Unequal Associations between Educational Attainment and Occupational Stress across Racial and Ethnic Groups

Assari, Shervin; Bazargan, Mohsen

doi:10.3390/ijerph16193539

Cited by 75 publications

(77 citation statements)

References 49 publications

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“…The observation that as income increases, the psychological well-being of middle-aged and older adults improves, but less for immigrants than non-immigrants, is an extension of previous literature on MDRs 21,22 of income, [23][24][25][26][27] educational attainment, 36 occupation, 29,30 and marital status 46 on a wide range of mental health outcomes, including psychological distress, 54 depression, 24,55 suicide, 31 and anxiety. 46 These MDRs go beyond physical health outcomes and extend to behavioral outcomes such as vaping, 33 smoking, 35,42,44,56,57 drinking, 34,58 diet, 59 and exercise.…”

Section: Discussionmentioning

confidence: 71%

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Assari

2020

Int J Travel Med Glob Health

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Introduction: Although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (SES) resources compared to socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). Most of the existing knowledge on MDRs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. As a result, very limited information exists on whether similar MDRs can be observed for middle-aged and older immigrants or not. Building on the MDRs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the United States. Methods: This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12166; 86.0%). The independent variable (IV) was income that was treated as a continuous variable. The dependent variable was mental well-being, also treated as a continuous variable. Age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. Immigration (nativity status) was the moderator. Logistic regression was applied for data analysis. Results: High income was associated with higher odds of good mental well-being in middle-aged and older adults. However, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults. Conclusion: In line with MDRs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. There is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. Such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.

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Section: Discussionmentioning

confidence: 71%

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Assari

2020

Int J Travel Med Glob Health

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“…Previous work has documented MDRs in terms of effects of educational attainment on job quality. For example, highly educated Black people work in high stress jobs, while highly educated White people work in low stress jobs (47). Another study showed that highly educated non-Hispanic Black people work in jobs that are high in second-hand tobacco exposure, while highly educated non-Hispanic White people work in jobs with low second-hand tobacco exposure (45,46).…”

Section: Discussionmentioning

confidence: 99%

“…The rst proposed mechanisms is the labor market discrimination (44). Under labor market discrimination, highly educated Blacks may have a lower chance to secure high quality, low stress, and high paying jobs (45)(46)(47). Thus highly educated non-Hispanic Blacks make lower income and are more likely to live under poverty despite high educational level, compared to non-Hispanic Whites with the same education (44,48,49).…”

Section: Due To Multiple Societal Mechanisms Ses Indicators May Genementioning

confidence: 99%

Education and Income Better Boost the Health of Non-Hispanic White than Black Americans

Assari

Bazargan

2020

Preprint

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Background. Socioeconomic status (SES) indicators such as education and income influence population health including but not limited to self-rated health (SRH). Based on Minorities' Diminished Returns (MDRs), however, we observe weaker health effects SES indicators for non-Hispanic Blacks compared to non-Hispanic Whites. While such diminished returns of SES resources are shown in nationally representative data and Michigan data, there is still a need to replicate these findings in other settings. This is particularly relevant because the effects of social SES indicators are not universal but vary across geographic locations. This cross-sectional study tested racial differences in the effects of high educational attainment and income on SRH among Californian adults. Methods. Survey of California Adults on Serious Illness and End-of-Life is a representative survey of Californian adults conducted for the California Health Care Foundation. The independent variables were educational attainment and income. The main outcome was poor/fair SRH. Age, gender, marital status, and employment were control variables (confounders). Racial group membership was the effect modifier. Linear regression model was utilized to analyze the data. Results. Overall, higher education and income were associated with better SRH. Race showed significant statistical interactions with education and income on SRH, indicating weaker boosting effects of high education and income on SRH of non-Hispanic Blacks than non-Hispanic Whites. At least some of the diminished return of education on health for non-Hispanic Blacks than non-Hispanic Whites was due to income. Conclusions. While high education and income improve SRH of Californians, these effects are unequal between non-Hispanic Blacks and non-Hispanic Whites with education and income showing diminished health returns for non-Hispanic Blacks than non-Hispanic Whites. More than the availability of education and income, what populations can do with their education and income may be important. Under segregation, racism, and discrimination, education and income have weaker effects on changing the living condition of the historically oppressed racial group. To close the existing racial gap in health, we need much more than equalizing access to education and income. Education quality of urban public schools should be improved. Types of occupations that are available in Black communities should be improved. Meanwhile, non-Hispanic Black middle class should be helped so they can better leverage their SES resources and turn to outcomes. Such changes need a through change to the living conditions of non-Hispanic Blacks across all SES levels.

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“…[7][8][9][10][11] The protective effect of education against occupational stress has also been found to be lower among NHBs relative to NHWs. 12 Consequently, work-related stress generally and perceived workplace discrimination in particular, may play a role in the CVD morbidity and mortality disparities observed among NHBs. Conversely, selfemployed NHBs may face more financial uncertainty, relative to NHB wage workers, potentially increasing stress levels and worsening health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Relationship Between Self-Employment and Health Among Blacks

Narain

Jeffers

2020

Health Equity

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There is some evidence that self-employment may improve measures of cardiovascular and general health among the general population; however, no studies have examined this relationship among Non-Hispanic Blacks (NHBs). Studying the health implications of self-employment among NHBs is important because of the disparities that persist in both cardiovascular health and self-employment rates between NHBs and other racial/ethnic subgroups. Methods: A pooled cross-sectional analysis of data from the Behavioral Risk Factor Surveillance System (2000 to 2014) was used to explore the association between self-employment and the following self-reported outcomes: ''no exercise,'' fruit consumption, vegetable consumption, days of alcohol consumption, fair or poor health, hypertension, poor mental health days, and poor physical health days among the total population of NHBs and across gender/income subgroups. Results: We find favorable associations between self-employment and several measures of cardiovascular health (increased fruit and vegetable consumption, reduced reports of ''no exercise,'' and reduced reports of hypertension) and positive associations between self-employment, poor mental health days, and days of alcohol consumption among the total population. The nature of these associations varies across gender/ income subgroup. Conclusions: Given the disparities between racial/ethnic subgroups with respect to adverse cardiovascular outcomes and the well-documented roles of exercise and blood pressure control in limiting cardiovascular disease, it is important to probe the relationship between self-employment and health among NHBs further.

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Unequal Associations between Educational Attainment and Occupational Stress across Racial and Ethnic Groups

Cited by 75 publications

References 49 publications

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Education and Income Better Boost the Health of Non-Hispanic White than Black Americans

Exploring the Relationship Between Self-Employment and Health Among Blacks

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