The Heterogeneous Effects of College Education on Outcomes Related to Deaths of Despair

J Health Soc Behav. 2025 Sep;66(3):357-378. doi: 10.1177/00221465241291845. Epub 2024 Nov 14.

Abstract

College education features prominently in research on determinants of deaths from substance use disorders and self-harm-outcomes collectively referred to as "deaths of despair" (DoD). Limited attention has been given to whether the protective effects of college education on indicators of despair vary by individuals' likelihood of college completion. We use data from the National Longitudinal Study of Adolescent to Adult Health for 6,145 individuals to test whether the protective effects of college completion on precursors to DoD vary according to individuals' propensity to attain a college degree. Understanding whether the benefits of college education differ depending on the propensity to complete it is important for designing effective educational policies. Using the heterogeneous treatment effects approach, we find that individuals with a relatively low propensity for graduating from college but who complete it have a lower likelihood of depressive symptoms, binge drinking, prescription drug abuse, and hard drug use.

Keywords: Add Health; deaths of despair; education; health; inequality.

MeSH terms

  • Adolescent
  • Adult
  • Binge Drinking
  • Depression* / epidemiology
  • Educational Status*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Self-Injurious Behavior* / mortality
  • Students* / psychology
  • Substance-Related Disorders* / mortality
  • United States / epidemiology
  • Universities
  • Young Adult