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      COVID-19 Pandemic as an Equalizer of the Health Returns of Educational Attainment for Black and White Americans

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          Abstract   

          Background

          COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals.

          Objectives

          The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic.

          Methods

          This study utilized data from the Health Information National Trends Survey (HINTS) 2020. Total sample included 1313 adult American; among them, 77.4% ( n = 1017) were non-Hispanic White, and 22.6% ( n = 296) were non-Hispanic Black. Educational attainment was the independent variable operationalized as years of education. The main outcomes were cigarette smoking, e-cigarette vaping, CMC, SRH, depressive symptoms, and obesity. Age, gender, and baseline physical health were covariates. Race/ethnicity was an effect modifier.

          Results

          Educational attainment was significantly associated with lower CMC, SRH, depressive symptoms, obesity, cigarette smoking, and e-cigarette vaping. Educational attainment did not show a significant interaction with race on any of our outcomes, suggesting that the health returns of education is similar between non-Hispanic White and non-Hispanic Black individuals.

          Conclusion

          COVID-19 may have operated as an equalizer of the returns of educational attainment. This observation may be because White may have more to lose; Black communities may be more resilient or have economic and social policies that buffered unemployment and poverty regardless of historical anti-Black oppression.

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          Most cited references117

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          Structural racism and health inequities in the USA: evidence and interventions

          The Lancet, 389(10077), 1453-1463
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            Neighborhoods and health.

            Features of neighborhoods or residential environments may affect health and contribute to social and race/ethnic inequalities in health. The study of neighborhood health effects has grown exponentially over the past 15 years. This chapter summarizes key work in this area with a particular focus on chronic disease outcomes (specifically obesity and related risk factors) and mental health (specifically depression and depressive symptoms). Empirical work is classified into two main eras: studies that use census proxies and studies that directly measure neighborhood attributes using a variety of approaches. Key conceptual and methodological challenges in studying neighborhood health effects are reviewed. Existing gaps in knowledge and promising new directions in the field are highlighted.
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              Stigma as a fundamental cause of population health inequalities.

              Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.
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                Author and article information

                Contributors
                assari@umich.edu
                Journal
                J Racial Ethn Health Disparities
                J Racial Ethn Health Disparities
                Journal of Racial and Ethnic Health Disparities
                Springer International Publishing (Cham )
                2197-3792
                2196-8837
                25 July 2023
                25 July 2023
                2024
                : 11
                : 3
                : 1223-1237
                Affiliations
                [1 ]Marginalized-Related Diminished Returns (MDRs) Center, Los Angeles, CA USA
                [2 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Department of Health Policy and Management, , Johns Hopkins Bloomberg School of Public Health, ; Baltimore, MD 21205 USA
                [3 ]School of Business, University of Maryland Global Campus (UMGC), ( https://ror.org/01w1pbe36) Adelphi, 20783 USA
                [4 ]Department of Family Medicine, Charles R Drew University of Medicine and Science, ( https://ror.org/038x2fh14) Los Angeles, CA USA
                [5 ]GRID grid.254041.6, ISNI 0000 0001 2323 2312, Department of Urban Public Health, , Charles R Drew University of Medicine and Science, ; Los Angeles, CA USA
                Author information
                http://orcid.org/0000-0002-5054-6250
                Article
                1601
                10.1007/s40615-023-01601-w
                11101502
                37490210
                b791c820-20fb-4e34-b837-2646ebfd7fde
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 9 December 2022
                : 6 April 2023
                : 11 April 2023
                Funding
                Funded by: Charles R. Drew University of Medicine and Science
                Categories
                Article
                Custom metadata
                © W. Montague Cobb-NMA Health Institute 2024

                socioeconomic status,educational attainment,marginalized-related diminished return,covid-19 pandemic

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