Marginalization-related Diminished Returns Research Articles

Immigration, Educational Attainment, and Subjective Health in the United States.

Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups. While we know more about marginalization due to race and ethnicity, limited information is available on MDRs of educational attainment among US immigrant individuals. This study compared immigrant and non-immigrant US adults aged 18 and over for the effects of educational attainment on subjective health (self-rated health; SRH). Data came from General Social Survey (GSS) that recruited a nationally representative sample of US adults from 1972 to 2022. Overall, GSS has enrolled 45,043 individuals who were either immigrant (4,247; 9.4%) and non-immigrant (40,796; 90.6%). The independent variable was educational attainment, the dependent variable was SRH (measured with a single item), confounders were age, gender, race, employment and marital status, and moderator was immigration (nativity) status. Higher educational attainment was associated with higher odds of good SRH (odds ratio OR = 2.08 for 12 years of education, OR = 2.81 for 13-15 years of education, OR = 4.38 for college graduation, and OR = 4.83 for graduate studies). However, we found significant statistical interaction between immigration status and college graduation on SRH, which was indicative of smaller association between college graduation and SRH for immigrant than non-immigrant US adults. In line with MDRs, the association between educational attainment and SRH was weaker for immigrant than non-immigrant. It is essential to implement two sets of policies to achieve health inequalities among immigrant populations: policies that increase educational attainment of immigrants and those that increase the health returns of educational attainment for immigrants.

Black Americans’ Diminished Return of Educational Attainment on Tobacco Use in Baltimore City

BackgroundSocioeconomic status (SES) indicators such as educational attainment are fundamental factors affecting health. One mechanism through which education affects health is by reducing the likelihood of engaging in high-risk behaviors such as smoking. However, according to the marginalization-related diminished returns (MDRs) theory, the association between education and health may be weaker for marginalized populations such as Black than White, primarily due to racism and discrimination. However, little is known about the racial variations in the differential associations between educational attainment and tobacco use in a local setting.AimThis study aimed to investigate the differential association between educational attainment and tobacco use among racial groups in a community sample in Baltimore City.MethodsThis cross-sectional study used data from a community survey conducted in 2012–2013 in Baltimore City among adults aged 18 years or older. The participants were 3501 adults. Univariate, bivariate, and logistic regression analyses were performed using Stata to investigate the racial difference in the association between education and two outcomes: current smoking status and menthol tobacco product use.ResultsThe study found that adults with a graduate degree were less likely to be current smokers (adjusted odds ratio [AOR]: 0.10, 95% confidence interval [CI]: 0.08–0.13) and menthol tobacco users (AOR: 0.10, 95% CI: 0.07–0.14) compared to those with less than high school diploma. The inverse associations between educational attainment and current smoking (AOR: 1.83, 95% CI: 1.05–3.21) and menthol tobacco product use (AOR: 4.73, 95% CI: 2.07–10.80) were weaker for Back individuals than those who were White.ConclusionDue to MDRs of educational attainment, while highly educated White adults show a low risk of tobacco use, educated Black adults remain at a disproportionately increased risk. The study emphasizes the need for better policies and programs that address minorities’ diminished return of education for tobacco use.

Allostatic load in the US general population: Race and educational intersection

ObjectivesEducational attainment is a protective factor against poor health, but high educational attainment has a weaker effect on black people than on white people; this pattern has been called marginalization-related diminished returns (MDRs). Using a national sample of white people and black people 25 years and above, this study estimates the association between high educational attainment and allostatic load between black people and white people, and within each group. Study designThis cross-sectional study uses data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016, including 2761 black people and 7058 white people. The outcome variable of interest was the Allostatic Load Scale (AL). We created the allostatic load scale by using 8 biomarkers, then created a binary variable (if ALS≥4 as 1 and ALS<4 as 0) to present elevated AL. MethodsWe used several weighted modified Poisson regression models controlling for educational attainment (a predictor) and race (a moderator variable), age, sex, and marital status. We also controlled the models for smoking and drinking status as health behavior variables. As a sensitivity analysis, we ran several sets of regression analysis using the AL scale as a continuous outcome variable. ResultsWe found an inverse association between AL and educational attainment. The interaction between race and education has resulted in an inverse association between AL and educational attainment, with a weaker association in black people than in white people. We found similar findings by running regression models with AL as a continuous variable. ConclusionsWe observed a weaker association between educational attainment and AL in black people than in white people, suggesting that educational attainment has more robust protection against allostatic load for white people than black people.

