BackgroundAlthough the effects of socioeconomic status (SES) on mortality are well established, these effects may vary based on contextual factors such as race and place. Using 25-year follow-up data of a nationally representative sample of adults in the U.S., this study had two aims: (1) to explore separate, additive, and multiplicative effects of race and place (urbanity) on mortality and (2) to test the effects of education and income on all-cause mortality based on race and place.MethodsThe Americans’ Changing Lives (ACL) Study followed Whites and Blacks 25 years and older from 1986 until 2011. The focal predictors were baseline SES (education and income) collected in 1986. The main outcome was time until death due to all causes from 1986 until 2011. Age, gender, behaviors (smoking and exercise), and health (chronic medical conditions, self-rated health, and depressive symptoms) at baseline were potential confounders. A series of survey Cox proportional hazard models were used to test protective effects of education and income on mortality based on race and urbanity.ResultsRace and place had separate but not additive or multiplicative effects on mortality. Higher education and income were protective against all-cause mortality in the pooled sample. Race and urbanity significantly interacted with baseline education but not income on all-cause mortality, suggesting that the protective effect of education but not income depend on race and place. While the protective effect of education were fully explained by baseline health status, the effect of income remained significant beyond health.ConclusionIn the U.S., the health return associated with education depends on race and place. This finding suggests that populations differently benefit from SES resources, particularly education. Differential effect of education on employment and health care may explain the different protective effect of education based on race and place. Findings support the “diminishing returns” hypothesis for Blacks.

PurposeAlthough the link between education and alcohol consumption is known, limited information exists on racial differences in this link. We conducted the current study to test Black–White differences in the association between education and alcohol consumption among older adults in the U.S.MethodsThis cross-sectional survey enrolled 1,493 Black (n = 734) and White (n = 759) older adults (age 66 or more) in U.S. Data came from the Religion, Aging, and Health Survey, 2001. Race, demographics, socioeconomics, and alcohol consumption were measured. Independent variable was education level. Outcome was alcohol consumption. Race was the focal moderator. Logistic regression was used for data analysis.ResultsEducation was positively associated with ever drinking in the pooled sample. However, race interacted with education level on drinking, suggesting a smaller effect of education on drinking for Blacks compared to Whites. Among Whites, high-school graduation and college graduation were associated with increased odds of ever drinking, net of covariates. Among Blacks, high-school graduation, but not college graduation, was associated with ever drinking.ConclusionBlacks and Whites differ in how socioeconomic status (i.e., education) shapes behaviors, especially health behaviors (i.e., drinking). How race modifies consequences and correlates of social determinants of health is not yet clear. College graduation may result in the same level of change to the social network and income of race group members. Weaker effect of education on health of Blacks may be due to the structural role of race and racism that has resulted in lower job availability and pay for Blacks.

Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

The intersection of race and gender alters the protective effects of social determinants on sustained health problems such as insomnia, physical inactivity, and BMI. Social groups particularly vary in the operant mechanisms by which SES contributes to maintaining health over time. The health effects are less universal for education than income. Race by gender groups differ more in SES determinants of BMI, insomnia, and physical inactivity than depressive symptoms and SRH.

Background: Most of the literature on the association between socioeconomic status (SES) and health is focused on the protective effects of SES. However, a growing literature suggests that high SES may also operate as a vulnerability factor. Aims: Using a national sample of African American youth, this study compared the effects of perceived discrimination on major depressive disorder (MDD) based on SES. Methods: The current cross-sectional study included 810 African American youth who participated in the National Survey of American Life-Adolescent supplement. The independent variable was perceived discrimination. Lifetime, 12-month, and 30-day MDD were the dependent variables. Age and gender were covariates. Three SES indicators (subjective SES, income, and poverty index) were moderators. We used logistic regressions for data analysis. Results: Perceived discrimination was associated with higher risk of lifetime, 12-month, and 30-day MDD. Interactions were found between subjective SES and perceived discrimination on lifetime, 12-month, and 30-day MDD, suggesting a stronger effect of perceived discrimination in youth with high subjective SES. Objective measures of SES (income and poverty index) did not interact with perceived discrimination on MDD. Conclusion: While perceived discrimination is a universally harmful risk factor for MDD, its effect may depend on the SES of the individual. Findings suggest that high subjective SES may operate as a vulnerability factor for African American youth.