Siddiq Hafifa, Darvishi Mona, Najand Babak
School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA.
Healthcare (Basel). 2023 Feb 5;11(4):463. doi: 10.3390/healthcare11040463.
Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals.
Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association.
This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972-2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis.
We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals.
This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants.
多项研究表明，高学历与更好的自评健康状况（SRH）之间存在关联。然而，近期研究表明，与本土出生的个体相比，移民在教育与SRH之间的关联可能较弱。
本调查使用美国老年人的全国样本，研究教育与SRH之间是否存在负相关，以及移民身份是否会调节这种关联。
本研究基于边际收益递减（MDRs）理论，该理论认为社会经济地位（SES）资源，如教育，可能会给边缘化群体带来不太有利的健康结果。数据来自1972 - 2021年的美国综合社会调查（GSS），这是一项美国的横断面调查。共纳入7999名65岁及以上的参与者。自变量为教育程度，以受教育年限衡量并作为连续变量处理。因变量为较差/一般（差）的SRH。移民身份为调节变量。年龄、性别和种族为控制变量。采用逻辑回归进行数据分析。
我们发现，较高的教育水平对较差的SRH具有保护作用。然而，这种效应在移民中比在美国本土出生的个体中更弱。
本研究发现，与移民相比，美国本土出生的老年人更有可能体验到其教育对较差SRH的保护作用。消除移民与美国本土出生个体之间的健康不平等需要超越社会经济地位（SES）平等的政策，并解决阻碍高学历移民的障碍。