Immigration Status, Socioeconomic Status, and Self-Rated Health in Europe.

The literature has established a protective effect of socioeconomic status (SES) indicators on health. However, at least in the US, these SES indicators tend to generate fewer health gains for marginalized groups including immigrants. As this literature mainly originated in the US, it is necessary to study whether these indicators similarly correlate with the health of foreign-born and native-born individuals in Europe. The current study was based on the Marginalization-related Diminished Returns (MDRs) theory and compared the effects of three SES indicators, namely parental education, own education and income, on self-rated health (SRH) of immigrant and native-born individuals. We used data from the European Social Survey 2020 (ESS 2020). Participants included 14,213 individuals who identified as either native-born (n = 9052) or foreign-born (n = 508). Education, income, and parental education were the independent variables. Self-rated health (SRH) was the outcome. Age and sex were covariates. Linear regression and logistic regression were used for data analysis. Overall, high education, income, and parental education were associated with lower odds of poor SRH. We documented a statistical interaction between immigration status and parental education, indicating a weaker inverse association between parental education and poor SRH for foreign-born than native-born individuals. The links between some but not all SES indicators vary across foreign-born and native-born individuals in Europe. Host countries seem to undervalue the parental educational attainment of foreign-born families. Future research should explore the role of time, period, cohort and country of origin as well as host country and associated policies in equalizing returns of SES indicators on the health of population subgroups. The results are important given that most studies on MDRs are developed in the US, and less is known about Europe. The results are also very important given the growing anti-immigrant sentiment and nationalist movements in Europe and the rest of the world.

Black-White Differences in the Protective Effects of Income against Perceived Financial Difficulties in the United States

One of the components of the protective effects of overall high socioeconomic status (SES) on health is high subjective SES. As SES has shown weaker health effects for marginalized groups, a phenomenon called Marginalization-related Diminished Returns (MDRs), we conducted this study to test differential associations between two objective SES indicators, namely education and household income, with a subjective SES indicator (perceived financial difficulties) by race. For this cross-sectional analysis, we used the Health Information National Trends Survey (HINTS 2020) data. Participants included 1403 individuals who identified as either non-Latino Black or non-Latino White. Age, sex, marital status, and employment were used as control variables, while education and income were used as independent variables. Perceived financial difficulties were the outcome. Binary logistic regression was used for main data analysis. Linear regression was used for sensitivity analysis. Overall, high education and household income were associated with lower odds of perceived financial difficulties. We documented a statistical interaction between race and income on subjective SES indicating a weaker inverse association between household income and perceived financial difficulties for non-Latino Black than non-Latino White individuals. The results remained similar using linear or logistic regression models. We did not find racial differences in the association between education and perceived financial difficulties. In the US, and under structural racism, the link between objective SES indicators such as income and perceived financial difficulties differs for non-Latino Black and non-Latino White people. Income may better reduce perceived financial difficulties for non-Latino Black than non-Latino White individuals. This finding is in line with the MDRs framework and suggests a mechanism for why we observe weaker health effects of objective SES indicators, such as income, for racial minorities in the US, and why we observe racial health disparities across class lines.

Blacks’ Diminished Salience of Age as a Determinant of Chronic Obstructive Respiratory Disease

Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial groups. Objectives: Using a conceptual model that considers race as a proxy of racism rather than genetics and attributing racial differences to sociological rather than biological differences, this study was conducted to explore racial differences in the effects of age on CRD. Based on Marginalization-related Diminished Returns (MDRs) framework, we expect diminished relevance of risk and resources for marginalized people due to racism, segregation, and social stratification. Methods: Using data from baseline population assessment of tobacco and health (PATH) Adults data, we included 23761 adults. The independent variable was age treated as a categorical variable. The primary outcome was presence of any CRD including asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Sex and education were the covariates. Race, as a proxy of racism, was the moderator. To analyze the data, we used logistic regression mode with and without interaction term between age and race. Results: Higher age was associated with higher odds of CRD, while sex, and socioeconomic status (SES) was controlled. In line with the MDRs framework, the positive association between age and CRD was weaker for Black than White adults. Conclusion: Under racism, age loses some of its effect as a major determinant of CRD across racialized groups

