objective is addressed using a multivariate regression analysis (multinomial logistic regression) which offers the advantage of the ability to handle categorical outcomes with more than two categories. The current study uses marginal effects (dy/dx) to analyse how education affects health outcomes in each category of health outcomes. 

Results: The results for the probability of predictor variables belonging to category 3 “good” [coded 3 on the dummy variable (DV)] are positive and significant [dy/dx = 0.328; p = 0.029], showing that the marginal effects of having an undergraduate degree and belonging to category 3 are higher (33pp) than in any other category. The empirical findings suggest that education can be an important determinant of behavioral transformation and later changes in health-related outcomes. 

Conclusion: Thus, it is the policy implications and recommendations of this study that improving health outcomes requires more than health sector solutions. As such, given that education shapes health behaviours and health outcomes across the course of life, policies must move beyond silos and intergrade health education in South Africa’s education system in order to rule out health illiteracy as a root cause of health inequality and poor health outcomes.