L’effet de la reforme Berthoin de 1959 sur la sante. Approche quasi-experimentale dans la cohorte Constances

Higher educational attainment is associated with better health, but whether policies that increase education improve health is not well established. This study examines the long-term impact of a major policy that increased compulsory years of schooling in France on cognition, mental health and physical functioning.

Data came from Constances, a cohort representative of the French population. We used a Regression Discontinuity Design (RDD) to compare the health of cohorts born just before and after the reform, which increased the minimum school leaving age from 14 to 16 years in 1959.

Average years of schooling increased by 2.9 months as a result of the policy. This increase was driven by participants from blue collar families, for whom years of schooling increased by 4.1 months. RDD estimates suggest that this reform led to higher cognitive scores (b=0.148, 95% confidence interval [CI] 0.02 to 0.27; odds ratio [OR] for top quartile of cognitive score=1.807, 95% CI 1.21 to 2.71) among men. Among women, increasing years of compulsory schooling did not increase cognitive scores and led to higher depression scores as measured by the Centre for Epidemiologic Studies Depression scale (b=1.5, 95% CI 0.320 to 2.724 and OR for elevated depressive symptoms=1.269, 95% CI 1.03 to 1.56). There was no effect on functional health outcomes.

An increase in compulsory schooling led to better cognitive function among men but increased depressive symptoms among women in older age. Compulsory schooling laws may have widened gender disparities in cognitive and mental health.