Noppert Grace A, Gaydosh Lauren, Harris Kathleen Mullan, Goodwin Andrea, Hummer Robert A
Carolina Population Center, University of North Carolina at Chapel Hill, USA.
Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, USA.
SSM Popul Health. 2021 Feb 14;13:100752. doi: 10.1016/j.ssmph.2021.100752. eCollection 2021 Mar.
Educational disparities in health and mortality are well-documented and evidence suggests that they may be widening. Yet, there is much unknown about when educational disparities begin to emerge and for whom. This paper investigates the association between educational attainment and cardiometabolic health in young adults with critical attention paid to differences across racial/ethnic and sex subgroups. We focus on cardiometabolic health in young adulthood as it is particularly relevant for understanding current population health trends. We used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) when participants were aged 12-19 years (Wave I) and aged 24-32 years (Wave IV). Using a series of logistic regression models, we first estimated the association between education and five markers of cardiometabolic health (high-risk blood pressure, high-risk waist circumference, diabetes/pre-diabetes, hyperlipidemia, and high-risk inflammation). We then examined the extent to which this association was explained by adolescent health and both adolescent and young adult socioeconomic status (SES) (including parental education, participant educational attainment, household income, and employment status). Finally, we investigated whether the association between educational attainment and cardiometabolic health differed by race/ethnicity and sex. We found evidence of an association between educational attainment and cardiometabolic health that persisted net of adolescent health, adolescent SES, and young adult SES. We also found some evidence of modest differences in this association by race/ethnicity and sex. Our findings suggest that even as early as young adulthood there are disparities in cardiometabolic health by educational attainment, which may lead to even larger disparities in late life health.
健康与死亡率方面的教育差距有充分记录，且有证据表明这些差距可能正在扩大。然而，关于教育差距何时开始出现以及针对哪些人群，仍有许多未知之处。本文研究了年轻成年人的教育程度与心脏代谢健康之间的关联，并特别关注种族/族裔和性别亚组之间的差异。我们关注年轻成年期的心脏代谢健康，因为这对于理解当前的人口健康趋势尤为重要。我们使用了青少年到成人健康全国纵向研究（Add Health）的数据，这些数据来自参与者12 - 19岁（第一波）和24 - 32岁（第四波）时的情况。通过一系列逻辑回归模型，我们首先估计了教育与心脏代谢健康的五个指标（高危血压、高危腰围、糖尿病/糖尿病前期、高脂血症和高危炎症）之间的关联。然后，我们考察了青少年健康以及青少年和年轻成年人的社会经济地位（SES）（包括父母教育程度、参与者教育程度、家庭收入和就业状况）对这种关联的解释程度。最后，我们研究了教育程度与心脏代谢健康之间的关联是否因种族/族裔和性别而有所不同。我们发现，在排除青少年健康、青少年SES和年轻成年人SES的影响后，教育程度与心脏代谢健康之间仍存在关联。我们还发现了一些证据，表明这种关联在种族/族裔和性别方面存在适度差异。我们的研究结果表明，即使早在年轻成年期，心脏代谢健康就因教育程度而存在差异，这可能导致晚年健康方面更大的差异。
