Department of Educational Leadership and Higher Education, St. Cloud State University, St. Cloud, MN, USA.
Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA.
BMC Womens Health. 2022 Mar 17;22(1):75. doi: 10.1186/s12905-022-01641-0.
Research suggests that non-Hispanic Black (henceforth, Black) women and people with lower educational attainment have higher levels of allostatic load (AL). This study sought to determine the association between educational attainment and AL among a large sample of Black women.
We analyzed data among 4177 Black women from the National Health and Nutrition Examination Survey years 1999-2018. AL score was defined as the total for abnormal measures of eight biomarkers. We further categorized participants with AL score greater than or equal to 4 as having high AL. We calculated mean estimates of total allostatic load scores using generalized linear models. We performed modified Poisson Regression models with robust variance estimation to estimate prevalence ratios (PRs) of high allostatic load and their associated 95% confidence intervals (CIs) by educational attainment.
Black women with a college degree or higher had the lowest prevalence of high allostatic load (31.8% vs. 42.7%, 36.3%, 36.6%), and age adjusted mean allostatic load scores (mean = 1.90 vs. mean = 2.34, mean = 1.99, mean = 2.05) when compared to Black women with less than a high school diploma, high school diploma or GED, and some college or associates degree respectively. Even after accounting for age, poverty-to-income ratio, smoking, congestive heart failure, and heart attack, Black college graduates had an 14.3% lower prevalence of high allostatic load (PR = 0.857, 95% CI 0.839-0.876) when compared to Black women with lower educational attainment.
Black women with a baccalaureate degree or higher educational attainment had lower allostatic load compared to Black women with less than a high school education. This finding further confirms higher education is a social determinant of health. Future research should explore differences in AL by more granular degree types.
研究表明，非西班牙裔黑人（以下简称黑人）和受教育程度较低的人群的全身适应综合征负担（AL）水平较高。本研究旨在确定在大量黑人女性样本中，受教育程度与 AL 之间的关联。
我们分析了 1999-2018 年全国健康和营养检查调查中 4177 名黑人女性的数据。AL 评分定义为 8 种生物标志物异常测量的总和。我们进一步将 AL 评分大于或等于 4 的参与者归类为高 AL。我们使用广义线性模型计算总全身适应负荷评分的平均值估计。我们使用修正泊松回归模型进行稳健方差估计，按受教育程度估计高全身适应负荷的患病率比（PR）及其 95%置信区间（CI）。
与高中以下、高中或同等学历、一些大学或副学士学位的黑人女性相比，拥有大学学位或更高学历的黑人女性的高全身适应负荷患病率最低（31.8%比 42.7%、36.3%、36.6%），年龄调整后的平均全身适应负荷评分（均值=1.90 比均值=2.34、均值=1.99、均值=2.05）。即使考虑到年龄、收入贫困比、吸烟、充血性心力衰竭和心脏病发作，与受教育程度较低的黑人女性相比，黑人大学毕业生的高全身适应负荷患病率低 14.3%（PR=0.857，95%CI 0.839-0.876）。
与受教育程度较低的黑人女性相比，拥有学士学位或更高学历的黑人女性的全身适应负荷较低。这一发现进一步证实了高等教育是健康的社会决定因素。未来的研究应探索更细粒度的学位类型的 AL 差异。
