Education matters. Those two words, by his own account, encapsulate a lifetime of experience for Bahadir Dursun, Ph.D., postdoctoral fellow at the Center for Health and Wellbeing (CHW). Both personally and professionally, Bahadir has demonstrated the power of knowledge, especially within the context of a developing country. Through his accomplishments and growing body of research, he sheds new light on the relationship between education and an individual’s health, hope, and happiness.

In this Spotlight, Bahadir discusses his background and interest in health economics. Deeply affected by inequities in schooling and health care, he has focused the bulk of his work on human capital formation along with its intergenerational effects on physical and psychological wellbeing.

Q. In retrospect, do you feel that your Turkish heritage affected the trajectory of your research and career?  Did your upbringing spark curiosity about the link between education and health?

A. Yes, I think so. I come from a small town called Savsat, which is known for its harsh climate and environment. Challenging conditions, combined with an increasing population, have created a shortage of natural resources. There is not enough agricultural land for everyone and little industry, so income sources are limited. As a result, most people leave the village to study and a lot of them become teachers, like my father. I realized that education is important at a very early age.

While still in elementary school, I was also thinking about health care. My mother was a nurse, so I literally grew up in a hospital. Because Turkey did not have a universal health care system until the 2000s, poor people coming from the villages did not have any insurance. I heard many touching stories about doctors and nurses providing care and medicine to their patients, even though it was against the law. These observations helped me understand inequalities in society. I learned that access to health care is a burden for many people, especially the poor, and that the consequences can be devastating.

While education and health care were very much a part of my upbringing, it wasn’t until my doctoral research that I recognized how much these two areas intersect.

Q. How is Turkey’s education system different than the United States? You and your parents attended high school and college. Is that customary or unusual in Turkish society?

A. In Turkey, children were only required to receive five years of schooling until 1997, when the education system changed overnight. Legislative reforms expanded compulsory education, forcing those born after 1986 to enroll in at least eight years of schooling. Even so, education is still a little bit stigmatized for Turkish women. The average education of females spans about 6.5 years in Turkey, compared to 13 years in both the U.S. and U.K.

On a more personal note, your question reminds me of a story from graduate school. One day I was sitting with a Turkish friend when we overheard a classmate, a citizen of the United States, talking about her father. He was an astronaut, highly educated with a prestigious background and a long Wikipedia page, while we came from families in which our grandparents could not even read or write. This was very interesting to me, and a striking example of disparities in education.

Q. You received a B.S. in business administration and finance from Marmara University, in Istanbul, Turkey, before earning your Ph.D. in economics from Louisiana State University (LSU). What affected those choices? Were you initially planning a career in the business sector?

A. When applying to college, I debated between two areas of study: economics and business management. I wasn’t expecting acceptance into the business program, which had a higher academic threshold, but I got in and thought that major would lead to a good career. I learned quickly, however, that economics offers more powerful tools for understanding the world around us. I wanted to investigate social issues, like a journalist, so I found a way to stay in academia.

People tend to think only about macroeconomics or microeconomics, but the field provides mechanisms for studying education, health, politics, and many other things. I got excited about the opportunities, leading me to earn a Ph.D. in economics at LSU.

Q. What was the subject of your dissertation and why?

A. I knew, from my own childhood experience, that education changes people’s lives. I was interested in exploring this phenomenon. As I refined topics for my dissertation, I realized that Turkey’s 1997 education reform provided an excellent opportunity for me to explore the black box of education. Specifically, I wanted to learn how additional schooling impacts the health and wellbeing of young adults in a developing country setting. The 1997 education reform provided an excellent, natural framework for investigating this question.

At the same time, while I was considering different subjects, my wife was pregnant. We wanted to be good parents… to know what we could do during pregnancy to increase our chance of having a healthy baby girl. That piqued my interest in infant health determinants.

Q. Can you elaborate on your doctoral research and conclusions, and how they may have influenced subsequent study?

A. My doctoral research established the basis for several papers, all examining how education affects health and wellbeing. My findings support a strong relationship and led to further investigation within the realm of health economics.

The first paper studied the causal impact of compulsory schooling on the happiness of young adults. I found that females who obtained a middle school diploma, or higher education, were generally happier and more hopeful than females who were not exposed to the reforms. On the other hand, males with extended schooling were less happy. Supplemental research suggests that an imbalance between aspirations and attainments may account for this disparity. It is also possible that males were not happy that females felt empowered by education.

A second paper examined the link between education and health indicators as well as smoking. It showed that extended schooling affected males and females differently. In this study, more schooling led to an increase in male obesity, while women were more likely to maintain a healthy body weight. Further analysis indicates that lack of mobility may have played a role, since the males spent more time sitting in front of a computer. I also found that education had no relation to smoking among men or women.

