Postsecondary Education and Adult Health Lifestyles: Examining Sources of Disparities

Objectives: Approximately 58.5 million Americans in their thirties and forties have some form of postsecondary education; however, health risk behaviors remain disproportionately concentrated among those with lower educational attainment. In this study, we examine and decompose disparities in adult health lifestyles by level of postsecondary education, identifying the underlying social and economic factors contributing to these differences. Methods: We drew data from Waves I (1995) and V (2018) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). We analyzed a composite health behavior index, capturing binge drinking, smoking, marijuana use, physical activity, nutrition, and body mass index, using Poisson regression models and Kitagawa-Oaxaca-Blinder decomposition techniques. Explanatory factors include demographic characteristics, parental background, social context, economic well-being, and employment characteristics. Results: Economic well-being explained the largest share of the disparities in health behaviors by postsecondary education. Demographics, parental background, and social context also contributed significantly. However, after controlling for personal and household income, employment characteristics did not account for a notable portion of the observed behavioral disparities. Conclusions: Disparities in adult health lifestyles related to postsecondary education are mainly caused by structural socioeconomic factors. Addressing these underlying factors may be essential to reducing behavioral inequalities linked to educational attainment.