Education, race, and high-density lipoprotein cholesterol among US adults

Am J Public Health. 1992 Jul;82(7):999-1006. doi: 10.2105/ajph.82.7.999.


Objectives: Although educational achievement is positively related to levels of high-density lipoprotein cholesterol (HDL-C) among White adults, there is an inverse association among Blacks. We assessed whether this interaction could be attributed to differences in the relation of education to correlates of HDL-C.

Methods: Cross-sectional analyses were based on data from 8391 White and 995 Black adults who participated in the Second National Health and Nutrition Examination Survey.

Results: Associations between education and HDL-C levels varied from negative (Black men), to nearly nonexistent (White men and Black women), to positive (White women). Mean HDL-C levels were higher among Blacks than among Whites, but differences varied according to educational achievement. Among adults with less than 9 years of education, mean levels were 6 to 10 mg/dL higher among Blacks, but the radical difference was less than 1 mg/dL among adults with at least 16 years of education. About 20% to 40% of these differences could be accounted for by obesity, alcohol consumption, and other characteristics.

Conclusions: Because of the implications for coronary heart disease risk, consideration should be given to behavioral characteristics associated with the interaction between race and educational achievement.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects
  • Black or African American / statistics & numerical data*
  • Body Mass Index
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • Dietary Fats / adverse effects
  • Drug Therapy
  • Educational Status*
  • Energy Intake
  • Exercise
  • Female
  • Health Status Indicators
  • Health Surveys
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / epidemiology*
  • Hypercholesterolemia / ethnology
  • Income
  • Interviews as Topic
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Socioeconomic Factors
  • United States / epidemiology
  • White People / statistics & numerical data*


  • Cholesterol, HDL
  • Dietary Fats