The United States experienced a period of rapid higher education expansion between the mid-1940s and mid-1970s. Although this expansion likely improved the health of people able to take advantage of new education opportunities, expansion may have also intensified health inequalities between college-educated and non-college-educated people (1) through the compositional change in the relative (dis)advantage of these groups, (2) through the displacement of non-college-educated people in a more competitive post-expansion labor market, and (3) by increasing health returns to a college degree. Our analyses, rooted in a counterfactual perspective, draw on data from the Health and Retirement Study that spans birth cohorts who came of age before and after the period of expansion, allowing us to differentiate people who earned a degree because of expansion but would not otherwise (conditional-earners) from people who would or would not have earned a degree regardless of expansion (always-earners and never-earners, respectively). Comparing changes in the health of these three groups before and after education expansion permits us to individually evaluate how compositional change, displacement, and increasing returns to education exacerbated health inequalities. Our findings suggest that education expansion improved the health of conditional-earners and magnified health inequalities through the mechanism of displacement.

在 1940 年代中期至 1970 年代中期，美国经历了高等教育快速扩张的时期。尽管这种扩张可能改善了能够利用新教育机会的人们的健康，但扩张也可能通过相对（不利）优势的构成变化，加剧了受过大学教育和未受过大学教育的人之间的健康不平等 (1)在这些群体中，(2) 通过在更具竞争力的后扩张劳动力市场中取代未受过大学教育的人，以及 (3) 通过增加大学学位的健康回报。我们的分析植根于反事实的观点，利用健康和退休研究的数据，这些数据涵盖了扩张时期前后成年的出生队列，允许我们将因扩张而获得学位但不会以其他方式获得学位的人（有条件获得者）与无论扩张如何都会或不会获得学位的人（分别为始终获得者和从未获得者）区分开来。比较这三个群体在教育扩张前后的健康变化，使我们能够单独评估教育的构成变化、位移和增加的回报如何加剧健康不平等。我们的研究结果表明，教育扩张通过替代机制改善了有条件收入者的健康状况，并扩大了健康不平等。比较这三个群体在教育扩张前后的健康变化，使我们能够单独评估教育的构成变化、位移和增加的回报如何加剧健康不平等。我们的研究结果表明，教育扩张通过替代机制改善了有条件收入者的健康状况，并扩大了健康不平等。比较这三个群体在教育扩张前后的健康变化，使我们能够单独评估教育的构成变化、位移和增加的回报如何加剧健康不平等。我们的研究结果表明，教育扩张通过替代机制改善了有条件收入者的健康状况，并扩大了健康不平等。