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Weaker Effects of Educational Attainment on Chronic Medical Conditions in American Indian Alaska Native, Black, and Latino Adults: National Health Interview Survey 2023. 教育程度对美国印第安人、阿拉斯加原住民、黑人和拉丁裔成年人慢性病的影响较弱:2023 年全国健康访谈调查》。
Pub Date : 2025-01-01 Epub Date: 2025-01-23 DOI: 10.31586/ojms.2025.1150
Shervin Assari, Hossein Zare

Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors contributing to these disparities. While higher socioeconomic status is generally associated with better health outcomes, this benefit may be diminished for racialized and minoritized populations.

Objective: This study investigates the protective effects of educational attainment and income-to-poverty ratio on the prevalence of chronic medical conditions and examines whether these effects vary across racial and ethnic groups, specifically among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino White adults.

Methods: Using data from the 2023 National Health Interview Survey (NHIS), this cross-sectional study analyzed the association between educational attainment and chronic medical conditions across racial and ethnic groups. Logistic regression models were employed to assess whether the strength of the relationship between education and chronic medical conditions differed by racial/ethnic group, controlling for key demographic and socioeconomic covariates. Sample size was 29,373 which was reflective of 256,566,689 US population.

Results: Consistent with the theory of Minorities' Diminished Returns, findings showed that the protective effects of higher educational attainment on chronic medical conditions were significantly weaker for Black, Latino, and American Indian and Alaska Native adults than for their non-Latino White counterparts. Even among individuals with higher education, Black, Latino, and American Indian and Alaska Native adults faced elevated risks of chronic medical conditions.

Conclusion: While educational attainment generally reduces the prevalence of chronic medical conditions, this protective effect is moderated by racial and ethnic background. Structural barriers limit the health benefits of educational attainment. This underscores the need for policies that address structural inequities-such as low- quality education and occupational segregation-that constrain the protective health effects of educational attainment for minoritized groups.

背景:慢性病是美国医疗支出、发病率和死亡率的主要驱动因素,也是健康差异的关键指标。与非拉丁裔白人相比,黑人、拉丁裔、美国印第安人和阿拉斯加原住民成年人的慢性病患病率高得不成比例,这凸显了研究造成这些差异的因素的迫切需要。虽然较高的社会经济地位通常与较好的健康结果相关,但对于种族化和少数民族人群来说,这种益处可能会被削弱:本研究调查了教育程度和收入与贫困比率对慢性病患病率的保护作用,并研究了这些作用在不同种族和族裔群体中是否存在差异,特别是在黑人、拉丁裔、美国印第安人和阿拉斯加原住民成年人中与非拉丁裔白人成年人相比是否存在差异:这项横断面研究利用 2023 年全国健康访谈调查 (NHIS) 的数据,分析了不同种族和族裔群体的受教育程度与慢性病之间的关系。采用逻辑回归模型来评估不同种族/族裔群体受教育程度与慢性病之间关系的强度是否存在差异,同时控制主要的人口和社会经济协变量。样本量为 29,373 个,反映了 256,566,689 个美国人口:结果:与 "少数群体收益递减 "理论一致,研究结果表明,对于黑人、拉丁裔、美国印第安人和阿拉斯加原住民成年人来说,较高的教育程度对慢性病的保护作用明显弱于非拉丁裔的白人成年人。即使在受教育程度较高的人群中,黑人、拉丁裔、美国印第安人和阿拉斯加原住民也面临着更高的慢性病风险:结论:虽然受教育程度普遍降低了慢性病的发病率,但这种保护作用会受到种族和民族背景的影响。结构性障碍限制了教育程度对健康的益处。这突出表明,有必要制定政策,解决结构性不公平问题,如低质量教育和职业隔离,这些问题限制了教育程度对少数群体健康的保护作用。
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Open journal of medical sciences
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