Marginalized-Related Diminished Returns (MDRs) Center, Los Angeles, CA, USA.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
J Racial Ethn Health Disparities. 2024 Jun;11(3):1223-1237. doi: 10.1007/s40615-023-01601-w. Epub 2023 Jul 25.
COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals.
The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic.
This study utilized data from the Health Information National Trends Survey (HINTS) 2020. Total sample included 1313 adult American; among them, 77.4% (n = 1017) were non-Hispanic White, and 22.6% (n = 296) were non-Hispanic Black. Educational attainment was the independent variable operationalized as years of education. The main outcomes were cigarette smoking, e-cigarette vaping, CMC, SRH, depressive symptoms, and obesity. Age, gender, and baseline physical health were covariates. Race/ethnicity was an effect modifier.
Educational attainment was significantly associated with lower CMC, SRH, depressive symptoms, obesity, cigarette smoking, and e-cigarette vaping. Educational attainment did not show a significant interaction with race on any of our outcomes, suggesting that the health returns of education is similar between non-Hispanic White and non-Hispanic Black individuals.
COVID-19 may have operated as an equalizer of the returns of educational attainment. This observation may be because White may have more to lose; Black communities may be more resilient or have economic and social policies that buffered unemployment and poverty regardless of historical anti-Black oppression.
COVID-19 大流行极大地影响了全球个人的社会和个人生活。边缘化相关回报递减(MDR)理论表明,与白人相比,教育程度对黑人的健康和行为结果的保护作用较弱。在 COVID-19 大流行之前进行的先前研究表明,与白人相比,黑人的教育程度回报较低。
本研究有三个目标:首先,检验教育程度与吸烟、电子烟吸食、存在慢性疾病(CMC)、自我报告的健康(SRH)、抑郁症状和肥胖之间的关联;其次,探讨 COVID-19 大流行期间美国这些关联中的种族差异;最后,比较 COVID-19 大流行前后种族与教育回报的相互作用。
本研究使用了来自健康信息国家趋势调查(HINTS)2020 的数据。总样本包括 1313 名美国成年人;其中,77.4%(n=1017)为非西班牙裔白人,22.6%(n=296)为非西班牙裔黑人。教育程度是作为受教育年限的自变量。主要结果是吸烟、电子烟吸食、CMC、SRH、抑郁症状和肥胖。年龄、性别和基线身体健康状况是协变量。种族/族裔是效应修饰符。
教育程度与较低的 CMC、SRH、抑郁症状、肥胖、吸烟和电子烟吸食显著相关。教育程度与种族之间的任何结果都没有显示出显著的相互作用,这表明非西班牙裔白人和非西班牙裔黑人的教育回报的健康效应相似。
COVID-19 可能是教育回报均等化的原因。这一观察结果可能是因为白人可能损失更多;黑人社区可能更有弹性,或者有经济和社会政策,无论历史上的反黑人压迫如何,都能缓冲失业和贫困。