Department of Epidemiology and Biostatistics, University of California, San Francisco; Department of Family and Community Medicine, University of California, San Francisco.
Department of Public and Nonprofit Administration, School of Management, University of San Francisco.
Ann Epidemiol. 2018 Nov;28(11):759-766.e5. doi: 10.1016/j.annepidem.2018.08.014. Epub 2018 Sep 6.
Evidence suggests education is an important life course determinant of health, but few studies examine differential returns to education by sociodemographic subgroup.
Using National Longitudinal Survey of Youth 1979 (n = 6158) cohort data, we evaluate education attained by age 25 years and physical health (PCS) and mental health component summary scores (MCS) at age 50 years. Race / ethnicity, sex, geography, immigration status, and childhood socioeconomic status (cSES) were evaluated as effect modifiers in birth year adjusted linear regression models.
The association between education and PCS was large among high cSES respondents (β = 0.81 per year of education, 95% CI: 0.67, 0.94), and larger among low cSES respondents (interaction β = 0.39, 95% CI: 0.06, 0.72). The association between education and MCS was imprecisely estimated among White men (β = 0.44; 95% CI: -0.03, 0.90), while, Black women benefited more from each year of education (interaction β = 0.91; 95% CI: 0.19, 1.64). Similarly, compared to socially advantaged groups, low cSES Blacks, and low and high cSES women benefited more from each year of education, while immigrants benefited less from each year of education.
If causal, increases in educational attainment may reduce some social inequities in health.
有证据表明，教育是健康的一个重要人生轨迹决定因素，但很少有研究考察社会人口亚组之间教育的差异回报。
利用国家青年纵向调查 1979 年（n=6158）队列数据，我们评估了 25 岁时获得的教育程度以及 50 岁时的身体健康（PCS）和心理健康综合评分（MCS）。种族/民族、性别、地理位置、移民身份和儿童社会经济地位（cSES）被评估为出生年份调整线性回归模型中的效应修饰剂。
在高 cSES 受访者中，教育与 PCS 之间的关联较大（每增加一年教育，β=0.81，95%CI：0.67，0.94），而在低 cSES 受访者中，关联更大（交互β=0.39，95%CI：0.06，0.72）。在白人男性中，教育与 MCS 之间的关联估计不精确（β=0.44；95%CI：-0.03，0.90），而黑人女性从每一年的教育中获益更多（交互β=0.91；95%CI：0.19，1.64）。同样，与社会地位较高的群体相比，低 cSES 的黑人以及低和高 cSES 的女性从每一年的教育中获益更多，而移民从每一年的教育中获益较少。
如果因果关系成立，教育程度的提高可能会减少一些健康方面的社会不平等。
