The education-health gradient: Revisiting the role of socio-emotional skills

Is the education-health gradient inflated because both education and health are associated with unobserved socio-emotional skills? We find that the gradient in health behaviors and outcomes is reduced by about 15 to 50% from accounting for fine-grained personality facets and up to another 50% from Locus of Control. Traditional aggregated Big-Five scales, however, have a much smaller contribution to the gradient. We use sibling-fixed effects to net out the contribution from genes and shared childhood environment, decomposing the gradient into its components with an order-invariant method. We rely on a large survey (N = 28,261) linked to high-quality Danish administrative registers with information on parental background and objectively measured diagnoses and care use. Accounting for Locus of Control yields the strongest gradient reduction in self-rated health status and objective diagnoses (30%–50%), and in health behaviors the most important factor is Extraversion, a skill that has been shown to be malleable in interventions.