Which factor is NOT associated with worse WAD outcomes?

• A. Lower education
• B. Older age
• C. Female sex
• D. Higher education

Answer: (D)

In whiplash-associated disorders, prognosis is shaped by factors that reflect a person’s ability to engage with care, gather information, and access resources. Higher education tends not to worsen outcomes; it often helps with recovery because it is linked to greater health literacy, better understanding of rehabilitation, and easier access to care and support. These advantages can lead to more effective participation in treatment and smoother recovery, so higher education is not associated with worse outcomes.

Lower education, older age, and female sex have more consistently been linked to poorer prognosis in this context—less health literacy or adherence potential, slower healing or more comorbidities with age, and a tendency for higher reported pain and disability in some studies. Therefore, the factor not associated with worse WAD outcomes is higher education.