Diminished Health Returns of Own and Parental Education for Immigrants in the United States

Background:Educational attainment is a strong social determinant of health.Marginalization-related Diminished Returns(MDRs),however,refer to smaller health effects of socioeconomic status,particularly educational attainment for marginalized groups compared to mainstream populations.While multiple studies have documented MDRs of educational attainment for racial,ethnic,and sexual minorities,there are no previous studies on MDRs of education among immigrants.Aims:To understand if the MDRs phenomenon also applies to immigrants,we compared immigrant and non-immigrant American adults for the effects of their own and parental educational attainment on subjective health.Methods:This study used a cross-sectional design and borrowed data from the General Social Survey(1972-2018).GSS is a series of nationally representative surveys in the U.S.Our analytical sample included 38,399 adults who were either non-immigrants(n=34903;90.9%)or immigrants(n=3496;9.1%).The main independent variables were own and parental educational attainment measured as four-level categorical variables.The dependent variable(DV)was poor subjective health,measured using a single item.Age,sex,marital status,and year of the survey were the covariates.Immigration status was the moderator.Results:Overall,individuals with higher educational attainment of own and parents reported better subjective health.We,however,found significant interactions between immigration status and both own and parental educational attainment on subjective health,which was suggestive of weaker protective effects of own and parental educational attainment against poor subjective health in immigrants than non-immigrant individuals.Conclusions:In the United States,immigrant adults experience poor subjective health disproportionate to their own and their parents educational attainment.That means we may observe worse than expected health of immigrants across all educational levels and social classes.Public policies should go beyond equal access to education by empowering marginalized people to leverage their education and secure better outcomes.