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

Educational disparities in health are well documented, yet the education-health relationship is inconsistent across racial/ethnic and nativity groups. These inconsistencies may arise from characteristics of the early life environments in which individuals attain their education. We evaluate this possibility by investigating (1) whether educational disparities in cardiometabolic risk vary by race/ethnicity and nativity among Black, Hispanic, 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.