Diminished Returns of Educational Attainment on Heart Disease among Black Americans

Abstract

Background:Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose:Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods:We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health -Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results:Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion:Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.

Parental Education and Youth Inhibitory Control in the Adolescent Brain Cognitive Development (ABCD) Study: Blacks’ Diminished Returns

“…Thus, researchers and policymakers should not only address inequality in SES, but they should also address inequality in the returns of SES. Unfortunately, NHB families are at a double disadvantage because they are affected by low SES and low return of the existing SES resources [52,104].…”

“…Multilevel economic, psychological, and societal mechanisms may be involved in explaining racial and ethnic gaps in the returns of parental education [52,104]. MDRs may be due to racism across multiple societal institutions and social structures [52,104].…”

“…Multilevel economic, psychological, and societal mechanisms may be involved in explaining racial and ethnic gaps in the returns of parental education [52,104]. MDRs may be due to racism across multiple societal institutions and social structures [52,104]. Racial/ethnic prejudice interferes with the processes that are needed to gain benefits from available SES resources [105][106][107].…”

Minorities’ Diminished Returns of Parental Educational Attainment on Adolescents’ Social, Emotional, and Behavioral Problems

“…The current study did not explore societal and contextual processes that could explain intergenerational MDRs of education for racial and ethnic minorities. MDRs may be due to institutional and structural racism [15,80]. Marginal returns may also be smaller for families with a history of childhood poverty [81].…”

“…Racial prejudice and discrimination may also interfere with the benefit that is expected to follow education [82][83][84]. Thus, multilevel economic, psychological, and societal mechanisms may be involved in explaining racial and ethnic gaps in the returns of parental education [15,80].…”