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Racial Disparities in the Health Benefits of Educational Attainment: A Study of Inflammatory Trajectories Among African American and White Adults

Fuller-Rowell, Thomas E. PhD; Curtis, David S. MS; Doan, Stacey N. PhD; Coe, Christopher L. PhD

doi: 10.1097/PSY.0000000000000128
Original Articles

Objective: The current study examined the prospective effects of educational attainment on proinflammatory physiology among African American and white adults.

Methods: Participants were 1192 African Americans and 1487 whites who participated in Year 5 (mean [standard deviation] age = 30 [3.5] years), and Year 20 (mean [standard deviation] age = 45 [3.5]) of an ongoing longitudinal study. Initial analyses focused on age-related changes in fibrinogen across racial groups, and parallel analyses for C-reactive protein and interleukin-6 assessed at Year 20. Models then estimated the effects of educational attainment on changes in inflammation for African Americans and whites before and after controlling for four blocks of covariates: a) early life adversity, b) health and health behaviors at baseline, c) employment and financial measures at baseline and follow-up, and d) psychosocial stresses in adulthood.

Results: African Americans had larger increases in fibrinogen over time than whites (B = 24.93, standard error = 3.24, p < .001), and 37% of this difference was explained after including all covariates. Effects of educational attainment were weaker for African Americans than for whites (B = 10.11, standard error = 3.29, p = .002), and only 8% of this difference was explained by covariates. Analyses for C-reactive protein and interleukin-6 yielded consistent results.

Conclusions: The effects of educational attainment on inflammation levels were stronger for white than for African American participants. Why African Americans do not show the same health benefits with educational attainment is an important question for health disparities research.

From the College of Human Sciences (T.E.F.-R., D.S.C.), Auburn University, Auburn, Alabama; Department of Psychology (S.N.D.), Boston University, Boston, Massachusetts; and Department of Psychology (C.L.C.), University of Wisconsin, Madison, Wisconsin.

Address correspondence and reprint requests to Thomas E. Fuller-Rowell, PhD, College of Human Sciences, Auburn University, 203 Spidle Hall, Auburn, AL 36849. E-mail: tef0005@auburn.edu

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.psychosomaticmedicine.org).

Received for publication December 2, 2013; revision received September 6, 2014.

Copyright © 2015 by American Psychosomatic Society
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