Document Type : Research Article

Author

Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan

Abstract

Background: Minorities’ diminished returns (MDRs) refer to smaller protects health effects of socioeconomic status (SES) indicators for Blacks and other minority groups than Whites. Objectives: The current study aimed to explore Black-White differences in the association between educational attainment and exercise frequency among women in the US.
Methods: For the current study, we used the National Survey of American Life’s (NSAL) data, which included 3175womenwhowere either White (n = 876) or Black (n = 2299). The independent variable was educational attainment. The dependent variable was exercise frequency. Age, region, household income, financial distress, marital status, unemployment, and depression were the covariates. Race was the focal moderator. Linear regression was applied for data analysis.
Results: In the overall sample of women, high educational attainment was associated with higher exercise frequency (b = 0.07, 95% CI = 0.02 - 0.12). Race and educational attainment showed a significant interaction (b = -0.09, 95% CI = -0.19 - 0.00), suggestive of a smaller effect of education attainment on exercise frequency for Black women than White women. In race specific models, high educational attainment was associated with higher exercise frequency for White (b = 0.12, 95% CI = 0.04 - 0.20) but not Black (b = 0.03, 95% CI = -0.03-0.08) women.
Conclusions: In line with the past research on MDRs, White women gain more health from their educational attainment than Black women. It is not race or class but race and class that shape the health behaviors of American women.

