Education, race, and high-density lipoprotein cholesterol among US adults.
OBJECTIVE
Although educational achievement is positively related to levels of high-density lipoprotein cholesterol (HDL-C) among White adults, there is an inverse association among Blacks. We assessed whether this interaction could be attributed to differences in the relation of education to correlates of HDL-C.


METHODS
Cross-sectional analyses were based on data from 8391 White and 995 Black adults who participated in the Second National Health and Nutrition Examination Survey.


RESULTS
Associations between education and HDL-C levels varied from negative (Black men), to nearly nonexistent (White men and Black women), to positive (White women). Mean HDL-C levels were higher among Blacks than among Whites, but differences varied according to educational achievement. Among adults with less than 9 years of education, mean levels were 6 to 10 mg/dL higher among Blacks, but the radical difference was less than 1 mg/dL among adults with at least 16 years of education. About 20% to 40% of these differences could be accounted for by obesity, alcohol consumption, and other characteristics.


CONCLUSIONS
Because of the implications for coronary heart disease risk, consideration should be given to behavioral characteristics associated with the interaction between race and educational achievement.
Freedman
D S
DS
Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, GA 30333.
Strogatz
D S
DS
Williamson
D F
DF
Aubert
R E
RE
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D004041:Dietary Fats / Q000009:adverse effects; D004358:Drug Therapy; D004522:Educational Status; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D008076:Cholesterol, HDL; D004041:Dietary Fats