Bell Caryn N, Tavares Carlos D, Owens-Young Jessica L, Thorpe Roland J
Department of Social, Behavioral, and Population Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States.
Department of Anthropology and Sociology, Lafayette College, Easton, PA, United States.
Front Epidemiol. 2022 Sep 26;2:991628. doi: 10.3389/fepid.2022.991628. eCollection 2022.
Self-employment is generally associated with better health outcomes and educational attainment can shape self-employment. Yet, Black Americans are less likely to be self-employed and analyses of self-employment and health among Black Americans are few. The aim of this study was to determine how educational attainment moderates the associations between self-employment and hypertension among Black adults.
Using data from the 2007-2018 National Health and Nutrition Examination Survey, participants who self-identified as non-Hispanic Black ( = 2,855) were categorized as (1) employees with no self-employment income, (2) employees with self-employment income, or (3) having full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used to determine whether educational attainment moderated the associations between self-employment and measured hypertension (i.e., 140/90 mm Hg or anti-hypertensive medication).
Most participants were employees with no self-employment income (81.9%), but 11.8% were employees reporting some self-employment income and 6.3% were self-employed full-time. About two in five (40.9%) had hypertension. Having full-time self-employment was associated with lower risk of hypertension compared to those who were employees (risk ratio = 0.82, 95% confidence interval = 0.67-0.98), and educational attainment moderated the associations among Black men such that part-time self-employment was associated with high rates of hypertension among Black men who had not completed high school.
These results suggest that full-time self-employment is associated with lower risk of hypertension among Black adults, but that being an employee with some self-employment income may elevate rates of hypertension among Black men depending on educational attainment. Future studies should assess pathways between self-employment and hypertension by educational attainment among Black women and men.
个体经营通常与更好的健康状况相关联，而受教育程度会影响个体经营。然而，美国黑人个体经营的可能性较小，且针对美国黑人个体经营与健康状况的分析较少。本研究的目的是确定受教育程度如何调节黑人成年人中个体经营与高血压之间的关联。
利用2007 - 2018年国家健康与营养检查调查的数据，自我认定为非西班牙裔黑人的参与者（n = 2855）被分为三类：（1）无个体经营收入的雇员；（2）有个体经营收入的雇员；（3）全职个体经营者。采用修正泊松回归和乘法交互项来确定受教育程度是否调节了个体经营与测量的高血压（即收缩压140/90 mmHg或正在服用抗高血压药物）之间的关联。
大多数参与者是无个体经营收入的雇员（81.9%），但11.8%是报告有个体经营收入的雇员，6.3%是全职个体经营者。约五分之二（40.9%）患有高血压。与雇员相比，全职个体经营与较低的高血压风险相关（风险比 = 0.82，95%置信区间 = 0.67 - 0.98），并且受教育程度调节了黑人男性之间的关联，即兼职个体经营与未完成高中学业的黑人男性中高血压的高发病率相关。
这些结果表明，全职个体经营与黑人成年人中较低的高血压风险相关，但作为有个体经营收入的雇员可能会根据受教育程度提高黑人男性的高血压发病率。未来的研究应评估黑人男性和女性中受教育程度在个体经营与高血压之间的途径。
