Racial Differences in the Association Between School Quality and Adult Health: A Nationally Representative Longitudinal Study

Although school quality is associated with greater educational attainment and better health in population-wide studies, it remains unclear whether these effects are experienced similarly across racial and ethnic groups in the USA. To explore this question, we used the nationally representative National Longitudinal Study of Adolescent to Adult Health to examine the association between four individual school quality indicators (student promotion rates, teacher retention, average daily attendance, parental involvement) in Wave I (grades 7-12th, age 12-19), with adult health outcomes in Wave V (age 32-42), stratified by race/ethnicity (White, Black, Latinx). The primary outcomes were self-rated health and depressive symptoms. Regression models adjusted for baseline health, individual, family, and school characteristics. Of 10,724 participants, approximately 50% identified as female, 63% White, 21% Black, 17% Latinx. School quality indicators were not statistically associated with adult depressive symptoms for White participants. Teacher retention was unrelated to self-rated health for any group, but was associated with greater depression symptoms in adulthood for Black and Latinx participants (β = 0.42-point higher score per 1 SD increase in teacher retention, 95% CI [0.153, 0.690], p = 0.002; β = 0.23-point higher score per 1 SD increase in teacher retention, 95% CI [0.003, 0.466], p = 0.047, respectively). Some conventional school quality indicators were associated with worse adult mental health for Black and Latinx participants. The findings suggest that more research is needed to understand what aspects of school quality may best promote life course health development for minoritized groups.