A Symbiosis of Access: Proliferating STEM PhD Training in the U.S. from 1920-2010.

Over the course of the 20th century, unprecedented growth in scientific discovery was fueled by broad growth in the number of university-based scientists. During this period the American undergraduate enrollment rate and number of universities with STEM graduate programs each doubled three times and the annual volume of new PhDs doubled six times. This generated the research capacity that allowed the United States to surpass early European-dominated science production and lead for the rest of the century. Here, we focus on origins in the organizational environment and institutional dynamics instead of conventional economic factors. We argue that three trends of such dynamics in the development of American higher education not often considered together-mass undergraduate education, decentralized founding of universities, and flexible mission charters for PhD training-form a process characterized by a term coined here: access symbiosis. Then using a 90-year data series on STEM PhD production and institutional development, we demonstrate the historical progression of these mutually beneficial trends. This access symbiosis in the U.S., and perhaps versions of it in other nations, is likely one critical component of the integration of higher education development with the growing global capacity for scientific discovery. These results are discussed in terms of the contributions of American universities to the Century of Science, recent international trends, and its future viability.

Educational Attainment and Psychological Distress Among Working-Age Adults in the United States.

This study builds on a growing body of literature analyzing the education-health gradient across detailed educational categories, which documents that US working-age adults who attended college but did not earn a bachelor's degree report equal or worse health than adults with a high school diploma. This is known as the "anomaly" in the education-health gradient. The purpose of this study is to test whether this pattern extends to measures of serious psychological distress (SPD) and individual symptoms by using data from the National Health Interview Survey (NHIS, 1997-2018) and a series of logistic regression models. We find that the anomaly in the education-health gradient is present for a summary measure of SPD as well as for five of the six symptoms that make up this measure. The exception was reporting feeling sad most or all the time during the last month, where adults with "some college" were found to have lower odds than those with a high school diploma. Further stratified analysis by sex revealed that this result for feeling sad was driven by women. In terms of associate degrees, our models show that adults with a vocational/technical associate degree have statically similar odds of SPD and reporting four out of six symptoms (exceptions were feeling hopeless and sadness), while those with an academic associate degree have significantly lower odds in all outcomes. The robustness of the models used is supported by an extensive sensitivity analysis. Overall, we find evidence of the anomaly in the education-health gradient in SPD and individual symptoms of psychological distress at the sub-baccalaureate level, adding to previous studies that document the anomaly in markers of physiological dysregulation, health conditions, vision problems, functional limitations, and pain.

Explaining the Education-Health Gradient in Preventing STIs in Andean Peru: Cognitive Executive Functioning, Awareness and Health Knowledge.

CONTEXT: Little is known about the pathways mediating the relationship between education and health. It is widely assumed that formal schooling leads to awareness of health risks (e.g., STIs) and, in turn, to adoption of preventive behavior (e.g., condom use); however, evidence supporting this mechanism has been limited. METHODS: Survey data were collected in 2010 from a sample of 247 adults aged 30-62 living in an isolated Andean district of Peru; these individuals had widely varying exposure to schooling, and their community had recently experienced elevated risks of STIs. Structural equation modeling was used to estimate the degree to which schooling is associated with cognitive resources, STI awareness and sexual health knowledge, and how these jointly are associated with ever-use of condoms. RESULTS: Thirty-two percent of respondents reported ever-use of condoms. One additional year of schooling was associated with a 2.7-percentage-point increase in the probability of condom use, after adjustment for covariates. The pathway between education and condom use was mediated by cognitive executive functioning (CEF) skills (0.26 standard deviations), STI awareness (0.09) and sexual health knowledge (0.10); CEF skills were associated with condom use both directly and indirectly, through STI awareness and sexual health knowledge, and accounted for two-thirds of the education-condom use gradient. CONCLUSIONS: The relationship between education and STI prevention may be more complex than is often assumed and is mediated by CEF skills, STI awareness and sexual health knowledge. Studies should examine whether STI prevention interventions are more effective if they enhance cognitive skills used to translate information into protective behaviors.

