Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S.

Abstract

Background: Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive PulmonaryDisease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs.Purpose: Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults.Methods: In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health(PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate = 3) and income (living out of poverty = 1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data.Results: Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with 49 Published by SCHOLINK INC. educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. Conclusions: Education and income better reduce the risk of CLDs among Whites than Hispanics andBlacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems. 58 Published by SCHOLINK INC.Hispanic people, a rate which is disproportionate to their SES. Researchers should know that health disparities are not merely due to the additive but also multiplicative effects of race, ethnicity and SES.Real solution to racial and health disparities in CLDs is not only increasing SES of Blacks and Hispanic but also empowering them to translate their available SES resources to health outcomes. Public policies that are needed should go beyond equalizing SES and specifically address societal barriers, environmental risk factors, and structural factors that endanger the health and well-...

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

“…These MDRs are also relevant to other types of marginalization based on sexual orientation and nativity (immigration) status. Individuals with LGBT [ 67 , 118 ] and immigrant status [ 64 , 65 , 119 , 120 ] show weaker health effects of SES than those with a non-LGBT and non-immigrant status. This non-specificity of MDRs across measures of the SES resource, outcomes, populations, and age groups suggests that MDRs are likely due to structural racism and social stratification, which cause disparities across domains [ 57 ].…”

Combined Effects of Ethnicity and Education on Burden of Depressive Symptoms over 24 Years in Middle-Aged and Older Adults in the United States

“…Our previous research also documented the considerably weaker impact of education and other SES indicators on the well-being of ethnic minorities other than non-Hispanic White Americans [17,71]. In various studies, education more strongly improved overall health [32,62,88], impulsivity [89], drinking [46,90], smoking [91,92], sleep [93], exercise [41], suicide [45], and depression [6,28,44] for non-Hispanic White Americans than ethnic minority Americans. These patterns are robust, as shown for Hispanics [94], non-Hispanic Blacks [95,96], Native Americans [36], East Asians [97,98], and members of the LGBT community [99].…”

National early warning score on admission as risk factor for invasive mechanical ventilation in COVID-19 patients

“…[ 15 ] Chronic lung disease was defined as asthma, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, interstitial lung disease, or bronchiectasis. [ 16 , 17 ] Additionally, any neurological disorders, such as Alzheimer disease, were also recorded. [ 15 ]…”