Keywords

1. Assari S. Health disparities due to diminished return among Black Americans: Public policy solutions. Soc Issues Pol Rev. 2018;12(1):112–45. doi: 10.1111/sipr.12042. ## 2. Assari S. Unequal gain of equal resources across racial groups. Int J Health Policy Manag. 2017;7(1):1–9. doi: 10.15171/ijhpm.2017.90. [PubMed: 29325397]. [PubMed Central: PMC5745862]. ## 3. Assari S. Parental educational attainment and mental well-being of college students; diminished returns of Blacks. Brain Sci. 2018;8(11). doi: 10.3390/brainsci8110193. [PubMed: 30380617]. [PubMed Central: PMC6266217]. ## 4. Assari S. Life expectancy gain due to employment status depends on race, gender, education, and their intersections. J Racial Ethn Health Disparities. 2018;5(2):375–86. doi: 10.1007/s40615-017-0381-x. [PubMed: 28634876]. [PubMed Central: PMC6392452]. ## 5. Assari S, Moghani Lankarani M. Poverty status and childhood asthma in White and Black families: National survey of children’s health. Healthcare (Basel). 2018;6(2). doi: 10.3390/healthcare6020062. [PubMed: 29895767]. [PubMed Central: PMC6023379]. ## 6. Assari S, Caldwell CH, Zimmerman MA. Family structure and subsequent anxiety symptoms; minorities’ diminished return. Brain Sci. 2018;8(6). doi: 10.3390/brainsci8060097. [PubMed: 29857488]. [PubMed Central: PMC6025006]. ## 7. Assari S, Mistry R. Diminished return of employment on ever smoking among hispanic Whites in Los Angeles. Health Equity. 2019;3(1):138–44. doi: 10.1089/heq.2018.0070. [PubMed: 31289772]. [PubMed Central: PMC6608689]. ## 8. Assari S. Socioeconomic status and self-rated oral health; diminished return among Hispanic Whites. Dent J (Basel). 2018;6(2). doi: 10.3390/dj6020011. [PubMed: 29695074]. [PubMed Central: PMC6023433]. ## 9. Assari S. Education attainment and obesity differential returns based on sexual orientation. Behav Sci (Basel). 2019;9(2). doi: 10.3390/bs9020016. [PubMed: 30699932]. [PubMed Central: PMC6406256]. ## 10. Assari S. Family income reduces risk of obesity for White but not Black children. Children (Basel). 2018;5(6). doi: 10.3390/children5060073. [PubMed: 29890778]. [PubMed Central: PMC6025246]. ## 11. Assari S, Lapeyrouse LM, NeighborsHW.Income and self-rated mental health: Diminished returns for high income Black Americans. Behav Sci (Basel). 2018;8(5). doi: 10.3390/bs8050050. [PubMed: 29772799]. [PubMed Central: PMC5981244]. ## 12. Assari S. High income protects Whites but not African Americans against risk of depression. Healthcare (Basel). 2018;6(2). doi: 10.3390/healthcare6020037. [PubMed: 29690595]. [PubMed Central: PMC6023547]. ## 13. Assari S, Farokhnia M, Mistry R. Education attainment and alcohol binge drinking: Diminished returns of Hispanics in Los Angeles. Behav Sci (Basel). 2019;9(1). doi: 10.3390/bs9010009. [PubMed: 30646592]. [PubMed Central: PMC6359422]. ## 14. Assari S, Lankarani MM. Education and alcohol consumption among older Americans; Black-White differences. Front Public Health. 2016;4:67. doi: 10.3389/fpubh.2016.00067. [PubMed: 27148514]. [PubMed Central: PMC4838609]. ## 15. Assari S. Ethnic and gender differences in additive effects of socioeconomics, psychiatric disorders, and subjective religiosity on suicidal ideation among Blacks. Int J Prev Med. 2015;6:53. doi: 10.4103/2008-7802.158913. [PubMed: 26180624]. [PubMed Central: PMC4498310]. ## 16. Assari S, Mistry R. Educational attainment and smoking status in a national sample of American adults; evidence for the Blacks’ diminished return. Int J Environ Res Public Health. 2018;15(4). doi: 10.3390/ijerph15040763. [PubMed: 29659482]. [PubMed Central: PMC5923805]. ## 17. Assari S, Caldwell CH, Mincy R. Family socioeconomic status at birth and youth impulsivity at age 15; Blacks’ diminished return. Children (Basel). 2018;5(5). doi: 10.3390/children5050058. [PubMed: 29724004]. [PubMed Central: PMC5977040]. ## 18. Assari S, Lankarani MM. Race and urbanity alter the protective effect of education but not income on mortality. Front Public Health. 2016;4:100. doi: 10.3389/fpubh.2016.00100. [PubMed: 27242992]. [PubMed Central: PMC4873510]. ## 19. Assari S, Nikahd A, Malekahmadi MR, Lankarani MM, Zamanian H. Race by gender group differences in the protective effects of socioeconomic factors against sustained health problems across five domains. J Racial Ethn Health Disparities. 2016. doi: 10.1007/s40615-016-0291-3. [PubMed: 27753050]. ## 20. Assari S, Caldwell CH. Family income at birth and risk of attention deficit hyperactivity disorder at age 15: Racial differences. Children (Basel). 2019;6(1). doi: 10.3390/children6010010. [PubMed: 30646634]. [PubMed Central: PMC6352113]. ## 21. Assari S. Socioeconomic determinants of systolic blood pressure; minorities’ diminished returns. J Health Econ Dev. 2019;1(1):1–11. [PubMed: 31428747]. [PubMed Central: PMC6699161]. ## 22. Jackson JS, Neighbors HW, Nesse RM, Trierweiler SJ, Torres M. Methodological innovations in the National Survey of American Life. Int J Methods Psychiatr Res. 2004;13(4):289–98. [PubMed: 15719533]. ## 23. Jackson JS, Torres M, Caldwell CH, Neighbors HW, Nesse RM, Taylor RJ, et al. The National Survey of American Life: A study of racial, ethnic and cultural influences on mental disorders and mental health. Int J Methods Psychiatr Res. 2004;13(4):196–207. [PubMed: 15719528]. ## 24. Assari S. Race, depression, and financial distress in a nationally representative sample of American adults. Brain Sci. 2019;9(2). doi: 10.3390/brainsci9020029. [PubMed: 30704114]. [PubMed Central: PMC6406793]. ## 25. Assari S. Social determinants of depression: The intersections of race, gender, and socioeconomic status. Brain Sci. 2017;7(12). doi: 10.3390/brainsci7120156. [PubMed: 29186800]. [PubMed Central: PMC5742759]. ## 26. Assari S, Moazen-Zadeh E. Ethnic variation in the cross-sectional association between domains of depressive symptoms and clinical depression. Front Psychiatry. 