Family Income May Better Protect White Than Black American Youth Against Suicidality

Background: High income is a protective factor against suicidality for children, youth, and adults, however, recent research has documented weaker health effects of high income for Black than White individuals, a pattern also called marginalization-related diminished returns (MDRs). Objectives: In this study, we tested racial variation in the association between high income and suicidality in a national sample of 9-10-year-old Black and White American children. Methods: This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study, which included 7298 White or Black children between the ages of 9 and 10. Of all the participants, 5652 were White and 1646 were Black. The predictor variable was family income, treated as a continuous measure. Race was the moderator. The outcome variable was suicidality, treated as a dummy variable, reflecting any positive suicidal thoughts or behaviors endorsed over the lifecourse. Covariates included sex, age, family structure (parental marital status), parental education, trauma, history of depression, neighborhood poverty, and family conflict. Logistic regression was used for data analysis. Results: Overall, family income was inversely associated with children’s suicidality, net of all covariates. A statistically significant interaction was found between race and family income, suggesting that the inverse association between family income and suicidality is weaker in Black than White children. Conclusion: The observed weaker association between income and suicidality in Black than White children suggests that family income does not provide the same protection against suicidality for Black as White children. Due to racism, income and some other socioeconomic status indicators show weaker than expected health effects on Black families in the US.

Diminished Effects of Educational Attainment on Time Spent on Substance/Drug Use in Latino Individuals: Analysis of the American Time Use Survey (ATUS)

Background: While socioeconomic status (SES) indicators such as educational attainment are among the major drivers of health behaviors such as substance use, the protective effects of these indicators may differ across ethnic groups. Built on the Marginalization related Diminished Returns (MDRs) phenomenon that refers to weaker health effects of SES indicators for marginalized and minoritized groups (vs. non-Latino White people), we conducted this study with two aims: First to test the association between educational attainment and time spent on substance/drug use, and second, to test for ethnic variation in this association. Methods: This cross-sectional study used the American Time Use Survey (ATUS 2019) data. Participants included 7380 individuals who were either Latino or non-Latino White. We tested for associations between time spent on substance/drug use and a continuous measure of educational attainment using linear regression. Age and sex were control variables. We used logistic regression for sensitivity analysis using any time spent on substance/drug as the outcome. Results: Overall, high educational attainment showed an inverse association with time spent on substance/drug use overall. We also documented a statistical interaction between ethnicity and educational attainment such that associations between educational attainment and time spent on substance/drug use was weaker in Latino vs. non-Latino White individuals. We could replicate the results using logistic regression for any time spent on substance/drug as the outcome. Conclusion: We observe that SES indicators such as educational attainment may have a differential protective effect against time spent on substance/drug use for diverse ethnic groups. In contrast to non-Latino White individuals, Latino individuals reported spending similar amounts of time on substance/drug use across the full SES spectrum. This finding is in line with the MDRs framework and may be attributable to the effects of structural racism, social stratification, and marginalization impacting ethnic minorities in the United States.

Developmental Cost of Being Asian but Living in the United States: Diminished Returns of Household Income on Cortical Surface Area in 9-10 Year Old Children

Introduction: While socioeconomic status (SES) indicators such as household income are known to be associated with larger cortical surface area, recent research on Marginalization-related Diminished Returns (MDRs) suggests that family SES indicators such as household income may have weaker effects on brain function and structure for non-White (marginalized) than White (privileged) families: a pattern that reflects structural and societal inequalities deeply intertwined into the United States social fabric. Methods: This is a cross-sectional study that used baseline data from the Adolescent Brain Cognitive Development (ABCD) study. Data was collected between 2016 and 2018. Overall, 6039 9–10-year-old children entered our analysis. The independent variable was household income. The moderator was race. The primary outcome was the overall cortical surface area. Age, sex, and family structure were the covariates. We used mixed effects regression models that adjusted for data analysis because ABCD data is nested into families, centers, and US states. Results: While high household income was associated with larger cortical surface area, this effect was weaker for Asian than non-Hispanic White children. This racial heterogeneity in the effects of household income on cortical surface area was documented by a statistically significant interaction between race and household income on cortical surface area. Conclusion: For American children, household income does not similarly correlate with cortical surface area of diverse racial groups. Brain development in the US is not solely a function of SES (availability of resources) but also how social groups are racialized and treated in the society. In the US, race, as a proxy of racism, limits how much SES can affect brain structures such as cerebral cortex. Due to racialization, segregation, discrimination, and marginalization, racial minority children may experience weaker effects of SES. Structural inequalities should be addressed to equalize the return of SES resources across racially diverse families.

