According to the study, a single year of maternal education reduced the risk of death for children under 5 years of age by 3%, and children born to mothers with 12 years of education are more than 30% less likely to die before age 5, compared to those born to mothers with zero years of education. Twelve years of paternal education reduced the risk of under-5 mortality by 17% compared to no years of education.
"This research is exciting because of the consistency of positive effects of education across geographies and time," said Hunter York, the study's lead author. "While this evidence isn't causal, it points to a relationship that goes beyond the influence of behaviors correlated with lower education, such as smoking, or policy interventions which aim to improve child survival regardless of parental education level, like free family planning. These are important mechanisms affecting the relationship between education and child health, but our results suggest a beneficial function of education in and of itself."
The study authors highlighted the importance of further research on paternal education, which has been studied far less than maternal education.
"Even after controlling for a mother's education, the father's education still matters," said Professor Emmanuela Gakidou, one of the senior authors on the study. "The majority of studies look only at maternal years of education, but it is crucial to understand and analyze the connection between the two, and not to discount the contribution of paternal education to child survival."
Over 300 studies from 92 countries were included in the analysis, capturing over three million live births. The researchers found that the protective effect of parental schooling strengthened as a child's age increased, but was significant for all age groups under 5 years.
For neonates (0-27 days), each additional year of maternal education reduced mortality risk by 1.5%. Each year of paternal education reduced risk by 1.1%.
For infants (1-11 months), each year of maternal education reduced mortality risk by 3.7%. Each year of paternal education reduced risk by 1.8%.
For young children (1-4 years), each year of maternal education reduced mortality risk by 4.4%. Each year of paternal education reduced risk by 2.2%.
The relationship was present across regions and after controlling for wealth or income, partner's education level, and the sex of the child.
"Further reductions in child mortality are needed, and investments in education may be key to achieving this," said CHAIN leader Professor Terje Andreas Eikemo. "It is time that education is brought onto the international policy agenda as a global determinant of child survival."
Importantly, the study also found that the impact of each additional year of education on child survival remained the same for primary, secondary, and tertiary education – indicating that a focus on only primary education misses opportunities to reduce the number of under-5 deaths and give children the best chance of survival.
"Even across generations, education and health are linked," said Kam Sripada, one of the study's lead authors. "Universal access to quality schooling must be a priority from the earliest years into higher education, both to support the current generation in reaching its potential and to help the next generation survive and thrive."
The study was funded by the Norwegian Research Council, the Bill & Melinda Gates Foundation, and the Rockefeller Foundation-Boston University Commission on Social Determinants, Data, and Decision Making (3-D Commission).
About the Institute for Health Metrics and Evaluation
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington School of Medicine that provides rigorous and comparable measurement of the world's most important health problems and evaluates the strategies used to address them. IHME is committed to transparency and makes this information widely available so that policymakers have the evidence they need to make informed decisions on allocating resources to improve population health.