Document Type : Original Article
Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California, USA
Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, California, USA
Marginalization-Related Diminished Returns (MDRs) Research Center, Los Angeles, California, USA
Introduction: Educational attainment is one of the main social determinants of health, however, based on a literature from the US, high educational attainment is associated with fewer health advantages for marginalized groups such as immigrants. A recent study has shown diminished returns of education on health. In the current study, built on the Marginalization-related Diminished Returns (MDRs) theory, the differential association between educational attainment and happiness in Europe by nativity status is tested.
Methods: For this cross-sectional study, we borrowed data from European Social Survey 2020 (ESS 2020). Participants included 9560 individuals who identified as either native-born (n = 9052) or immigrant (n = 508) individuals who had worked in the past week and were residing in one of these ten countries: Bulgaria, Czechia, Estonia, Finland, France, Croatia, Hungary, Lithuania, Slovenia, and Slovakia. Age, sex, and self-rate health were control variables, while educational attainment was the independent variable. Happiness was the outcome. Linear regression was used for data analysis. Poisson regression was used for sensitivity analysis.
Results: Overall, high educational attainment was associated with higher levels of happiness. We documented a statistical interaction between nativity status and education on happiness, indicating a weaker inverse association between educational attainment and happiness for immigrant than native-born individuals. The results remained similar using linear or Poisson regression models.
Conclusion: Similar to the US, the link between educational attainment and happiness also depends on nativity in Europe. Countries of host undervalue the educational attainment of immigrants. Future research should explore the role of labor market discrimination and other racialization and xenophobia on reducing the return of education for immigrants. Given the existing MDRs, and because diminished returns are a mechanism behind disparities, policymakers should go beyond equal SDOH and equalize the return of SDOHs. Policies such as equal pay and additional enforcement of antidiscrimination may help. The results are important given the anti-immigrant sentiment and nationalist movements in Europe and around the world.