Unhealthy Diet of High Socioeconomic Children of Color: Marginalization-Related Diminished Returns

Background: While socioeconomic status (SES) indicators such as parental educational attainment and household income are among the primary drivers of individual health, the effects of household SES indicators (for example, parental educational attainment and family income) on health behaviors such as a healthy diet may differ by ethnicity, as discussed by the Marginalization related Diminished Returns (MDRs) phenomenon. Objectives: Built on the MDRs, this study had two aims: first, to test the associations between family SES indicators (parental educational attainment and household income) and diet quality, and second, to test ethnic variation in these associations. Materials and Methods: This longitudinal study used the Adolescent Brain Cognitive Development (ABCD) baseline and year 2 data. Participants included 5,856 individuals who were either Black, White, Latino, or non-Latino. Age, sex, family structure (parental marital status), parental education, and family income were studied. The outcomes were the amount and frequency of consuming fish, soup, vegetables, fruits, hot dogs, French fries, ketchup, soda, and sugary beverages. Linear regression was used for performing the main data analysis. Results: Overall, high educational attainment and family income showed a positive association with fruit consumption and a negative association with the consumption of hot dogs, fries, soda, and sugary beverages in the overall population. We documented statistically significant interactions between ethnicity and educational attainment and household income on our dietary habits of interest, indicating weaker associations between family SES and diet in Black and Latino than non-Latino White individuals. Conclusion: We observe that household SES differently improves the dietary quality of diverse ethnic groups. Due to MDRs of education and income in ethnic minorities, children from highly educated and high-income families eat less healthily than their non-Latino White counterparts. This finding is in line with the MDRs framework that ethnic health disparities sustain across class lines.

Diminished Protective Effects of Education, Income and Employment against Obesity Risk in Black Women at Reproductive Age: National Health and Nutrition Examination Survey (NHANES 1999-2016)

Background: Socioeconomic status (SES) indicators protect individuals and populations against health problems such as obesity. Marginalizationrelated Diminished Returns (MDRs), however, refer to the weaker economic and health returns of education, employment, and income for Black than the returns for White people. Aims: To test the effects of three major SES indicators, namely educational attainment, employment, and income, on obesity for women at reproductive age, and to test variation in these associations by race. Methods: We used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Sample was limited to non-Latino White and Black women at reproductive age (age between 20 and 44). Analytical sample was composed of 5237 women. Survey regressions were used to test the effects of education, employment, and income (independent variables) on obesity (dependent variable) and by race (moderator). Results: Overall, educational attainment and income were inversely associated with odds of obesity in our sample, however, we found significant interactions indicating that the effects of education, employment, and income were all weaker for Black than White women. Conclusions: In line with MDRs, and probably due to structural racism, social stratification, labor market discrimination, and different food options, obesity remains higher than expected in highly educated, employed, and highincome Black women, a pattern that is not seen in White women. Black middleclass women at reproductive age remain at risk for obesity. To eliminate racial disparities in perinatal outcomes, we need to go beyond low SES and address the perinatal needs of middle-class Black women, for whom obesity remains a health risk.

