Do the health benefits of education vary by sociodemographic subgroup? Differential returns to education and implications for health inequities

Ann Epidemiol. 2018 Nov;28(11):759-766.e5. doi: 10.1016/j.annepidem.2018.08.014. Epub 2018 Sep 6.

Abstract

Purpose: Evidence suggests education is an important life course determinant of health, but few studies examine differential returns to education by sociodemographic subgroup.

Methods: Using National Longitudinal Survey of Youth 1979 (n = 6158) cohort data, we evaluate education attained by age 25 years and physical health (PCS) and mental health component summary scores (MCS) at age 50 years. Race / ethnicity, sex, geography, immigration status, and childhood socioeconomic status (cSES) were evaluated as effect modifiers in birth year adjusted linear regression models.

Results: The association between education and PCS was large among high cSES respondents (β = 0.81 per year of education, 95% CI: 0.67, 0.94), and larger among low cSES respondents (interaction β = 0.39, 95% CI: 0.06, 0.72). The association between education and MCS was imprecisely estimated among White men (β = 0.44; 95% CI: -0.03, 0.90), while, Black women benefited more from each year of education (interaction β = 0.91; 95% CI: 0.19, 1.64). Similarly, compared to socially advantaged groups, low cSES Blacks, and low and high cSES women benefited more from each year of education, while immigrants benefited less from each year of education.

Conclusions: If causal, increases in educational attainment may reduce some social inequities in health.

Keywords: Educational status; Ethnic groups; Immigrants; Socioeconomic factors; health status disparities; sex.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black People
  • Black or African American
  • Educational Status*
  • Emigrants and Immigrants / statistics & numerical data*
  • Ethnicity / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Health Status*
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Racial Groups / statistics & numerical data*
  • Social Class
  • Socioeconomic Factors*
  • United States / epidemiology
  • White People