Educational Attainment Research Articles

Reassessing migration outcomes: secondary education attainment and educational reproduction among Bolivian-origin youth in Argentina, Bolivians in Bolivia, and native Argentines

ABSTRACT Research examining the socioeconomic outcomes of migrants and their children often compares them with native populations in host countries. However, there is a limited understanding of how they fare relative to non-migrants in their origin countries. This study uses large-scale census microdata (2001–2012) to address this gap. It examines the educational attainment of Bolivian-origin youth born in Argentina, comparing their outcomes with those of their peers in Bolivia and native Argentines. In doing so, this study sheds light on the often-overlooked South-South migration corridor. The analysis - which focuses on individuals aged 19 to 25 living with their parents - shows that Bolivian-origin youth in Argentina are, on average, more likely to complete secondary education than their native Argentine peers. However, they are less likely to attain this educational level than their counterparts residing in Bolivia. Further examination reveals variations by gender, parental education, and census wave.

Age-related cataract without surgery is related to exacerbated depression symptoms: a cross-sectional study of Chinese adults from Anhui, China.

The present study sought to evaluate the relationship between age-related cataracts, a prevalent ocular condition among the elderly, and the occurrence of depressive symptoms within a cohort of Chinese adults residing in Anhui, China. A survey involving 252 Chinese individuals aged 65 years and older was conducted at Lu'an People's Hospital. Depressive symptoms were assessed using the Hamilton Depression Scale (HAMD) consisting of 17 items, while age-related cataracts were clinically classified according to the Lens Opacities Classification System (LOCS) III. Depressive symptoms were identified by a HAMD score exceeding 7. Logistic regression analyses were employed to determine the odds ratios (OR) and 95% confidence intervals (CI) pertaining to the association between age-related cataracts and depressive symptoms. Cataract patients aged 65 years and older had significantly higher scores of depressive symptoms than those under 65 years (mean scores of 8.17 ± 3.26 versus 5.18 ± 1.86, p < 0.001). In addition, patients aged 65 years and above exhibited a diminished quality of life relative to patients aged under 65 years. The findings indicated that adults experiencing depressive symptoms reported lower monthly incomes (p = 0.036), lower educational attainment (p = 0.044), and living alone (p = 0.007). Furthermore, fewer elderly patients with depressive symptoms received surgical treatment (15 patients) than those without depressive symptoms (61 patients), with a significant difference (p = 0.011). Multivariate analysis revealed that the presence of depressive symptoms was significantly correlated with a lack of formal education (p = 0.048), reduced income (p = 0.003), solitary living arrangements (p = 0.025), and the presence of cataracts without surgical intervention (p = 0.007). These findings suggested a significant association between age-related cataracts and depressive symptoms among older adults. Specifically, cataracts that remain untreated surgically were notably linked to depression in elderly patients. It is recommended that initiatives and resources be directed toward surgical treatment programs for cataracts in individuals exhibiting depressive symptoms.

Vertical Mobility and Mental Gap of Scheduled Caste Students in West Bengal

This study investigates the complex relationship between vertical mobility and the mental gap experienced by Scheduled Caste (SC) students in West Bengal. Vertical mobility refers to the process by which individuals or groups ascend the social hierarchy, while the mental gap represents psychological barriers that often impede SC students from realizing their full potential. This research aims to elucidate various aspects of vertical mobility, examine the factors contributing to the mental gap experienced by SC students in higher education, and explore strategies to address these challenges to promote both personal development and upward mobility. To accomplish this objective, we employed qualitative documentary analysis and conducted a comprehensive review of existing literature, policy documents, and relevant case studies to gain a deeper understanding of the socioeconomic realities and educational trajectories of SC students. Our findings indicate that vertical mobility encompasses multiple dimensions, including educational attainment, career progression, and diverse social perspectives. Furthermore, we identified key contributors to the mental gap, such as internalized biases, economic constraints, and the pervasive influence of caste consciousness. By elucidating these critical factors, this study sought to propose effective strategies for bridging mental gaps and enhancing upward mobility among SC students. Ultimately, this research aims to contribute to the ongoing discourse surrounding social equity and empowerment for marginalized communities, emphasizing the urgent need for targeted interventions that facilitate the full integration of SC students into mainstream educational and social spheres.

