Assari Shervin, Cobb Sharon, Saqib Mohammed, Bazargan Mohsen
Departments of Family Medicine, Charles R Drew University of Medicine and Science.
School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States.
J Ment Health Clin Psychol. 2020;4(2):49-62. doi: 10.29245/2578-2959/2020/2.1203. Epub 2020 Jun 18.
A large body of empirical evidence on Minorities' Diminished Returns (MDRs) suggests that educational attainment shows smaller health effects for Blacks compared to Whites. At the same time, economic strain may operate as a risk factor for a wide range of undesired mental and physical health outcomes in Black communities.
The current study investigated the combined effects of education and economic strain on the following five health outcomes in Black older adults in underserved areas of South Los Angeles: depressive symptoms, number of chronic diseases, pain intensity, self-rated health, and sick days.
This cross-sectional study included 619 Black older adults residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics, economic strain, health insurance, living arrangement, marital status, health behaviors, depressive symptoms, pain intensity, number of chronic diseases, sick days, and self-rated health were collected. Five linear regressions were used to analyze the data.
Although high education was associated with less economic strain, it was the economic strain, not educational attainment, which was universally associated with depressive symptoms, pain intensity, self-rated health, chronic diseases, and sick days, independent of covariates. Similar patterns emerged for all health outcomes suggesting that the risk associated with economic strain and lack of health gain due to educational attainment are both robust and independent of type of health outcome.
In economically constrained urban environments, economic strain is a more salient social determinant of health of Black older adults than educational attainment. While education loses some of its protective effects, economic strain deteriorates health of Black population across domains. There is a need for bold economic and social policies that increase access of Black communities to cash at times of emergency. There is also a need to improve the education quality in the Black communities.
大量关于少数族裔回报递减（MDRs）的实证证据表明，与白人相比，教育程度对黑人健康的影响较小。与此同时，经济压力可能是黑人社区中一系列不良身心健康结果的风险因素。
本研究调查了教育和经济压力对洛杉矶南部服务不足地区黑人老年人以下五种健康结果的综合影响：抑郁症状、慢性病数量、疼痛强度、自评健康状况和病假天数。
这项横断面研究纳入了619名居住在洛杉矶南部的黑人老年人。收集了有关人口统计学因素（年龄和性别）、社会经济特征、经济压力、健康保险、生活安排、婚姻状况、健康行为、抑郁症状、疼痛强度、慢性病数量、病假天数和自评健康状况的数据。使用五个线性回归分析数据。
尽管高学历与较低的经济压力相关，但普遍与抑郁症状、疼痛强度、自评健康状况、慢性病和病假天数相关的是经济压力，而非教育程度，且独立于协变量。所有健康结果都出现了类似的模式，这表明与经济压力相关的风险以及教育程度带来的健康收益不足都是强大且独立于健康结果类型的。
在经济受限的城市环境中，经济压力对黑人老年人健康的社会决定因素比教育程度更为显著。虽然教育失去了一些保护作用，但经济压力会在各个领域恶化黑人的健康状况。需要大胆的经济和社会政策，以增加黑人社区在紧急情况下获得现金的机会。还需要提高黑人社区的教育质量。
