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

Hossein Zare1,2, Babak Najand3, Adriele Fugal4

  • 1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.

Public Health in Practice (Oxford, England)
|September 15, 2023
PubMed
Summary

Educational attainment offers less protection against allostatic load for Black individuals compared to White individuals, a phenomenon known as marginalization-related diminished returns. This study highlights racial disparities in health benefits derived from education.

Keywords:
Allostatic loadEducational attainmentRaceSocial determinants

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Area of Science:

  • Public Health
  • Sociology
  • Health Disparities

Background:

  • Educational attainment is a known determinant of health.
  • However, its protective effect on health outcomes may vary across racial groups.
  • Marginalization-related diminished returns (MDRs) describe situations where socioeconomic factors have weaker effects in marginalized populations.

Purpose of the Study:

  • To investigate the association between high educational attainment and allostatic load.
  • To examine racial differences in this association, specifically comparing Black and White individuals.
  • To explore the concept of MDRs in the context of education and allostatic load.

Main Methods:

  • Cross-sectional study using National Health and Nutrition Examination Survey (NHANES) data (1999-2016).
  • Included 2761 Black and 7058 White participants aged 25 and above.
  • Allostatic Load Scale (AL) was measured using 8 biomarkers, with elevated AL defined as AL≥4.

Main Results:

  • An inverse association was found between allostatic load and educational attainment.
  • A significant interaction between race and education indicated a weaker inverse association for Black individuals compared to White individuals.
  • These findings were consistent when allostatic load was analyzed as a continuous variable.

Conclusions:

  • Educational attainment provides a weaker protective effect against allostatic load for Black people than for White people.
  • This suggests that the health benefits of education are not equally distributed across racial groups.
  • The study supports the MDRs hypothesis, indicating disparities in how education translates to health protection.