Investigation of Differences in Allostatic Load among Black Men by Level of Educational Attainment: High School Graduates Experience the Highest Levels of Stress

Charles R. Rogers, Justin X. Moore, Danielle R. Gilmore, Ethan Petersen, Ellen Brooks, Carson Kennedy and Roland J. Thorpe
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Charles R. Rogers: Department of Family & Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
Justin X. Moore: Cancer Prevention, Control & Population Health, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Danielle R. Gilmore: Trachtenberg School of Public Policy and Administration, George Washington University, Washington, DC 20052, USA
Ethan Petersen: Department of Family & Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
Ellen Brooks: Department of Family & Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
Carson Kennedy: Department of Family & Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
Roland J. Thorpe: Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD 21205, USA

IJERPH, 2022, vol. 19, issue 6, 1-11

Abstract: Allostatic load (AL)—the biological assessment of long-term exposure to stress—may explain mortality-rate disparities among non-Hispanic Black (Black) men. We aimed to investigate AL among Black men with equivalent education status after controlling for income. A cross-sectional study was employed to investigate AL among 4113 Black men who participated in the National Health and Nutrition Examination Survey between 1999–2018. A summation of 8 biomarker factors were used to compute AL, differences in socio-demographic characteristics by education status were evaluated, and health behaviors that may influence AL were examined. To determine the high-risk thresholds for each AL component, we examined each component’s distribution among NHB men for whom complete biomarker data were available in the NHANES sample. High-risk thresholds were determined as either (1) above the 75th percentile for body mass index (BMI), diastolic blood pressure (DBP), glycated hemoglobin, systolic blood pressure (SBP), total cholesterol, and serum triglycerides; or (2) below the 25th percentile for serum albumin and serum creatinine. Modified Poisson regression models were used to estimate prevalence ratios and their associated 95% confidence intervals for high AL risk while adjusting for potential confounders. Black men with a high school diploma/GED had a greater prevalence of high AL compared with Black men who had other levels of education, and a slightly higher prevalence of high AL compared with Black men who had less than a high school education. Black men with college degrees had a lower prevalence of high AL than Black men with the lowest levels of educational attainment. Researchers must further examine the hidden costs stemming from the interplay between discrimination associated with being Black in America and systemic racism in the educational system—which may be preventing Black men from achieving optimal health.

Keywords: allostasis; health equity; men’s health; socioeconomic factors; social determinants of health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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