美国青少年的父母教育程度与慢性疾病；少数族裔的回报递减。
Parental Educational Attainment and Chronic Medical Conditions among American Youth; Minorities' Diminished Returns.
作者信息
Assari Shervin, Bazargan Mohsen, Caldwell Cleopatra
机构信息
Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
出版信息
Children (Basel). 2019 Aug 26;6(9):96. doi: 10.3390/children6090096.
BACKGROUND
Parental educational attainment is protective against chronic medical conditions (CMCs). According to the minorities' diminished returns (MDRs) theory, however, the health effects of socioeconomic status (SES) indicators are smaller for socially marginalized groups such as racial and ethnic minorities rather than Whites.
AIMS
To explore racial and ethnic differences in the effect of parental educational attainment on CMCs in a nationally representative sample of American youth.
METHODS
In this cross-sectional study, we used baseline data of 10,701 12-17 years old youth in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the independent variable. The dependent variable was the number of CMCs in youth. Age, gender, and family structure were covariates. Race and ethnicity were the focal moderators. Linear and multinomial regression were applied to analyze the data.
RESULTS
Overall, higher parental educational attainment was associated with a lower number of CMCs. Race and ethnicity, however, showed significant interactions with parental educational attainment on a number of CMCs as well as 2+ CMCs, suggesting that the effect of parenting educational attainment on CMCs is significantly smaller for Black and Hispanic than White youth.
CONCLUSIONS
In the United States, race and ethnicity alter the health gains that are expected to follow parental educational attainment. While White youth who are from highly educated families are most healthy, Black and Hispanic youth from highly educated families remain at higher risk for CMCs. That means, while the most socially privileged group, Whites, gain the most health from their parental education, Blacks and Hispanics, the least privileged groups, gain the least. The result is a disproportionately high number of CMCs in middle-class Blacks and Hispanics. Economic, social, public, and health policy makers should be aware that health disparities are not all due to lower SES of the disadvantaged group but also diminished returns of SES resources for them. Youth physical health disparities due to race and ethnicity exist across all SES levels.
背景
父母的教育程度对慢性疾病具有预防作用。然而，根据少数群体收益递减（MDRs）理论，社会经济地位（SES）指标对社会边缘化群体（如少数种族和少数民族）的健康影响要小于白人。
目的
在美国全国代表性的青少年样本中，探讨父母教育程度对慢性疾病的影响在种族和民族上的差异。
方法
在这项横断面研究中，我们使用了烟草与健康人口评估（PATH；2013）中10701名12 - 17岁青少年的基线数据。父母的教育程度是自变量。因变量是青少年慢性疾病的数量。年龄、性别和家庭结构是协变量。种族和民族是重点调节变量。采用线性回归和多项回归分析数据。
结果
总体而言，父母教育程度越高，青少年患慢性疾病的数量越少。然而，种族和民族在一些慢性疾病以及两种及以上慢性疾病方面与父母教育程度存在显著的交互作用，这表明父母教育程度对黑人及西班牙裔青少年慢性疾病的影响明显小于白人青少年。
结论
在美国，种族和民族改变了父母教育程度所预期带来的健康收益。虽然来自高学历家庭的白人青少年最健康，但来自高学历家庭的黑人和西班牙裔青少年患慢性疾病的风险仍然较高。这意味着，作为社会最具特权的群体，白人从父母教育中获得的健康收益最大，而黑人和西班牙裔作为最缺乏特权的群体，获得的收益最少。结果是中产阶级黑人和西班牙裔患慢性疾病的人数比例过高。经济、社会以及公共卫生政策制定者应意识到，健康差距并非完全归因于弱势群体较低的社会经济地位，还在于社会经济地位资源对他们的收益递减。所有社会经济水平都存在因种族和民族导致的青少年身体健康差距。
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