How Do the Socio-economic Characteristics of Individual Members Influence the Business Effectiveness and Performance of Self-help Groups with Concerning Sustainable Development Goals: An SEM Approach

This study investigates how the socio-economic characteristics of individual members influence the business effectiveness and performance of Self-Help Groups (SHGs) in the context of sustainable development goals, with a focus on the cities of Bhopal, Indore, Gwalior, and Jabalpur in Madhya Pradesh. The research is underpinned by the sustainable development goals framework, emphasizing the role of social capital and economic empowerment in the success of SHGs. Data were gathered from 384 SHG members using a standardized questionnaire. Structural Equation Modeling (SEM) was employed through SmartPLS to analyze the impact of various socio-economic factors, including income level, social capital, educational attainment, household size, and age of the respondents on SHG performance. The analysis reveals that household size and age do not significantly impact SHG performance. However, income level, social capital, and educational attainment are significant contributors to the effectiveness and performance of SHGs. The findings underscore the importance of these variables in achieving the sustainable development goals through SHG initiatives. The study provides actionable insights for policymakers and SHG organizers, suggesting that targeted interventions should focus on enhancing income levels, social capital, and education among SHG members to improve group performance and support sustainable development. This research adds to the literature by offering a region-specific analysis of the socio-economic factors influencing SHG performance, with empirical evidence from key cities in Madhya Pradesh, contributing to the broader discourse on sustainable development.

The Economics of Production and Marketing of Oyster Mushroom (Pleurotus ostreatus) in Bukidnon, Philippines

Bukidnon, a province in Region X, is known for its high percentage of oyster mushrooms, accounting for 85.15 percent of total produce. This research aimed to determine production and marketing practices, yield per fruiting bag, marketing channels, and costs. We observed three marketing channels, and the average yield per bag was 0.18 grams per day. Variables affecting productivity included extension visits, educational attainment, culture house temperature, and substrate types. However, producers faced issues like spawn unavailability, poor development, and spoilage. The lack of government equipment support and lower prices led to many farmers stopping production, especially during the pandemic.

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data.

Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.

KNOWLEDGE, ATTITUDES AND PRACTICES TOWARDS OPEN EDUCATIONAL RESOURCES IN HIGHER EDUCATION INSTITUTIONS IN THE PHILIPPINES

Open educational resources (OER) are well-known around the world and globally it gives revenue to Higher Education Institutions (HEIs). It also gives benefits in various Asian countries. However, in the Philippines there is a lack of information and implementation. With the update in education and the shift in learning modality a great need for educational resources - free and open to the public increases, especially in the outrage of the pandemic. These events and phenomena also create a schism between librarians' perspectives and practices on OER. This paper examines the academic librarians' knowledge, attitudes, and practices (KAP) toward OER in higher education institutions in the Philippines. Specifically, this paper is aimed at assessing the level of KAP toward OER among the librarians. It also investigates the relationship between KAP-OER and the profiles of academic librarians and libraries, as well as the differences between KAP-OER and sex, higher educational attainment, and years of service. The respondents of the study were the 57 academic librarians from different HEIs in the Philippines. An adapted questionnaire was used, and it was administered online through Google forms. Results show that academic librarians reinforce the trend of infrequent engagement in OER practices at the school. In terms of reuse, revise, remix, and redistribution, the respondents express a tendency to rarely engage in these practices at our school, with mean scores ranging from 5.31 to 5.75. On the general aspects of OER, the respondents exhibit a positive attitude, with a mean score of 5.27. The respondents and library profiles record no relationship to KAP. In contrast, print and nonprint resources can positively affect KAP. While sexes, highest educational attainment, and number of years of service shows no difference. This study concludes that Philippine academic librarians challenged in terms of KAP-OER. Thus, require the interventions for improvement. This study confirms that more research is needed. It suggests providing OER seminars and training, promoting OER through collaboration, funding, institutional incentives, and support for OER activities.