RESUMEN Contexto: Se sabe poco acerca de las vías que median la relación entre el nivel educativo y la salud. Generalmente se supone que la escolaridad formal conduce a la conciencia de los riesgos para la salud (por ejemplo, las ITS) y, a su vez, a la adopción de un comportamiento preventivo (por ejemplo, el uso del condón); sin embargo, la evidencia que apoya este mecanismo ha sido limitada. Métodos: Los datos de la encuesta se obtuvieron en 2010 de una muestra de 247 adultos de 30 a 62 años que vivían en un distrito andino aislado de Perú; estas personas tenían una exposición muy variable a la escolaridad y su comunidad había experimentado recientemente riesgos elevados de ITS. Se usó el modelo de ecuaciones estructurales para estimar el grado en que la escolaridad se asociaba con los recursos cognitivos, la conciencia de las ITS y el conocimiento de la salud sexual y cómo estos se asocian conjuntamente con el haber usado alguna vez condones. Resultados: El treinta y dos por ciento de los encuestados informaron que alguna vez usaron condones. Un año adicional de escolaridad se asoció con un aumento de 2.7 puntos porcentuales en la probabilidad de uso del condón, después del ajuste por covariables. La vía entre el nivel educativo y el uso del condón estuvo mediada por las habilidades de funcionamiento cognitivo ejecutivo (FCE) (0.26 desviaciones estándar), conciencia de las ITS (0.09) y conocimiento de salud sexual (0.10); Las habilidades de FCE se asociaron con el uso del condón tanto directa como indirectamente, a través de la conciencia de las ITS y los conocimientos sobre salud sexual y representaron dos tercios del gradiente educativo del uso del condón. Conclusiones: La relación entre el nivel educativo y la prevención de las ITS podría ser más compleja de lo que a menudo se supone y está mediada por las habilidades de FCE, la conciencia de las ITS y el conocimiento de la salud sexual. Los estudios deben examinar si las intervenciones de prevención de ITS son más efectivas si mejoran las habilidades cognitivas utilizadas para traducir la información en comportamientos protectores.

RÉSUMÉ Contexte: Les voies de médiation de la relation entre l'éducation et la santé ne sont guère documentées. Il est généralement présumé que la scolarité mène à la conscience des risques de santé (par ex., les IST), qui conduit à son tour à l'adoption d'un comportement préventif (par ex., l'utilisation du préservatif). Les données qui appuient ce mécanisme sont cependant limitées. Méthodes: Des données d'enquête ont été collectées en 2010 auprès d'un échantillon de 247 adultes de 30 à 62 ans vivant dans un district andin isolé du Pérou. Ces personnes présentaient une exposition fort variable à la scolarité et leur communauté était depuis peu confrontée à un risque élevé d'IST. La modélisation par équation structurelle a permis d'estimer le degré d'association entre, d'une part, la scolarité et, d'autre part, les ressources cognitives, la conscience des IST et la connaissance en matière de santé sexuelle, ainsi que de déterminer l'association globale de ces éléments avec le fait d'avoir déjà utilisé le préservatif. Résultats: Trente-deux pour cent des répondants ont déclaré avoir utilisé le préservatif. Chaque année supplémentaire de scolarité s'est avérée associée à une augmentation de 2,7 points de pourcentage de la probabilité d'usage du préservatif, sous correction des covariables. Le lien entre l'éducation et l'utilisation du préservatif était induit par les compétences de fonctionnement exécutif cognitif (FEC) (écarts types de 0,26), la conscience des IST (0,09) et la connaissance en matière de santé sexuelle (0,10). Les compétences FEC étaient associées à l'utilisation du préservatif de façon directe et indirecte, du fait de la conscience des IST et de la connaissance en matière de santé sexuelle; elles représentaient deux tiers du gradient éducation-utilisation du préservatif. Conclusions: La relation entre l'éducation et la prévention des IST peut être plus complexe qu'on ne le pense souvent. Elle est induite par les compétences FEC, la conscience des IST et la connaissance en matière de santé sexuelle. Il serait utile d'examiner si les interventions de prévention des IST sont plus efficaces quand elles améliorent les compétences cognitives qui traduisent l'information en comportements de protection.

The Population Education Transition Curve: Education Gradients Across Population Exposure to New Health Risks.

The salutary effect of formal education on health-risk behaviors and mortality is extensively documented: ceteris paribus, greater educational attainment leads to healthier lives and longevity. Even though the epidemiological evidence has strongly indicated formal education as a leading "social vaccine," there is intermittent reporting of counter-education gradients for health-risk behavior and associated outcomes for certain populations during specific periods. How can education have both beneficial and harmful effects on health, and under which contexts do particular effects emerge? It is useful to conceptualize the influence of education as a process sensitive to the nature, timing of entry, and uniqueness of a new pleasurable and desirable lifestyle and/or product (such as smoking) with initially unclear health risks for populations. Developed herein is a hypothesis that the education gradient comprises multiple potent pathways (material, psychological, cognitive) by which health-risk behaviors are influenced, and that there can be circumstances under which pathways act in opposite directions or are differentially suppressed and enhanced. We propose the population education transition (PET) curve as a unifying functional form to predict shifting education gradients across the onset and course of a population's exposure to new health risks and their associated consequences. Then, we estimate PET curves for cases with prior epidemiological evidence of heterogeneous education gradients with health-risk behaviors related to mass-produced cigarettes in China and the United States; saturated fats, sugar, and processed food diets in Latin America; and HIV infection in sub-Saharan Africa. Each offers speculation on interactions between environmental factors during population exposure and education pathways to health-risk behaviors that could be responsible for the temporal dynamics of PET curves. Past epidemiological studies reporting either negative or positive education gradients may not represent contradictory findings as much as come from analyses unintentionally limited to just one part of the PET process. Last, the PET curve formulation offers richer nuances about educational pathways, macro-historical population dynamics, and the fundamental cause of disease paradigm.