Abstract
Objectives: Minorities’ Diminished Returns (MDRs) refers to the weaker protective health effects of socioeconomic status (SES) for minorities, particularly educational attainment for racial and ethnic minorities, compared to the general population. This pattern has been documented among African-Americans compared to Whites, however, we know very little about MDRs for educational attainment on disability among Hispanics compared to Non-Hispanic Whites. Aims: This cross-sectional study explored ethnic variation in the effects of educational attainment on severity of disability in the United States of America (USA). Materials and Methods: The 2015 National Health Interview Survey (NHIS) was a national survey of the general population in the USA. The total sample was 1021 American adults that reported some disability. Of the 1021 participants, 855 identified as Non-Hispanic and 165 identified as Hispanic. The independent variable was educational attainment. The main outcome was severity of disability measured using self-reported data. Age, gender, and race were covariates. Ethnicity was the effect modifier. Results: Among individuals with a disability, higher levels of educational attainment were associated with fewer disabilities, independent of all confounders. When ethnicity and educational attainment were interacted on severity of disability, the results indicated a smaller protective effect for Hispanics than for Non-Hispanics with a disability. Ethnicity-stratified models showed an effect for Non-Hispanics but not for Hispanics. Conclusions: The protective effects of educational attainment against severity of disability are smaller for Hispanics than for Non-Hispanics. To prevent health disparities, there is a need to minimize MDRs of SES for ethnic minorities. To do so, there is a need for innovative economic, public, and social policies that are not limited to equalizing educational attainment but that also help minorities leverage their resources and gain tangible outcomes.
Highlights
Socioeconomic status (SES) indicators are protective against undesired health outcomes [1,2,3]
When ethnicity and educational attainment were interacted on severity of disability, the results indicated a smaller protective effect for Hispanics than for Non-Hispanics with a disability
The current study showed that higher educational attainment was associated with fewer disabilities for the pooled sample
Summary
Socioeconomic status (SES) indicators (e.g., educational attainment) are protective against undesired health outcomes [1,2,3]. Individuals with a higher educational attainment are at a lower risk of disability and morbidity defined in terms of chronic medical conditions (CMCs) [1,4,5,6,7,8,9,10]. The health effects of an SES indicator, such as educational attainment, differ widely among various locations and populations [13,14,15,16]. The effects of SES on morbidity, CMCs, and disability are shown to vary between sub-populations [14,15]. According to the Minorities’ Diminished Returns (MDRs) [17,18], the health of members of marginalized groups [19] is not heavily influenced
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