Racial Variation in the Association between Educational Attainment and Self-Rated Health

Abstract Background: Minorities’ Diminished Return theory can be defined as the systematically smaller effects of socioeconomic status (SES) indicators on the health and well-being of minority populations compared to Whites. To test whether Minorities’ Diminished Return theory holds for self-rated health (SRH), we investigated Black–White differences in the effects of education and income on SRH. Methods: Data from the Health Information National Trends Survey (HINTS) 2017 was used. HINTS 2017 ( n = 3217) is a nationally cross-sectional survey of American adults. The current analysis included 2277 adults who were either Whites ( n = 1868; 82%) or Blacks ( n = 409; 18%). Education and income were the independent variables. Poor/fair SRH was the dependent variable. Covariates included age, gender, obesity, and health behaviors (smoking and exercise). Race was the focal moderator. We ran logistic regressions in the overall sample, with and without race by SES (education and income) interactions. Results: Higher education was associated with lower risk of poor/fair SRH in the pooled sample. We found an interaction between race and education, but not race and income, in relation to SRH, suggesting a stronger association for Whites than Blacks. Conclusions: Minorities’ Diminished Return theory is also relevant to the effects of educational attainment on SRH. The relative disadvantage of Blacks compared to Whites in gaining SRH from educational attainment may reflect structural racism that systemically hinders Blacks. There is a need for additional research on specific societal barriers that minimize Blacks’ health gain from their SES resources. Policies and programs should help Black individuals leverage their SES resources. View Full-Tex