Mortality from type 2 diabetes mellitus across municipalities in Mexico

BackgroundOne in six Mexican adults’ lives with type 2 diabetes mellitus (T2DM), which is the third leading cause of death in the country. Analyzing the geographic distribution of T2DM mortality helps identify regions with higher mortality rates. This study aimed to examine the spatial patterns of mortality from type 2 diabetes mellitus (T2DM) across municipalities in Mexico and to analyze the main contextual factors linked to this cause of death in 2020.MethodsWe employed a spatial Bayesian hierarchical regression model to estimate the risk and probability of death from type 2 diabetes mellitus (T2DM) across Mexico’s municipalities.ResultsThe SMR results revealed geographic and age-specific patterns. Central Mexico and the Yucatán Peninsula exhibited the highest excess mortality rates. For the population under 50 years of age, municipalities in Oaxaca had the highest T2DM mortality rates, whereas those aged 50 years old and older had the highest rates in Tlaxcala and Puebla. Socioeconomic factors such as low levels of educational attainment, lack of health services, dietary deficiency, and marginalization were positively associated with increased T2DM mortality risk. By contrast, GDP per capita showed a negative association. High-risk areas for T2DM mortality were prominent along the south of the Pacific Coast, the Bajío, Central Mexico, and southern Yucatán for those under 50, and along a central strip extending to the Yucatán Peninsula for the older population. Significant uncertainties in mortality risk were identified, with Central Mexico, Oaxaca, Chiapas, and Tabasco showing high probabilities of excess risk for those under 50 years of age and extended risk areas along the Gulf of Mexico for those 50 years old and older.ConclusionsThe assessment and identification of spatial distribution patterns associated with T2DM mortality, and its main contextual factors, are crucial for informing effective public health policies aimed at reducing the impact of this chronic disease in Mexico.

Determinants of cognitive health in the elderly: a comprehensive analysis of demographics, health status, and lifestyle factors from NHANES.

This study analyzes data from the National Health and Nutrition Examination Survey (NHANES) to identify factors influencing cognitive performance among the elderly, as measured by the Digit Symbol Substitution Test (DSST). Employing multivariable linear regression, we evaluated the impact of demographic, lifestyle, and health-related factors on cognitive function in U.S. adults aged 60 and older. Our findings indicate that advanced age, particularly in those aged 70-79 and 80 + years, is associated with lower DSST scores. Male gender is linked with reduced cognitive performance, while higher educational attainment appears protective. Lifestyle factors, including current smoking and higher alcohol consumption, negatively impact cognitive outcomes, and excessive sleep duration (over 9h) is also detrimental. Among health conditions, diabetes, chronic heart failure, and a history of stroke were associated with cognitive declines. Furthermore, increasing severity of depression correlates with lower cognitive function. These results underline the need for comprehensive public health strategies that integrate lifestyle modifications and chronic disease management to maintain cognitive health in older adults.

Brain health is essential for smooth economic transitions: towards socio-economic sustainability, productivity and well-being

Abstract Optimal brain health is essential to smoothing major global skill-intensive economic transitions, such as the bioeconomy, green, care economy and digital transitions. Good brain health is vital to socio-economic sustainability, productivity and well-being. The care transition focuses on recognizing and investing in care services and care work as essential for economic growth and social well-being. The green transition involves shifting towards environmentally sustainable and fairer societies to combat climate change and environmental degradation. The digital transition aims to unlock digital growth potential and deploy innovative solutions for businesses and citizens, and to improve the accessibility and efficiency of services. The bioeconomy transition refers to the shift towards an economy based on products, services and processes derived from biological resources, such as plants and microorganisms. Brain capital, which encompasses brain health and brain skills, is a critical economic asset for the success of economies of the future. The brain economy transition from a brain-negative (brain-unhealthy) economy, which depletes brain capital, to a brain-positive (brain-healthy) economy, which arrests and reverses the loss of brain capital, will be foundational to these major transitions. Increased brain capital is vital to educational attainment, upskilling and reskilling. In this paper, we provide a detailed roadmap for the brain economy transition.

Prevalence and Level of Depression, Anxiety and Stress Among Frontliners Using the Depression, Anxiety and Stress Scale (DASS)-21 in a Tertiary Hospital in Manila, Philippines During the COVID-19 Pandemic: a Cross-Sectional Study

Background: COVID-19 was declared as a pandemic by the World Health Organization (WHO) in March 2020. It has affected millions globally and remains as a public health concern until today. Objectives: The study aims to identify the prevalence of depression, anxiety and stress among UST hospital frontliners during the COVID-19 pandemic using the Depression, Anxiety and Stress Scale (DASS)-21 scale. Methods: A cross-sectional study was conducted among 272 frontliners in a tertiary hospital in Manila, Philippines using the DASS-21 scale. Results: Based on data gathered from the responses of participants using the DASS-21 scale, the prevalence of depression, anxiety and stress among the frontliners were 28.68%, 35.66% and 14.71%, respectively. Being single, living alone, higher degree of educational attainment (postgraduate), trainees (residents and fellows) and those having pulmonary comorbidities were associated with increasing level of depression and stress. Respondents who had less work experience (less than 5 years) had significant depression; being single presented with higher anxiety; and those who had a previous COVID-19 infection had higher degree of stress. Conclusion: Several demographic and occupational characteristics, in accordance to the COVID-19 pandemic, yielded significant results regarding the presence of depression, anxiety and stress. The study recommends closer follow-up of participants which recorded high severity scores in the DASS-21 scale as well as regular psychological briefing and counseling to assess if there are other contributory factors to such responses. Ultimately, this may enlighten us on how to provide holistic care to our own hospital staff. Keywords: COVID-19, Depression, Anxiety, Stress, DASS-21 scale

