Assari Shervin, Bazargan Mohsen
Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
J Med Res Innov. 2019;3(2). doi: 10.32892/jmri.179. Epub 2019 Jul 24.
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. 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.
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.
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.
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.
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.
高学历促进人群健康的机制之一是减少接触二手烟等环境风险因素。然而，有一种理论认为，与白人相比，种族和少数族裔个体，尤其是黑人和西班牙裔，学历的保护作用可能较小。
在美国成年人全国样本中，探讨学历与工作场所二手烟接触之间关联的种族和族裔差异。
数据来自全国健康访谈调查（2015年NHIS），这是一项横断面研究，纳入了15726名在职成年人。自变量是学历，因变量是工作场所的任何二手烟接触和每日二手烟接触，年龄和性别是协变量，种族和族裔是调节变量。
总体而言，较高的学历与工作场所任何二手烟接触和每日二手烟接触几率较低相关。种族和族裔均与学历相互作用，这表明学历对降低工作场所任何二手烟接触和每日二手烟接触几率的保护作用，对黑人和西班牙裔系统性地小于白人。
在美国，种族和族裔限制了学历带来的健康益处。虽然学历有助于个人避免接触二手烟等环境风险因素，但这对白人比对黑人和西班牙裔更有效。结果是，高学历的黑人和西班牙裔患癌症和烟草相关疾病的风险增加。鉴于少数族裔是美国人口增长最快的部分，这些结果很重要。我们不应假设学历对所有种族和族裔群体都有同样的保护作用。在这种情况下，学历可能会增加而非减少健康差距。
