title: Historical Differences in School Term Length and Measured Blood Pressure: Contributions to Persistent Racial Disparities among US-Born Adults.
abstract: Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.
  
  
  
  National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression models adjusted for age, state and year of birth to estimate effects of term length on systolic and diastolic blood pressure (SBP and DBP) and hypertension for US-born adults. We also tested whether correcting years of schooling for term length differences attenuated estimated racial disparities.
  
  
  
  Among black women, 10% longer school term was associated with lower SBP, DBP and hypertension prevalence (2.1 mmHg, 1.0 mmHg, and 5.0 percentage points respectively). Associations for whites and for black men were not statistically significant. Adjustment for education incorporating corrections for differences in school term length slightly attenuated estimated racial disparities.
  
  
  
  Longer school term length predicted better BP outcomes among black women, but not black men or whites.
authors.affiliation: Harvard Center for Population and Development Studies, Harvard School of Public Health, Cambridge, Massachusetts, United States of America.
authors.forename: Sze Yan
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and The Aging Brain, and Department of Neurology, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: Beatrix D
authors.initials: BD
authors.lastname: Capistrant
authors.affiliation: Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, United States of America.
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001794:Blood Pressure; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012574:Schools; D014481:United States / Q000453:epidemiology; D044465:White People