Extent of Electronic Gadget Addiction and Reading Skills of Grade One Learners

This study aimed to examine how gadget addiction affects the reading skills of Grade One learners. The study population consisted of Grade One learners aged 6 to 8, with 42% being female and 58% male. An analysis of the parents' educational attainment showed that 2% of the mothers had master’s units, while 18% of the mothers and 8% of the fathers were college graduates. Additionally, 16% of the mothers and 24% of the fathers had some college education, and 58% of the mothers and 40% of the fathers were high school graduates. Regarding family size, 50% of the learners had 1-2 siblings, and 38% had 3-4 siblings, while 58% of the families had a combined monthly income of ₱10,000 or below. The study found that the learners exhibited a moderate level of gadget addiction. In terms of reading skills, 78% of the learners were classified as outstanding, 16% as very satisfactory, 25% as satisfactory, and only 4% as poor. A statistical analysis of the relationship between gadget addiction and reading skills revealed a negligible negative correlation, with a value of -0.066, indicating that increased gadget use had a minimal impact on reading proficiency. The results suggest that while gadget addiction exists, it does not significantly hinder the reading development of Grade One learners, but continued monitoring and interventions are recommended.

From Roe to Dobbs: 50 Years of Cause and Effect of US State Abortion Regulations.

The Roe era was hardly a monolith. For more than 50 years-beginning with abortion reforms in the 1960s and continuing through the Dobbs decision in 2022-state regulations of abortion were neither uniform nor consistent. States reformed and repealed abortion bans leading up to the Roe decision in 1973. Following Roe, they enacted both demand-side regulations of people seeking abortions and supply-side regulations of people providing abortions. The resulting laboratory of state policies affords natural experiments that have yielded evidence on the effects of abortion regulations on demographic, health, economic, and other social outcomes. I present a brief history of state policy variation from 1967 through 2016 and review the empirical scholarship studying its effects. This literature demonstrates that the liberalization of abortion access in the 1960s and 1970s allowed women greater control over their fertility, resulting in increased educational attainment and earnings. Subsequent state restrictions in the 1980s through 2010s had the opposite effect, particularly when they increased the financial and logistical costs of obtaining an abortion. I conclude with a discussion of implications for the post-Dobbs era, considering to what extent evidence from the past foretells the future.

War Reparations, Structural Change, and Intergenerational Mobility

Abstract From 1944 to 1952, largely agrarian Finland had to export, on average, 4% of its yearly GDP in industrial products to the Soviet Union as war reparations. To meet the reparation demands, the Finnish state needed to provide extensive but temporary support to Soviet-assigned industries with insufficient production capacity. This paper documents the long-term impacts of this extensive and temporary industrial policy on industrial and local development and on individual outcomes. Using newly digitized datasets, I show in a difference-in-differences setup that the short-term nonmarket production persistently and significantly increased the employment and production of the manufacturing industries exposed to the policy. These industries plausibly benefited from large initial investments and exposure to export markets associated with the war reparations. The episode further led to local development and structural change, as the more exposed regions became persistently more industrialized. I substantiate these within-Finland results with triple-difference setups employing comparable Norwegian data. I further use Finnish administrative data to study the long-term individual impacts of the episode. Tracking individuals over 30 years, I show that the initial state investments and the persistent change in the local industrial structure increased long-term incomes, led to more educational attainment, and promoted the upward mobility of children and young adults living in the more exposed regions prior to the war reparations period. The observed effects are driven by the more advanced heavy industry, which received the majority of state assistance.

Skill bias in the labour market: Evidence from Iran

Purpose ― Most global economies are dealing with the issue of skill bias. In developing and underdeveloped countries, skill bias poses a problem by preventing the educated from participating in the economy's production function, especially in the long run. This paper expands on the skill-wage relationship and investigates this issue in the case of Iran from 1981 to 2021.Methods- Applying Impulse Responses from VECM and the Structural VAR model separates the relationship between skill and wage into short- and long-term effects. The structural wage model was estimated using the structural vector auto-regression model.Findings ― The results show that skill played a significant role in wage determination only for three periods in the short run, and the effect was neutral in the long run. This means that skill accumulation through advancement in graduate and postgraduate study is unlikely to increase wages in the long run.Implication ― According to the findings, skill bias implies that education attainment in the Iranian labour market can only improve wages to a minimum extent. This also proves that factors other than education determine wage growth in the economy. Originality ― The skill-wage relationship has not been a focus of studies in education outcome fields. Moreover, in the case of Iran, this investigation is novel, and there is a lack of studies on the relationship between compensation and skill.

