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Adults who received a high school equivalency diploma have significantly poorer health outcomes than traditional graduates, according to a new study.
Older Americans with a General Education Development (GED) certificate had a higher risk for mental, hearing and vision impairments, limitations in activities of daily living and mobility issues, University of Toronto researchers found.
"Although a large body of research has demonstrated that high school graduates generally have better health outcomes than high school dropouts, less research has examined health outcomes specifically among GED recipients,"said lead study author Esme Fuller-Thomson. She is a professor of social work and director of the Institute for Life Course & Aging.
"There is often an underlying assumption that a GED is equivalent to a high school diploma, but a growing body of research has shown that these groups may not be comparable in health status as previously assumed,"she said in a university news release.
To learn more, the researchers looked at data from 400,000 older adults from the American Community Survey.
Previous studies of health differences between GED recipients and high school graduates had largely focused on young and middle-aged adults.
One possible explanation for health disparities researchers identified: Each year of education increases cognitive reserve. That helps the brain better tolerate age-related changes and reduces the likelihood of dementia in early old age.
GED recipients often spend fewer years in formal education.
Other research has found that GED recipients are less likely to use preventive health care services and have access to health insurance. This may account for their higher risk of hearing and vision impairment.
"The assumed equivalency between a GED and a high school diploma often fails to consider the broader contextual factors that influence educational attainment,"said study co-author Robin Grossman, a university graduate with a masters in social work.
"Even if a GED recipient has approximately the same level of knowledge as a high school graduate, there may still be critical differences such as years spent in school and time spent socializing with other high school students and educators," Grossman explained. "There are countless factors that can make the experiences of GED recipients and high school graduates fundamentally different."
Breaking down the data by sex and age, the research team found similar patterns. An exception was among those aged 85 and older.
"The oldest cohort in our study were those who were born in 1932 or earlier. Many of these individuals grew up during the Great Depression and may have served in the Second World War,"said study co-author Andie MacNeil, a research assistant at the university.
Many may have left school to serve in the military before they were able to graduate, MacNeil noted.
"In these situations, their reasons for obtaining a GED might be quite different from younger cohorts who were unable to complete high school due to challenging home life or other life circumstances,"MacNeil said.
The researchers said further study is needed.
"It's important that we better understand the mechanisms that may impact the relationship between educational attainment and health outcomes in older adulthood,"Fuller-Thomson said. "We hope our findings will encourage more research to examine health differences between different levels of educational attainment, with particular consideration for those with a GED."
The findings were published online recently in The International Journal of Aging and Human Development.
More information
The U.S. National Institute on Aging has more on healthy aging.
SOURCE: University of Toronto, news release, Oct. 31, 2023