Education Level and Self-rated Health in the United States: Immigrants’ Diminished Returns

  • سال انتشار: 1399
  • محل انتشار: مجله پزشکی سفر و بهداشت جهانی، دوره: 8، شماره: 3
  • کد COI اختصاصی: JR_IJTMGH-8-3_006
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 107
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نویسندگان

Shervin Assari

Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Maryver Perez

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Nay’Air Johnson

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Nikesha Williams

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Esmeralda Carrillo

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Leslye Garcia

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

Xiaxiang Hollis

Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA

چکیده

Introduction: Although education is among the major socioeconomic status (SES) resources that influence populations’ and individuals’ health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. Methods: With a cross-sectional design, this study employed data from the ۲۰۱۵ National Health Interview Survey (NHIS), a survey that had enrolled ۳۳,۶۵۴ adults who were either immigrants (n = ۶۲۲۵; ۱۸.۵%) or non-immigrants (n = ۲۷ ۴۲۹; ۸۱.۵%). The independent variable was education level, treated as a categorical variable. The dependent variable was poor SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Results: Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. Conclusion: In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.

کلیدواژه ها

Population Groups, Immigration, Immigrants, Nativity, Socioeconomic status, self-rated health

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