2016;7:53. doi: 10.3389/fpsyt.2016.00053. [PubMed: 27148084]. [PubMed Central: PMC4834296]. ## 27. Zajacova A, Johnson-Lawrence V. Anomaly in the education-health gradient: Biomarker profiles among adults with sub accalaureate attainment levels. SSM Popul Health. 2016;2:360–4. doi: 10.1016/j.ssmph.2016.05.001. [PubMed: 28580414]. [PubMed Central: PMC5450821]. ## 28. Zajacova A, Rogers RG, Johnson-Lawrence V. Glitch in the gradient: Additional education does not uniformly equal better health. Soc Sci Med. 2012;75(11):2007–12. doi: 10.1016/j.socscimed.2012.07.036. [PubMed: 22920276]. [PubMed Central: PMC5544818]. ## 29. Assari S, Preiser B, Kelly M. Education and income predict future emotional well-being of Whites but not Blacks: A ten-year cohort. Brain Sci. 2018;8(7). doi: 10.3390/brainsci8070122. [PubMed: 29966278]. [PubMed Central: PMC6070982]. ## 30. Assari S, Lankarani M. Educational attainment promotes fruit and vegetable intake for Whites but not Blacks. J. 2018;1(1):29–41. doi: 10.3390/j1010005. ## 31. Assari S. Parental education better helps White than Black families escape poverty: National Survey of Children’s Health. Economies. 2018;6(2):30. doi: 10.3390/economies6020030. ## 32. Assari S. Parental education attainment and educational upward mobility; role of race and gender. Behav Sci (Basel). 2018;8(11). doi: 10.3390/bs8110107. [PubMed: 30469353]. [PubMed Central: PMC6262323]. ## 33. Assari S. Educational attainment better protects African American women than African American men against depressive symptoms and psychological distress. Brain Sci. 2018;8(10). doi: 10.3390/brainsci8100182. [PubMed: 30274391]. [PubMed Central: PMC6210325]. ## 34. Assari S, Hani N. Household income and children’s unmet dental care need; Blacks’ diminished return. Dent J (Basel). 2018;6(2). doi: 10.3390/dj6020017. [PubMed: 29867015]. [PubMed Central: PMC6023279]. ## 35. Assari S, Moghani Lankarani M. Workplace racial composition explains high perceived discrimination of high socioeconomic status African American men. Brain Sci. 2018;8(8). doi: 10.3390/brainsci8080139. [PubMed: 30060492]. [PubMed Central: PMC6120025]. ## 36. Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks’ diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. J Urban Health. 2018;95(1):21–35. doi: 10.1007/s11524-017-0217-3. [PubMed: 29230628]. [PubMed Central: PMC5862702]. ## 37. Malambo P, De Villiers A, Lambert EV, Puoane T, Kengne AP. Associations of perceived neighbourhood safety from traffic and crime with overweight/obesity among South African adults of low-socioeconomic status. PLoS One. 2018;13(10). e0206408. doi: 10.1371/journal.pone.0206408. [PubMed: 30379921]. [PubMed Central: PMC6209311]. ## 38. Assari S, Moghani Lankarani M, Caldwell CH, Zimmerman MA. Fear of neighborhood violence during adolescence predicts development of obesity a decade later: Gender differences among African Americans. Arch Trauma Res. 2016;5(2). e31475. doi: 10.5812/atr.31475. [PubMed: 27679791]. [PubMed Central: PMC5035671]. ## 39. Choi SW, Park DJ, Kim J, Park TJ, Kim JS, Byun S, et al. Association between obesity and neighborhood socioeconomic status in Korean adolescents based on the 2013 Korea Youth Risk Behavior Web-Based Survey. Korean J Fam Med. 2016;37(1):64–70. doi: 10.4082/kjfm.2016.37.1.64. [PubMed: 26885325]. [PubMed Central: PMC4754289]. ## 40. Li F, Harmer P, Cardinal BJ, Bosworth M, Johnson-Shelton D. Obesity and the built environment: Does the density of neighborhood fast-food outlets matter? Am J Health Promot. 2009;23(3):203–9. doi: 10.4278/ajhp.071214133. [PubMed: 19149426]. [PubMed Central: PMC2730045]. ## 41. Kwate NO. Fried chicken and fresh apples: Racial segregation as a fundamental cause of fast food density in Black neighborhoods. Health Place. 2008;14(1):32–44. doi: 10.1016/j.healthplace.2007.04.001. [PubMed: 17576089]. ## 42. Assari S. Psychosocial correlates of body mass index in the United States: Intersection of race, gender and age. Iran J Psychiatry Behav Sci. 2016;10(2). e3458. doi: 10.17795/ijpbs-3458. [PubMed: 27822270]. [PubMed Central: PMC5097345]. ## 43. Carter JD, Assari S. Sustained obesity and depressive symptoms over 6 years: Race by gender differences in the health and retirement study. Front Aging Neurosci. 2016;8:312. doi: 10.3389/fnagi.2016.00312. [PubMed: 28101050]. [PubMed Central: PMC5209386]. ## 44. Assari S, Lankarani MM. Mediating effect of perceived overweight on the association between actual obesity and intention for weight control; role of race, ethnicity, and gender. Int J Prev Med. 2015;6:102. doi: 10.4103/2008-7802.167616. [PubMed: 26644903]. [PubMed Central: PMC4671177]. ## 45. Assari S, Lankarani MM. The association between obesity and weight loss intention weaker among Blacks and men than Whites and women. J Racial Ethn Health Disparities. 2015;2(3):414–20. doi: 10.1007/s40615-015-0115-x. [PubMed: 26462289]. [PubMed Central: PMC4599706]. ## 46. Assari S. Additive effects of anxiety and depression on body mass index among Blacks: Role of ethnicity and gender. Int Cardiovasc Res J. 2014;8(2):44–51. [PubMed: 24936480]. [PubMed Central: PMC4058483]. ##