Degrees of health disparities: Health status disparities between young adults with high school diplomas, sub-baccalaureate degrees, and baccalaureate degrees

Health Serv Outcomes Res Methodol. 2012 Jun;12(2-3):156-168. doi: 10.1007/s10742-012-0094-x.


Community colleges have increased post-secondary educational access for disadvantaged youth, but it is unknown how community college degrees fit into the educational gradient of health status disparities. Using data from high school graduates in the National Longitudinal Study of Adolescent Health, we compared young adults ages 26-31 whose highest degrees were high school diplomas (n=5584), sub-baccalaureate credentials (sub-BAs include community college certificates and associate's degrees) (n=2415), and baccalaureate degrees (BAs) (n=3303) on measures of hypertension, obesity, smoking, sleep problems, dyslipidemia, and depression. Comparisons used multivariate Poisson regression with robust standard errors after exact and nearest-neighbor Mahalanobis matching within propensity score calipers on 23 baseline factors measured in 1995. High school graduates and sub-BAs differed significantly on 3 of 23 baseline factors. After matching, sub-BAs were 16% less likely to smoke daily than if they had only a high school diploma but did not differ in other health status measures. Sub-BAs and BAs differed significantly on 14 of 23 baseline factors. After matching, BAs were 60% less likely to smoke daily, 14% less likely to be obese, and 38% less likely to have been diagnosed with depression. Sub-BA degrees are accessible to high school graduates irrespective of academic backgrounds and predict lower smoking prevalence. BAs are less accessible to high school graduates and predict lower chances of smoking, depression, and obesity.