The prevalence and determinants of unmet healthcare needs in Bulgaria

Self-reported unmet healthcare needs are a useful indicator of access to healthcare, but there is little research from low- and middle-income countries. This study sought to investigate the prevalence and determinants of unmet needs arising from wait times, distance/transportation and financial affordability in Bulgaria using European Health Interview Survey data. We explored associations between individual characteristics and the probability of reporting unmet need by fitting logistic regression models to the data. Unaffordability-related unmet needs were the most cited barrier to access. The largest proportion of people reported unmet dental care needs (14%) or unmet needs due to unaffordability of medicines (8%); distance/transportation problems were the least cited reason (3%). People with poor physical and mental health had a substantially higher probability of experiencing unmet needs. Those with a disability, less disposable income, less social support and lower educational attainment were also more likely to report unmet healthcare needs. People who lived in rural areas experienced specific barriers to access, most notably from distance or transportation issues. Unmet healthcare needs lead to inefficiencies for the healthcare system and are more prevalent among already disadvantaged societal groups. Ensuring better access to healthcare is therefore important from both the efficiency and equity perspectives.

How can HIV self-testing facilitate increased access to HIV testing among multiply marginalised populations? Perspectives from GBMSM and trans women in England and Wales

Background HIV self-testing (HIVST) may facilitate marginalised populations’ uptake of HIV testing, but whether the extent of marginalisation challenges individual uptake of HIVST remains under-researched. We aim to explore the perspectives of multiply marginalised cis-gender gay, bisexual and other men who have sex with men (GBMSM) and trans women on whether HIVST might increase their uptake of HIV testing. Methods We reanalysed qualitative interview data from SELPHI (the UK’s largest HIVST randomised trial) collected between 2017 and 2020 from marginalised populations, defined as people self-identifying as non-heterosexual, transgender, non-White ethnicity and/or with low educational attainment. Thirty-eight interviews with multiply marginalised individuals were thematically examined using the framework method. We specifically focussed on kit usability (a function of the interaction between blood-based HIVST kits and users), perspectives on how HIVST can improve access to HIV testing and suggestions on need-based scale-up of HIVST. Results HIVST kits were considered usable and acceptable by multiply marginalised GBMSM and trans women. The majority of interviewees highlighted multi-levelled barriers to accessing HIV testing services due to structural and social marginalisation. Their multiply marginalised identities did not impede HIVST uptake but often form motivation to self-test. Three potential roles of HIVST in the HIV testing landscape were identified: (1) alternation of HIVST and facility-based testing, (2) integration of HIVST into sexual health services and (3) substituting facility-based testing with HIVST in the future. Perceived beneficiaries of HIVST included trans communities, individuals with undisclosed sexuality and people with physical disabilities. Discussion HIVST can facilitate marginalised populations’ access and uptake of HIV testing by alternating with, integrating into and substituting for facility-based services in the UK. Marginalised identities did not present challenges but rather opportunities for person-centred scale-up of HIVST. Future implementation programmes should ensure equitable access to HIVST among trans people, men unable to disclose their sexuality, and perhaps people with physical disabilities.

Resilience rewritten: Ann’s journey from adversity to entrepreneurship

Research methodology None. Case overview/synopsis The case study follows Ann’s journey towards entrepreneurship, focusing on the challenges she faced and how early educational interventions influenced her life decisions. Despite numerous obstacles, Ann’s perseverance, bolstered by her family’s support and her passion, led to her successful reintegration into academia and the launch of an entrepreneurial venture in the UK. Her story highlights the dilemma of balancing educational attainment with entrepreneurial aspirations, especially for at-risk students. Ann’s experience prompts critical discussions about the intersection of education and entrepreneurship, the importance of experiential learning and the role of mentorship in realizing business ideas. The nurturing environment of her business school, through guest lectures and real-world success stories, played a significant role in shaping her academic and professional outlook. This case raises essential questions about the role of higher education in fostering entrepreneurial skills and integrating experiential learning within academic curricula. Ann’s journey exemplifies the power of resilience and determination in overcoming systemic and entrepreneurial challenges, particularly for women facing similar struggles. Her story illuminates the multifaceted process of turning a personal experience into an entrepreneurial opportunity, emphasizing the critical role of mentorship and support networks in developing a viable business idea. Complexity academic level This case study is best suited to undergraduate and graduate students enrolled in management and business-related courses that focus on entrepreneurship and entrepreneurial education. The case study is relevant in various business disciplines as it informs students of the process and challenges related to business start-ups and acquiring related capabilities. Instructors are encouraged to have students read the extensive reference list provided at the end to broaden their understanding and knowledge of entrepreneurship, including its processes, context and practices.

