Shervin Assari, Sharon Cobb, Mohammed Saqib, Mohsen Bazargan
{"title":"美国黑人受教育程度对心脏病的影响减弱。","authors":"Shervin Assari, Sharon Cobb, Mohammed Saqib, Mohsen Bazargan","doi":"10.2174/1874192402014010005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease.</p><p><strong>Purpose: </strong>Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults.</p><p><strong>Methods: </strong>We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data.</p><p><strong>Results: </strong>Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals.</p><p><strong>Conclusion: </strong>Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.</p>","PeriodicalId":53619,"journal":{"name":"Open Cardiovascular Medicine Journal","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217286/pdf/nihms-1585714.pdf","citationCount":"22","resultStr":"{\"title\":\"Diminished Returns of Educational Attainment on Heart Disease among Black Americans.\",\"authors\":\"Shervin Assari, Sharon Cobb, Mohammed Saqib, Mohsen Bazargan\",\"doi\":\"10.2174/1874192402014010005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease.</p><p><strong>Purpose: </strong>Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults.</p><p><strong>Methods: </strong>We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data.</p><p><strong>Results: </strong>Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals.</p><p><strong>Conclusion: </strong>Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.</p>\",\"PeriodicalId\":53619,\"journal\":{\"name\":\"Open Cardiovascular Medicine Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2020-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217286/pdf/nihms-1585714.pdf\",\"citationCount\":\"22\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Cardiovascular Medicine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874192402014010005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/4/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Cardiovascular Medicine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874192402014010005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/4/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Diminished Returns of Educational Attainment on Heart Disease among Black Americans.
Background: Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease.
Purpose: Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults.
Methods: We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data.
Results: Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals.
Conclusion: Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
期刊介绍：
The Open Cardiovascular Medicine Journal is an open access online journal which publishes research articles, reviews/mini-reviews, case studies, short communications/letters and guest edited thematic issues on the understanding of scientific advances in the field of cardiovascular medicine, written and reviewed by globally recognized experts. Manuscripts on range of topics including cardiac and circulatory system disorders, heart failure, cardiac surgery and pharmacological treatment, arrhythmias, pacing and cellular electrophysiology, atrial fibrillation, vascular and lymphatic research and other related fields are considered for publication. The Open Cardiovascular Medicine Journal, a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide.
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