Diminished returns to Black health: A Canadian problem?

High educational attainment is generally associated with better health outcomes. Yet, studies in the United States show diminished returns to education, such that the health benefits conferred from high educational attainment are weaker for Black Americans. Little is known about whether the diminished returns phenomenon also shapes the health of Black Canadians. To address this gap, this study investigated whether there is an education gradient among Black and White Canadians, such that higher educational attainment is associated with better health, and whether Black Canadians experience diminished health returns.

Data from Canadian adults aged 25-64 (Black: N = 200, White: N = 8200) who responded to the 2018 cycle of the Longitudinal and International Study of Adults were analyzed cross-sectionally. Logistic regression models estimated the associations between educational attainment and good self-rated health. An interaction term tested variation in the education-health gradient by race. All models were adjusted for age, sex, and nativity.

Fully adjusted models show the odds of reporting good self-rated health generally increased across levels of education. Findings also show that although statistically significant support for the diminishing returns hypothesis was fleeting, this likely reflects insufficient sample size, thus speaking to the need for better Canadian data.

Our findings confirm that educational advancement generally confers health benefits for Black and White Canadians. Additional research with larger samples is needed, however, to better understand the systemic mechanisms which may preclude racialized populations from fully reaping the health benefits of education.