The Open Cardiovascular Medicine Journal




ISSN: 1874-1924 ― Volume 14, 2020
RESEARCH ARTICLE

Diminished Returns of Educational Attainment on Heart Disease among Black Americans



Shervin Assari1, *, Sharon Cobb2, Mohammed Saqib3, Mohsen Bazargan1, 4
1 Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
2 School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
3 Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
4 Department of Family Medicine, UCLA, Los Angeles, CA, USA

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.

Keywords: Socioeconomic position, Socioeconomic status, Educational attainment, Ethnicity, Race, Ethnic groups, African Americans, Blacks, Heart disease.


Article Information


Identifiers and Pagination:

Year: 2020
Volume: 14
First Page: 5
Last Page: 12
Publisher Id: TOCMJ-14-5
DOI: 10.2174/1874192402014010005

Article History:

Received Date: 30/12/2019
Revision Received Date: 07/03/2020
Acceptance Date: 09/03/2020
Electronic publication date: 16/04/2020
Collection year: 2020

© 2020 Assari et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA; Tel.: +734-232-0445, Fax: +734-615-8739; E-mail: assari@umich.edu



Track Your Manuscript:


Endorsements



"I am very satisfied by all the services, friendly communication and the attention that was given to my manuscript. My sincere gratitude tou you and the entire team of Bentham Open"


Aristofanis Gikas
Health Centre of Kalivia, K
alivia, Attiki,
Greece


Browse Contents



Webmaster Contact: info@benthamopen.net
Copyright © 2020 Bentham Open