Indonesian WAIS-IV Cultural Research.

This study examined regional differences between Indonesians on the Wechsler Adult Intelligence Scale-IV Indonesia (WAIS-IV ID) and, in comparison, to the US. Three hypotheses were examined: a) Java will demonstrate stronger WAIS-IV ID performances than non-Java (NJ) samples. b) WAIS-IV ID performances will be correlated with educational attainment. c) Indonesians with higher levels of education will perform comparably to US samples. The WAIS-IV was translated into Bahasa Indonesia and administered to a convenience sample representative of the Indonesian population breakdown by island. Comparisons between Java and NJ samples were analyzed by analyses of covariance controlling for education attainment. Comparisons between the Indonesian and US samples were analyzed by one sample t-tests. The Java sample performed significantly higher than the NJ sample. Performances for the Java but not the NJ sample significantly correlated with educational attainment. Indonesians performed significantly lower than the US on 19/20 WAIS-IV ID subtests measures. However, the Java sample demonstrated comparable performances with the US with both countries scoring significantly higher than the other on select subtests and indexes. The Java sample demonstrated lower performances for older age cohorts with increasingly stronger scores across younger age cohorts. This pattern was paralleled by increases in educational attainment. All hypotheses were supported except for correlations between educational attainment and WAIS-IV ID performances which was significant for the Java sample but not the NJ sample. Findings were interpreted within the context of economics and educational attainment and quality.

Independent associations of educational attainment and its joint associations with LE8 score for risk of cardiovascular disease incidence and mortality among Chinese people

Abstract Background/Introduction Educational attainment is a social determinant of health. Quantifying its associations with risk of cardiovascular disease (CVD) incidence and mortality has public health importance. Recently, the American Heart Association introduced the Life’s Essential 8 (LE8) score to evaluate CVD risk. However, it remains unclear how educational attainment and the LE8 score interact in their joint associations with CVD and mortality. Purpose To examine the associations of educational level with the incidence of CVD, including coronary heart disease (CHD) and stroke, and total mortality. Also, we examined the joint associations of educational level and the LE8 score with CVD incidence and total mortality. Methods We prospectively followed 91,744 Chinese adults from the Kailuan Study (2006-2021), who were free of CVD at baseline. Information on educational level, diet, lifestyle, and health conditions was collected every 2 years. LE8 score was calculated based on eight components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. We used time-dependent Cox models to assess the associations of educational level with the outcomes as well as the joint associations of educational level and LE8 score, with adjustments for demographics, dietary and lifestyle factors, and medical history. Results During a mean follow-up of 13.1 years, there were 12,916 incident CVD cases and 13,090 deaths. Compared with the participants who only received illiteracy or elementary education, those who received high school education and above had a lower risk of CVD incidence (HR = 0.82, 95% CI = 0.76, 0.88), stroke incidence (0.72, (0.66, 0.79)), and total mortality (0.73, (0.68, 0.77)). Educational level was not associated with risk of CHD. Furthermore, significant additive interactions between educational attainment and LE8 score on the risk of CVD and mortality were observed (all p values for additive interactions &amp;lt;0.01). Compared with the participants who only received illiteracy or elementary education and had a low LE8 score, those who only received illiteracy or elementary education but had a high LE8 score still had a 27%-47% lower risk of CVD and total mortality, while those who received high school education and above and had a high LE8 score had a 51%-74% lower risk of CVD and total mortality. Conclusions Higher educational level was associated with a lower risk of CVD and mortality. These inverse associations were most apparent among participants with both a high educational level and a high LE8 score, while the participants with a low educational level but with a high LE8 score still had a significantly lower risk. These findings highlight the importance of improvement in educational attainment in preventing CVD events and deaths, and suggest that CVD events and deaths attributable to lower levels of education may be reduced by improving LE8 score.