High Economic Stress May Explain Worse-Than-Expected Health of Highly Educated Chinese Americans

Introduction: Low stress is one of many plausible mechanisms that may explain the health effects of educational attainment. However, Marginalization-related Diminished Returns (MDRs) refer to the weaker health effects of educational attainment for marginalized, compared to privileged, groups. We are unaware of any previous studies that have compared Asian and non-Hispanic White Americans for the effects of educational attainment on perceived economic stress. The aim was to compare Chinese and non-Hispanic White Americans for the association between educational attainment and perceived economic stress in a national sample of American adults. This is important given stress is a risk factor for poor health. Methods: This study analyzed cross-sectional data of 20,793 adults who participated in the National Health Interview Survey (NHIS 2015). From all participants, 403 individuals were Chinese Americans, and 20,390 were non-Hispanic Whites. Perceived economic stress was the outcome of interest. Years of education (educational attainment) was the predictor variable of interest. Gender, age, region, marital status, sexual orientation (i.e., lesbian, gay, bisexual, and transgender (LGBT)), and immigration status were covariates. Race/ethnicity was the effect modifier. Results: Overall, higher educational attainment was associated with lower levels of perceived economic stress. A statistically significant interaction showed that the effect of educational attainment on reducing perceived economic stress is smaller for Chinese Americans than Non-Hispanic Whites. Conclusion: Educational attainment is not similarly protective against perceived economic stress across all social groups. Thus, perceived economic stress may explain why ethnic minorities and immigrants gain decreased benefits from their educational attainment than the mainstream and privileged social group.

Diminished Association between Parental Education and Parahippocampal Cortical Thickness in Pre-Adolescents in the US

Introduction: Socioeconomic status (SES) indicators, such as parental education and household income, are associated with the thickness of various cortical areas. However, less is known about the parahippocampal region. Additionally, more research is required regarding how the correlation between SES indicators and cortical thickness differs among diverse racial groups. Purpose: This study uses a national sample of pre-adolescents ages 9 to 10 years old in the US and was performed with two aims in mind. First, to investigate the correlations between two SES indicators, namely parental education and household income, and parahippocampal cortical thickness. Second, to explore racial differences in these associations. Methods: In this cross-sectional study, we used data from the Adolescent Brain Cognitive Development (ABCD) study to analyze the Structural Magnetic Resonance Imaging (sMRI) data of 9,849 US pre-adolescents between the ages of 9 and 10 years old. The main outcomes were parahippocampal cortical thickness separately calculated for the right and the left hemispheres using sMRI. The independent variables were parental education and household income, which were both treated as nominal variables. Age, sex, ethnicity, and family structure were the covariates, and race was the moderator. Mixed-effects regression models were used for data analysis with and without interaction terms. Results: High income positively associated with right and left parahippocampal cortical thickness in the fully adjusted models. Race showed a statistically significant interaction with parental education on children’s parahippocampal cortical thickness, suggesting that the correlations between parental education with the right and left parahippocampal cortical thickness were significantly larger for White than Black and other/mixed race pre-adolescents. No interaction was found for household income and race. Conclusions: The association between parental education and pre-adolescents parahippocampal cortical thickness may be weaker in Black than in White American children. Consistent with the findings of Marginalization-related Diminished Returns (MDRs), parental education shows weaker links for some brain indicators, such as parahippocampal cortical thickness, in Black and other racial and minority children when compared to White children.

Parental Educational Attainment, the Superior Temporal Cortical Surface Area, and Reading Ability among American Children: A Test of Marginalization-Related Diminished Returns.

