High Economic Stress May Explain Worse-Than-Expected Health of Highly Educated Chinese Americans

Document Type : Original Article


1 School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA

2 Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA



Introduction: Low stress is one of many plausible mechanisms that may explain the health effects of educational attainment. However, Marginalization-related Diminished Returns (MDRs) refer to the weaker health effects of educational attainment for marginalized, compared to privileged, groups. We are unaware of any previous studies that have compared Asian and non-Hispanic White Americans for the effects of educational attainment on perceived economic stress. The aim was to compare Chinese and non-Hispanic White Americans for the association between educational attainment and perceived economic stress in a national sample of American adults. This is important given stress is a risk factor for poor health.
Methods: This study analyzed cross-sectional data of 20,793 adults who participated in the National Health Interview Survey (NHIS 2015). From all participants, 403 individuals were Chinese Americans, and 20,390 were non-Hispanic Whites. Perceived economic stress was the outcome of interest. Years of education (educational attainment) was the predictor variable of interest. Gender, age, region, marital status, sexual orientation (i.e., lesbian, gay, bisexual, and transgender (LGBT)), and immigration status were covariates. Race/ethnicity was the effect modifier.
Results: Overall, higher educational attainment was associated with lower levels of perceived economic stress. A statistically significant interaction showed that the effect of educational attainment on reducing perceived economic stress is smaller for Chinese Americans than Non-Hispanic Whites.
Conclusion: Educational attainment is not similarly protective against perceived economic stress across all social groups. Thus, perceived economic stress may explain why ethnic minorities and immigrants gain decreased benefits from their educational attainment than the mainstream and privileged social group.