Q. Were you surprised that education did not alter smoking behaviors in young adults?  

A. Yes, it was a little surprising and something I explored further in my next paper, which measured the impact of maternal schooling on infant health. We know, from previous literature, that one of the most harmful infant health determinants is smoking during pregnancy. In this study, we found that three additional years of compulsory education decreased smoking by expectant mothers and improved health outcomes for infants. Results showed reductions in low birth weight, premature birth, and child mortality. In fact, this research arguably provides the strongest evidence to date that raising the level of maternal education improves the health of children in developing countries.

Q. What brought you to CHW as a postdoctoral research associate?

A. Marc Fleurbaey [former Robert E. Kuenne Professor in Economics and Humanistic Studies, Professor of Public Affairs and the University Center for Human Values] invited me to design and teach a new course on microeconomics and public policy for Princeton’s School of Public and International Affairs. Expanding upon the standard curriculum, the redesigned course introduces economic concepts within the context of real-world issues, such as health, education, taxation, environment, and climate.

I also valued the opportunity to work with Janet Currie [Henry Putnam Professor of Economics and Public Affairs, Co-Director of CHW] who is greatly respected within her field and one of the brightest minds of her generation. She has contributed enormously to infant health research, one of my key interests.

Q. Tell us about your research at Princeton over the past three years.

A. My research remains concentrated on infant health determinants, though I’ve shifted my attention to the United States. First, I examined the effects of curriculum reforms. In the 1980s, a report prepared by the National Commission on Excellence in Education, “A Nation at Risk,” suggested that the U.S. was losing its technological edge to other countries, prompting an increase in the number of compulsory math and science courses for high school students. My colleagues and I looked at the intergenerational effects of such reforms, comparing infant health outcomes between Black and white babies. The difference was striking. We found that the additional requirements, especially with regard to math classes, decreased the incidence of low birth weight and premature birth for Black mothers while having no significant impact for white mothers. These consequences reduced health inequalities at birth by over 10 percent. In this study, we also investigated if and how the benefits of better infant health persist into adulthood, in terms of jobs, earnings and opportunities. By analyzing 30 plus years of data, we calculated a sizable social gain, showing that coursework in core subject areas not only matters today but well into the future.

The second paper I’ve been working on examines how mass shootings influence infant health outcomes in the United States. According to a Gallup survey, one of the top five fears among Americans is becoming the victim of a mass shooting, and at least 50 percent of women are at least somewhat worried about that possibility. For this study, I explored how expectant mothers and their babies are affected by indirect exposures to mass shootings that occur within their own counties of residence. My results indicate that stress induced by mass shootings can have a detrimental impact on newborns. Specifically, findings revealed that mass shootings that occurred during the second trimester of pregnancy increased the likelihood of very premature birth and very low birth weight, incurring medical costs as large as $361 million and social costs exceeding a billion dollars. I plan to explore this subject further, researching the broader relationship between gun violence and health issues.

Q. What do you find most gratifying about teaching, particularly at Princeton?

A. Teaching allows you to touch students’ lives and change their understanding of the world. In my microeconomics course for the Princeton School of Public and International Affairs, for instance, we use economic principles to answer the hard questions, such as whether it is worth it to buy health insurance. We discuss the opportunity costs, the benefits, and how to calculate them. It is very exciting to break through their preconceived ideas and open their minds, to show them that nothing is black and white; everything has shades of gray.

Q. What is on the horizon?  Will you continue probing issues at the crossroads of education, health, and economics?

A. Yes. Research within the context of health economics is important because it produces results that may be relevant for establishing health policy. The United States, for example, spends a significant fraction of its GDP on health care, so it is essential to understand the underlying issues. Furthermore, the Covid-19 pandemic has shown us that public health has global importance with enormous consequences on everything, from jobs to education. I would love to investigate those effects in the future alongside my research on the human capital aspects of health, and the relationship between gun violence and health outcomes.

Research is all about putting another brick in the wall – taking small steps toward solving complex problems. I hope, through my studies and teaching, that I can find and share knowledge that makes a difference in global health and wellbeing.

Q. To wrap up, would you be willing to share a personal interest or fun fact – something your students or colleagues may not know about you?

A. I really like basketball. Back in high school and middle school, I spent a lot of time on the courts. Basketball was a big part of my childhood and something I still enjoy watching and playing. 

Also, many of my students are intrigued by the imaginary people and places featured in my problem sets. They ask about this in my course evaluations! For the most part, these names have some sort of connection to my family or personal life. The “mysterious Republic of Arsiyan,” for example, is a nod to my grandfather’s village in Turkey, and my three-year-old daughter, Derin, has appeared as president of a foreign country. The secret is out!