Background: Recent studies have shown that parental educational attainment is associated with a larger superior temporal cortical surface area associated with higher reading ability in children. Simultaneously, the marginalization-related diminished returns (MDRs) framework suggests that, due to structural racism and social stratification, returns of parental education are smaller for black and other racial/ethnic minority children compared to their white counterparts. Purpose: This study used a large national sample of 9–10-year-old American children to investigate associations between parental educational attainment, the right and left superior temporal cortical surface area, and reading ability across diverse racial/ethnic groups. Methods: This was a cross-sectional analysis that included 10,817 9–10-year-old children from the Adolescent Brain Cognitive Development (ABCD) study. Parental educational attainment was treated as a five-level categorical variable. Children’s right and left superior temporal cortical surface area and reading ability were continuous variables. Race/ethnicity was the moderator. To adjust for the nested nature of the ABCD data, mixed-effects regression models were used to test the associations between parental education, superior temporal cortical surface area, and reading ability overall and by race/ethnicity. Results: Overall, high parental educational attainment was associated with greater superior temporal cortical surface area and reading ability in children. In the pooled sample, we found statistically significant interactions between race/ethnicity and parental educational attainment on children’s right and left superior temporal cortical surface area, suggesting that high parental educational attainment has a smaller boosting effect on children’s superior temporal cortical surface area for black than white children. We also found a significant interaction between race and the left superior temporal surface area on reading ability, indicating weaker associations for Alaskan Natives, Native Hawaiians, and Pacific Islanders (AIAN/NHPI) than white children. We also found interactions between race and parental educational attainment on reading ability, indicating more potent effects for black children than white children. Conclusion: While parental educational attainment may improve children’s superior temporal cortical surface area, promoting reading ability, this effect may be unequal across racial/ethnic groups. To minimize the racial/ethnic gap in children’s brain development and school achievement, we need to address societal barriers that diminish parental educational attainment’s marginal returns for middle-class minority families. Social and public policies need to go beyond equal access and address structural and societal barriers that hinder middle-class families of color and their children. Future research should test how racism, social stratification, segregation, and discrimination, which shape the daily lives of non-white individuals, take a toll on children’s brains and academic development.

Race, Socioeconomic Status, and Cerebellum Cortex Fractional Anisotropy in Pre-Adolescents.

Cerebellum cortex fractional anisotropy is a proxy of the integrity of the cerebellum cortex. However, less is known about how it is shaped by race and socioeconomic status (SES) indicators such as parental education and household income. In a national sample of American pre-adolescents, this study had two aims: to test the effects of two SES indicators, namely parental education and household income, on cerebellum cortex fractional anisotropy, and to explore racial differences in these effects. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we analyzed the diffusion Magnetic Resonance Imaging (dMRI) data of 9565, 9-10-year-old pre-adolescents. The main outcomes were cerebellum cortex fractional anisotropy separately calculated for right and left hemispheres using dMRI. The independent variables were parental education and household income; both treated as categorical variables. Age, sex, ethnicity, and family marital status were the covariates. Race was the moderator. To analyze the data, we used mixed-effects regression models without and with interaction terms. We controlled for propensity score and MRI device. High parental education and household income were associated with lower right and left cerebellum cortex fractional anisotropy. In the pooled sample, we found significant interactions between race and parental education and household income, suggesting that the effects of parental education and household income on the right and left cerebellum cortex fractional anisotropy are all significantly larger for White than for Black pre-adolescents. The effects of SES indicators, namely parental education and household income, on pre-adolescents' cerebellum cortex microstructure and integrity are weaker in Black than in White families. This finding is in line with the Marginalization-related Diminished Returns (MDRs), defined as weaker effects of SES indicators for Blacks and other racial and minority groups than for Whites.

Black-White Achievement Gap: Role of Race, School Urbanity, and Parental Education.

BackgroundRecent research on Marginalization-related Diminished Returns (MDRs) has documented weaker boosting effects of parental educational attainment on educational outcomes of Black than White students. Such MDRs of parental education seem to contribute to the Black-White achievement gap. Given that Blacks are more likely than Whites to attend urban schools, there is a need to study if these MDRs can be replicated at both urban and suburban schools.AimTo test the contribution of diminished returns of parental educational attainment on the Black-White achievement gap in urban and suburban American high schools.MethodsA cross-sectional study that used baseline Education Longitudinal Study (ELS-2002) data, a nationally representative study of 10th grade adolescents in the United States. This study analyzed 8315 youths who were either non-Hispanic White (n = 6539, 78.6%) or non-Hispanic Black (n = 1776, 21.4%) who were attending either suburban (n = 5188, 62.4%) or urban (n = 3127, 37.6%) schools. The outcome was standard math and reading grades. The independent variable was parental educational attainment. Gender, parental marital status, and school characteristics (% free lunch and relationship quality with the teacher) were the confounders. Race/ethnicity was the effect of modifier. School urbanity was the strata. Linear regression was used for data analysis.ResultsIn urban and suburban schools, higher parental educational attainment was associated with higher math and reading test scores. In urban and suburban schools, Black students had considerably lower reading and math scores than White students. At urban but not suburban schools, significant interactions were found between race (Non-Hispanic Black) and parental education attainment (years of schooling) on reading and math scores, suggested that the protective effect of parental education on students’ reading and math scores (ie school achievement) is smaller for Non-Hispanic Black relative to Non-Hispanic White youth only in urban but not sub-urban schools.ConclusionDiminished returns of parental education (MDRs) contribute to the racial achievement gap in urban but not suburban American high schools. This result is important given Black students are more likely to attend urban schools than White students. As MDRs are not universal and depend on context, future research should study contextual characteristics of urban schools that contribute to MDRs.

