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

Arash Rahmani; Babak Najand; Najmeh Maharlouei; Hossein Zare; Shervin Assari

doi:10.1007/s40615-023-01601-w

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

J Racial Ethn Health Disparities. 2023 Jul 25. doi: 10.1007/s40615-023-01601-w. Online ahead of print.

Authors

Arash Rahmani¹, Babak Najand¹, Najmeh Maharlouei¹, Hossein Zare^{2

3}, Shervin Assari^{4

5

6}

Affiliations

¹ Marginalized-Related Diminished Returns (MDRs) Center, Los Angeles, CA, USA.
² 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), Adelphi, 20783, USA.
⁴ Marginalized-Related Diminished Returns (MDRs) Center, Los Angeles, CA, USA. assari@umich.edu.
⁵ Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA. assari@umich.edu.
⁶ Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA. assari@umich.edu.

PMID: 37490210
DOI: 10.1007/s40615-023-01601-w

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.

Keywords: COVID-19 pandemic; Educational attainment; Marginalized-related diminished return; Socioeconomic status.