Contextualizing Educational Disparities in Health: Variations by Race/Ethnicity, Nativity, and County-Level Characteristics

Abstract

Educational disparities in health are well documented, yet the education– health rela tion ship is incon sis tent across racial/eth nic and nativ ity groups. These inconsistencies may arise from characteristics of the early life environments in which indi vid u als attain their edu ca tion. We eval u ate this pos si bil ity by inves ti gat ing (1) whether edu ca tional disparities in cardiometabolic risk vary by race/eth nic ity and nativ ity among Black, His panic, and White young adults; (2) the extent to which racial/ethnic-nativity differences in the education–health relationship are contingent on economic, policy, and social characteristics of counties of early life residence; and (3) the county characteristics associated with the best health at higher levels of education for each racial/ethnic-nativity group. Using data from the National Longitudinal Study of Adolescent to Adult Health, we find that Black young adults who achieve high levels of education exhibit worse health across a majority of contexts relative to their White and Hispanic counterparts. Additionally, we observe more favorable health at higher levels of education across almost all contexts for White individuals. For all other racial/ethnic-nativity groups, the relationship between education and health depends on the characteristics of the early life counties of residence. Findings highlight place-based factors that may contribute to the development of racial/ethnic and nativity differences in the education–health relationship among U.S. young adults.