Social Determinants of Change in Smoking Status over a 26-Year Follow up Period among Middle-Aged and Older Americans

Educational attainment and income are among major socioeconomic status (SES) indicators that are inversely associated with cigarette smoking. Marginalization-related Diminished Returns (MDRs), however, are weaker protective effects of SES indicators for racial and ethnic minority groups compared to non-Hispanic White people. The aim is to test whether racial and ethnic differences exist in the effects of educational attainment and income on cigarette smoking of middle-aged and older American adults. This is a 26-year longitudinal study using data from the Health and Retirement Study (HRS), a nationally representative study of middle-aged and older adults in the US. A total number of 11,316 middle-aged and older adults (age ≥ 50) were followed for up to 26 years. The independent variables were educational attainment and income. The dependent variables were always smoking and being quitters over the follow-up time. Age, gender, self-rated health, and chronic medical conditions were the covariates. Race/ethnicity was the moderator. Logistic regressions were used to analyze the data. Most participants were never smokers (n = 7950), followed by quitters (n = 1765), always smokers (n = 1272), and initiators (n = 329). Overall, high educational attainment (OR = 0.92, 95% CI = 0.90 - 0.95) and income (OR = 0.99, 95% CI = 0.99 - 0.99) reduced the odds of being always smoker. High educational attainment (OR = 1.05, 95% CI = 1.02 - 1.08) was associated with higher odds of being a quitter. Ethnicity, however, showed significant interactions with education on both outcomes suggesting that the effects of educational attainment on reducing the odds of always being a smoker (OR = 1.24, 95% CI = 1.14 - 1.35) and increasing the odds of quitting (OR = 0.84, 95% CI = 0.75 - 0.93) were smaller for Hispanics than non-Hispanics. In the United States, middle-aged and older Hispanic adults remain at high risk of smoking cigarettes despite high educational attainment. That is, high educational attainment may better help non-Hispanic than Hispanic middle-aged and older adults to avoid cigarette smoking. As a result, we may observe a more than expected burden of tobacco use in middle class Hispanic middle-aged and older adults. Policymakers should not reduce racial and ethnic tobacco inequalities to SES gap, as ethnic tobacco disparities may persist in high SES levels as well.

Family's Subjective Economic Status and Children's Matrix Reasoning: Blacks' Diminished Returns.

Due to a pattern known as Marginalization-related Diminished Returns (MDRs), historically oppressed non-Hispanic Black Americans show weaker effects of economic status on health and development, when compared to socially privileged non-Hispanic White Americans. Such MDRs are also documented for the effects of economic status on the school performance of non-Hispanic Black children. However, the existing knowledge is minimal on similar diminished returns on children's intelligence. To compare racial and ethnic groups for the effect of subjective economic status on children's cognitive performance, we compared non-Hispanic White and non-Hispanic Black children for the effects of subjective economic status on children's matrix reasoning. This cross-sectional study included 7898 children from the Adolescent Brain Cognitive Development (ABCD) study. The predictor variable was subjective economic status, which was treated as a continuous measure. The primary outcome was children's matrix reasoning, a domain of cognitive performance, measured by the Wechsler Intelligence Scales for Children-IV (WISC-V) matrix reasoning total score. Overall, high subjective economic status was associated with higher matrix reasoning score. Race showed a statistically significant interaction with subjective economic status on children's matrix reasoning score. This interaction suggested that high subjective economic status has a smaller boosting effect on increasing matrix reasoning score for non-Hispanic Black children relative to non-Hispanic White children. The degree by which subjective economic status correlates with matrix reasoning score, an important domain of cognitive performance, depends on race and racialization. Non-Hispanic Black children may show weaker gains in matrix reasoning from their subjective economic status than their non-Hispanic White counterparts. To minimize the racial gap in cognitive performance, we need to address diminished returns that occur as a result of the racialization of racial and ethnic minority children. Not only should we equalize economic status, but also increase the marginal returns of economic status for racial minorities, particularly non-Hispanic Black families. Such efforts require public policies that go beyond access and also consider how we can empower non-Hispanic Black communities and families so they can more effectively leverage and utilize their economic resources to secure measurable and tangible outcomes. Structural and societal barriers such as residential and school segregation may hinder non-Hispanic Black children from receiving the full effects of their family-level economic status on a variety of outcomes, including their cognitive performance.

Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States.

Objectives: Marginalization-related diminished returns (MDRs) refer to weaker health effects of educational attainment for socially marginalized groups compared to the socially privileged groups. Most of the existing literature on MDRs, however, has focused on marginalization due to race, ethnicity, and sexual orientation. Thus, very limited information exists on MDRs of educational attainment among immigrant populations in the United States.Aims: Building on the MDRs framework and using a nationally representative sample of US adults, we compared immigrant and native-born adults for the effects of educational attainment on psychological distress, self-rated health (SRH), and chronic diseases (CDs).Methods: The 2015 National Health Interview Survey (NHIS) has enrolled 33,672 individuals who were either immigrant (n = 6,225; 18.5%) or native born (n = 27,429; 81.5%). The independent variable (IV) was educational attainment, which was treated as a categorical variable. The dependent variables included psychological distress, SRH, and CDs, all of which were dichotomous variables. Age, gender, race, ethnicity, and region were confounders. Immigration (nativity status) was the moderator.Results: Higher educational attainment was associated with lower odds of psychological distress, poor SRH, and CDs. However, immigration showed a significant statistical interaction with college graduation on all outcomes, which were suggestive of smaller protective effects of college graduation on psychological distress, poor SRH, and CDs for immigrant than native-born adults.Conclusions: In the US, the associations between educational attainment and psychological distress, SRH, and CDs are all weaker for immigrant than native-born adults. To prevent health disparities, it is essential to decompose health inequalities that are due to low educational attainment from those that are due to diminished returns of educational attainment (i.e., MDRs). There is a need to help highly educated immigrant adults secure positive health outcomes, similar to their native-born counterparts. Such changes may require bold and innovative economic, public, and social policies that help immigrant adults to more effectively mobilize their educational attainment to secure tangible outcomes. Elimination of health disparities in the US requires efforts that go beyond equalizing access to education.

Diminished Health Returns of Own and Parental Education for Immigrants in the United States

Background: Educational attainment is a strong social determinant of health. Marginalization-related Diminished Returns (MDRs), however, refer to smaller health effects of socioeconomic status, particularly educational attainment for marginalized groups compared to mainstream populations. While multiple studies have documented MDRs of educational attainment for racial, ethnic, and sexual minorities, there are no previous studies on MDRs of education among immigrants.Aims: To understand if the MDRs phenomenon also applies to immigrants, we compared immigrant and non-immigrant American adults for the effects of their own and parental educational attainment on subjective health.Methods: This study used a cross-sectional design and borrowed data from the General Social Survey (1972-2018). GSS is a series of nationally representative surveys in the U.S. Our analytical sample included 38,399 adults who were either non-immigrants (n = 34903; 90.9%) or immigrants (n = 3496; 9.1%). The main independent variables were own and parental educational attainment measured as four-level categorical variables. The dependent variable (DV) was poor subjective health, measured using a single item. Age, sex, marital status, and year of the survey were the covariates. Immigration status was the moderator.Results: Overall, individuals with higher educational attainment of own and parents reported better subjective health. We, however, found significant interactions between immigration status and both own and parental educational attainment on subjective health, which was suggestive of weaker protective effects of own and parental educational attainment against poor subjective health in immigrants than non-immigrant individuals.Conclusions: In the United States, immigrant adults experience poor subjective health disproportionate to their own and their parents educational attainment. That means we may observe worse than expected health of immigrants across all educational levels and social classes. Public policies should go beyond equal access to education by empowering marginalized people to leverage their education and secure better outcomes.