Schooling has smaller or insignificant effects on adult health in the US than suggested by cross-sectional associations: new estimates using relatively large samples of identical twins.

Numerous theoretical reasons have been posited about why more schooling might improve health. Adult health outcomes and behaviors generally are significantly associated with schooling. However, such associations do not necessarily imply that schooling has causal effects on health outcomes and behaviors. Causal estimates based on schooling variation from policies and from within-MZ (monozygotic) twins have reached mixed conclusions. This study contributed new estimates of cross-sectional associations and within-MZ causal effects using three relatively large US twins samples. The estimates suggested that schooling was significantly associated with numerous health outcomes and behaviors. However, with within-MZ twins control for unobserved factors, schooling was no longer associated with most indicators of better health (with the exception of self-reported health), while it continued to be associated with outcomes such as fertility and spousal schooling. Similar patterns were observed for spousal schooling.