ArticleInternational journal of biomedical engineering and clinical science2019
High Education Level Protects European Americans but Not African Americans Against Chronic Obstructive Pulmonary Disease: National Health Interview Survey.
Article in International journal of biomedical engineering and clinical science, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Diminished Returns of Educational Attainment on Hypertension Prevalence among American Indian and Alaska Native Adults: National Health Interview Survey 2023.Global journal of cardiovascular diseases · 2025Article
- Article
- Self-Rated Health of US Older Adults in the General Social Survey (GSS) 1972-2021: Complexity of the Associations of Education and Immigration.Healthcare (Basel, Switzerland) · 2023Article
- Diminished Returns in Europe: Socioeconomic Status and Ethno-Racial Health Disparities Across 30 Countries in the European Social Survey.Journal of racial and ethnic health disparities · 2022Article
- Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences.International journal of environmental research and public health · 2022Review
- Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006-2017: Evidence from Spanish National Health Surveys.Journal of clinical medicine · 2021Article
- Smoking Status and Well-Being of Underserved African American Older Adults.Behavioral sciences (Basel, Switzerland) · 2020Article
- Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults.JAMA network open · 2020Article
- Parent Education and Future Transition to Cigarette Smoking: Latinos' Diminished Returns.Frontiers in pediatrics · 2020Article
- Understanding America: Unequal Economic Returns of Years of Schooling in Whites and Blacks.World journal of educational research (Los Angeles, Calif.) · 2020Article
- Racial Difference in the Relationship Between Health and Happiness in the United States.Psychology research and behavior management · 2020Article
- Diminished Returns of Educational Attainment on Heart Disease among Black Americans.The open cardiovascular medicine journal · 2020Article
- Social Determinants of Hookah Smoking in the United States.Journal of mental health & clinical psychology · 2020Article
- Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S.Research in health science · 2020Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEducation level reduces the risk of chronic diseases (CDs), including Chronic Obstructive Pulmonary Disease (COPD). Minorities' Diminished Returns, however, refer to smaller health benefits of socioeconomic position (SEP) improvement for racial and ethnic minorities compared to majority groups. It is not known if MDRs exist for the effects of education level on COPD for African Americans (AAs), relative to European Americans (EAs).
aimsUsing a nationally representative sample, the current study explored racial and ethnic variation in the association between education level and COPD among American adults.
methodsData came from the National Health Interview Survey (NHIS 2015), a national survey. A total of 25,488 adults (18+ years old) were included in the study. From this number, 4,533 (17.8%) were AAs and 20,955 (82.2%) were EAs. Education level was the independent variable. Outcome was COPD. Age, gender, and income were the covariates. Race/ethnicity was the moderator.
resultsOverall, education level was inversely associated with the odds of COPD. A statistically significant interaction was found between race/ethnicity and education level on odds of COPD, indicating smaller effect of education for AAs compared to EAs.
conclusionsIn line with the Minorities' Diminished Returns (MDRs), highly educated AAs remained at high risk for COPD, a pattern which is not observed for EAs. Policies that exclusively address racial/ethnic inequalities in SEP may not be enough for eliminating racial/ethnic inequalities in COPD in the US. Public policies must go beyond equalizing SEP and address structural and environmental barriers that disproportionately increase risk of COPD in AAs across SEP levels. Future research should test if residential segregation and exposure to air pollutants contributes to high prevalence of COPD in highly educated AAs. Research is needed on multi-level interventions that may minimize MDR-related health disparities.
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