Assari Shervin
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2700, USA.
Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
Behav Sci (Basel). 2019 Jan 29;9(2):16. doi: 10.3390/bs9020016.
Although high educational attainment is linked to better health and lower health risk behaviors, this effect may be systemically smaller for racial and ethnic minority groups compared to Whites. However, it is still unknown whether these diminished returns also apply to marginalization based on sexual orientation. In a national sample of adults which was composed of people of color, we compared straight and homosexual people for the association between education attainment and obesity. The Social Justice Sexuality Project (SJS-2010) is a cross-sectional national survey of health and wellbeing of predominantly people of color who identify as homosexual. The current analysis included 2884 adults (age 24 or more) who were either heterosexual (n = 260) or homosexual (n = 2624). The predictor variable was education attainment, and the outcome variable was obesity status (body mass index larger than 30 kg/m² [kilograms per meter squared]). Demographic factors (age and gender), household income, nativity (US born vs. immigrant), and health (self-rated health and current smoking) were the covariates. Sexual orientation was the moderator. In the pooled sample, high education attainment was protective against obesity status. Sexual orientation interacted with education attainment on odds of obesity, which was suggestive of stronger protective effects of high education attainment against obesity for heterosexual than homosexual individuals. High education attainment better protects heterosexual than homosexual people against obesity, a pattern similar to what has been observed for comparison of Whites and non-Whites. Smaller protective effects of education attainment on health behaviors of marginalized people are possibly, due to prejudice and discrimination that they experience. Discrimination may minimize stigmatized individuals' abilities to mobilize their economic and human resources and translate them to tangible outcomes. This finding extends the Minorities' Diminished Returns theory, suggesting that it is not just race/ethnicity but possibly any marginalizing and stigmatizing social identity that results in diminished returns of socioeconomic status resources.
尽管高学历与更好的健康状况及更低的健康风险行为相关,但与白人相比,这种影响在种族和少数民族群体中可能总体上更小。然而,基于性取向的边缘化群体是否也存在这种回报递减的情况仍不明确。在一个由有色人种组成的全国成年人样本中,我们比较了异性恋者和同性恋者在教育程度与肥胖之间的关联。社会正义性取向项目(SJS - 2010)是一项针对主要为认同自己为同性恋的有色人种的健康与幸福状况的全国性横断面调查。当前分析纳入了2884名成年人(年龄24岁及以上),其中异性恋者(n = 260),同性恋者(n = 2624)。预测变量是教育程度,结果变量是肥胖状况(体重指数大于30千克/平方米)。人口统计学因素(年龄和性别)、家庭收入、出生地(美国出生与移民)以及健康状况(自我评估健康和当前吸烟情况)为协变量。性取向为调节变量。在合并样本中,高学历对肥胖状况具有保护作用。性取向与教育程度在肥胖几率上存在交互作用,这表明高学历对异性恋者肥胖的保护作用比对同性恋者更强。高学历对异性恋者比对同性恋者在预防肥胖方面有更好的保护作用,这一模式与白人和非白人比较时所观察到的相似。教育程度对边缘化人群健康行为的保护作用较小,可能是由于他们所经历的偏见和歧视。歧视可能会削弱受污名化个体调动其经济和人力资源并将其转化为实际成果的能力。这一发现扩展了少数群体回报递减理论,表明不仅是种族/族裔,可能任何导致边缘化和污名化的社会身份都会导致社会经济地位资源的回报递减。