Blacks’ Diminished Health Returns of Educational Attainment: Health and Retirement Study

Abstract

Background: Education level reduces the risk of health problems such as poor self-rated health (SRH), high body mass index (BMI), and depressive symptoms (DS). Marginalization – related Diminished Returns (MDRs), however, refer to smaller health benefits of socioeconomic status (SES) indicators particularly educational attainment for the members of racial minority groups such as non-Hispanic Blacks compared to the majority group (non-Hispanic Whites). It is not known, however, if MDRs also hold for middle-age and older adults over a long period of time. 
 Aims: The current study used a nationally representative data set to explore racial variation in the predictive utility of baseline education level on protecting people against poor SRH, BMI, and DS. 
 Methods: Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study that followed 10,023 middle-aged and older adults (50+ years old) for up to 26 years. From this number, 1877 (18.7%) were non-Hispanic Black Americans, and 8,146 (81.3%) were non-Hispanic White Americans. Education level was the independent variable. We used cluster analysis to categorize individuals to low and high-risk groups (outcome) based on SRH, BMI, and DS over 26 years. Age and gender were the covariates. Race was the moderator. 
 Results: Overall, high education level reduced the odds of poor SRH, BMI, and DS over the 26 years of follow up. Interactions were observed between race and education on all three health outcomes indicating smaller protective effects of baseline educational attainment on poor health over time, regardless of the outcome. 
 Conclusions: In line with the MDRs, highly educated non-Hispanic Black Americans remain at high risk for poor health across domains, a risk which is unexpected given their education. The risk of all health outcomes, however, is lowest for non-Hispanic White Americans with highest education. Policies that exclusively focus on equalizing racial gaps in SES (e.g., education) may fail to eliminate the racial and ethnic health inequalities because of the racial inequalities in the marginal health return of education. Public policies must equalize education quality and address structural and environmental barriers that are disproportionately more common in the lives of non-Hispanic Black Americans, even at high education levels. Future research should test how contextual factors, segregation, labor market practices, childhood poverty, and education quality reduces the health return of education for highly educated non-Hispanic Black Americans.

Intersecting Early-Life Selection Mechanisms: Socio-Historical Changes in Racially Stratified Effects of Education on Functional Limitations in the United States

“…Nevertheless, findings showed weaker effects of educational attainment on the functional limitations of Black adults than White adults, suggesting that their effects were racially stratified. Findings align with previous studies that reported lower returns for Black Americans from SES in terms of self-rated health, chronic disease, body mass index, and activity limitations (Assari, 2020; Braveman et al, 2010; Holmes & Zajacova, 2014; Hudson et al, 2013). These findings reflect detrimental health impacts of overtly racist practices against Black Americans before the Civil Rights Act, such as redlining, segregated schools, and the discriminatory labor market (Hout, 1984).…”

“…With a few exceptions (e.g., Barnes et al, 2011; Ostrove et al, 1999), a growing number of studies have established racial stratification in the education-health gradient. Using both regional (e.g., Turner et al, 2017) and national data (e.g., Holmes & Zajacova, 2014), these studies have documented that education has a lesser impact on self-rated health, chronic diseases, body mass index, and activity limitations for Black Americans than White Americans (Assari, 2020; Braveman et al, 2010; Cummings & Jackson, 2008; Farmer & Ferraro, 2005). However, little attention has been paid to the role of intersecting early-life selection mechanisms (i.e., selection bias or confounding bias introduced by observed common causes such as childhood socioeconomic status (SES) that impact both educational attainment and health) in constituting racial stratification in the effects of education on later-life health.…”

Association of socioeconomic status with arterial stiffness in older African American and White Adults: The ARIC Study Cohort

“…7,17 Similar to a prior analysis using the Health and Retirement Study data examining the MDRs of education against self-rated health, BMI, and depressive symptoms, no differences were found for the protective effects of higher education against self-rated health and depressive symptoms for Black or White adults. 30 One potential explanation for our findings is that the MDRs hypothesis has a larger impact at the higher end of the SES distribution. Recent findings from Spikes et.…”

Minorities’ diminished psychedelic returns

“…Ample evidence shows diminished returns for economic/class achievement for Black people. Compared to Whites, increased education among Black people is not associated with better mental or physical health, including self-reported health or depressive symptoms (Assari, 2020;Assari et al, 2018a), emotional well-being (Assari et al, 2018b), obesity (Assari, 2018b), or chronic obstructive pulmonary disease (Assari et al, 2019a). Education was also not a protective factor against negative health behaviors, including smoking (Assari and Mistry, 2018) or alcohol binge drinking (Assari et al, 2019b).…”

“…Most recently, researchers have begun to analyze the potential of psychedelics to positively impact the health of people of color who, compared to their White counterparts, continue to suffer both mentally and psychologically with higher rates of all-cause morbidity, which results in a lower life expectancy (Assari, 2017a, 2018a, 2020; Assari, Lapeyrouse, et al, 2018; Assari and Mistry, 2018; Assari, Preiser, et al, 2018b; Assari, Chalian, et al, 2019; Assari, Farokhnia, et al, 2019). But results are proving mixed.…”