Unequal Effects of Educational Attainment on Workplace Exposure to Second-Hand Smoke by Race and Ethnicity; Minorities’ Diminished Returns in the National Health Interview Survey (NHIS)

Abstract

Background: One of the mechanisms by which high educational attainment promotes populations’ health is through reducing exposure to environmental risk factors such as second-hand smoke. Minorities’ Diminished Returns theory, however, posits that the protective effect of educational attainment may be smaller for racial and ethnic minority individuals particularly Blacks and Hispanics compared to Whites. Aims: To explore racial and ethnic differences in the association between educational attainment and second-hand smoke exposure at work in a national sample of American adults. Methods: Data came from the National Health Interview Survey (NHIS 2015), a cross-sectional study that included 15,726 employed adults. The independent variable was educational attainment, the dependent variables were any and daily second-hand smoke exposure at workplace, age and gender were covariates, and race and ethnicity were the moderators. Results: Overall, higher educational attainment was associated with lower odds of any and daily second-hand smoke exposure at work. Race and ethnicity both interacted with educational attainment suggesting that the protective effects of educational attainment on reducing the odds of any and daily second-hand smoke exposure at work are systemically smaller for Blacks and Hispanics than Whites. Conclusions: In the United States, race and ethnicity bound the health gains that follow educational attainment. While educational attainment helps individuals avoid environmental risk factors such as second-hand smoke, this is more valid for Whites than Blacks and Hispanics. The result is additional risk of cancer and tobacco related disease in highly educated Blacks and Hispanics. The results are important given racial and ethnic minorities are the largest growing section of the US population. We should not assume that educational attainment is similarly protective across all racial and ethnic groups. In this context, educational attainment may increase, rather than reduce, health disparities.

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

“…We also observed a mean of 12.8 years of education, which suggests that our sample was a well-educated group. Participants were still living in low SES areas, suggesting that education has smaller than expected effects on changing AA life conditions [52][53][54][55][56].…”

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

“…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. 11 Finally, MDRs are seen for physical health outcomes such as obesity, 36,37 self-rated health, 23,32,54 CMCs, 25,26,38 disability, 60 and mortality.…”

Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults

“…Educational Attainment, Race/Ethnicity, and Exposure to Tobacco Advertisement Among US Young Adults Given the existing weaker-than-expected associations of health outcomes with education for racial/ethnic minority groups, racial/ethnic gaps in tobacco exposure may increase, rather than decrease, as socioeconomic status increases. 26 Rather than socioeconomic status per se, the major risk factors for tobacco disparities in middle-class racial/ethnic minority groups 16,17 may be residual environmental exposures that continue regardless of socioeconomic status. The findings in this study suggest that at least some of the additional risk of tobacco use in highly educated racial/ethnic minority groups may be associated with environmental risk factors for tobacco use.…”

“…Despite replicability of studies showing diminished health outcomes associated with educational attainment among racial/ethnic minority groups, 16,17 few studies have explored specific mechanisms for this phenomenon in the field of tobacco use. 25 In a 2019 study, 26 secondhand workplace exposure to cigarette smoke was higher in highly educated Hispanic and African American individuals, which was attributed to labor market discrimination, which often results in Hispanic and with white households. One mechanism to be examined in this study is the differential role of higher educational attainment associated with risk of exposure to tobacco advertisement in Hispanic, African American, and white individuals.…”