Assari Shervin
Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor 48109-2700, MI, USA.
Department of Psychiatry, University of Michigan, Ann Arbor 48109-2700, MI, USA 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
Dent J (Basel). 2018 Apr 24;6(2):11. doi: 10.3390/dj6020011.
An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites ( = 7587) or Hispanic Whites ( = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.
大量知识文献记载，与白人相比，社会经济地位（SES）对黑人健康的影响较弱，这一现象也被称为黑人的回报递减。然而，目前尚不清楚这种回报递减现象是否也适用于其他少数族裔，如西班牙裔。本研究使用具有全国代表性的样本，旨在比较非西班牙裔白人和西班牙裔白人中SES对自评口腔健康的影响。在这项横断面研究中，我们使用了2001 - 2003年协作精神病流行病学调查（CPES）的数据。通过全国代表性抽样，CPES纳入了11207名成年人，其中非西班牙裔白人有7587名，西班牙裔白人有3620名。因变量是自评口腔健康，作为二分变量处理。自变量包括教育程度、收入、就业状况和婚姻状况。种族是核心调节变量。年龄和性别是协变量。数据分析采用逻辑回归。在合并样本中，教育程度、收入、就业状况和婚姻状况与口腔健康相关。虽然在非西班牙裔白人中，教育程度、收入、就业状况和婚姻状况与口腔健康相关，但在西班牙裔白人中未发现这些关联。与黑人的回报递减模式类似，西班牙裔白人和非西班牙裔白人之间存在SES指标的差异收益，西班牙裔白人处于劣势。SES回报递减应被视为美国种族口腔健康差异背后一个被系统性忽视的促成机制。西班牙裔存在类似黑人的回报递减现象，这表明这些过程并非少数族裔群体所特有，非白人群体获益较少是因为他们没有享受到白人的特权和优势。
