Although lower education is strongly associated with poor health in minority people, more so than in majority people, pathways underlying the relationships are less understood. This book chapter examined how socioeconomic status (SES) lifestyle mediated the relationships between education and health between majority and minority groups in Bangladesh. In so doing we directly assessed our research objectives from representative sample (N=550, age range 20-30 years) from Muslim (n=190), Hindu (n=180) and Santal (n=180) men in Bangladesh. In data analysis, descriptive and statistical mediating tools were used. The results from mediation analysis suggested that lower SES and lifestyle mediated the association between education and health between majority and minority groups, after accounting for demographic characteristics. The current study provides evidence that lower education, SES and unhealthy lifestyle contributes to poor health in the minority groups in Bangladesh. Further research and health policy implications are discussed.
TopIntroduction
Research over past decade suggests that education influences socioeconomic attainment and subjective health and social well-being (Cutler & LIeras-Muney, 2006; Mirowsky & Ross, 2003). By education we mean years of formal schooling that help individuals not only to attain valued social positions, including occupation, income, power, and healthy lifestyle but also foster health in their life cycle (Braveman & Egerter, 2009; Grossman & Kaestner, 1997; Ross & Mirowsky, 1999; Winkleby et al., 1990). How does education foster health? Decades of research suggest that education influences health in several pathways: Physiological process, socioeconomic status (SES), socio-demographic status, lifestyle, and psychosocial process (sense of personal control, social stress, and social support). Particularly, human capital theory of learned effectiveness and research by Mirowsky et al. (2003) and Ross’s et al. (1999) have shown that lower educational attainment is linked to poorer health, mediating through lower SES and unhealthy lifestyle in general population. For example, Ross and Willigen, using representative sample (1997) found that the well-educated people have lower level of physical and emotional distress by the pathways of paid work, stable job, and accumulating economic resources with high personal control, stable marital relation, and social support. Using telephone survey of 2593 representative sample aged 18-95, Ross and Mirowsky (1999) found that quantity, credential, and selection of formal education was positively linked to physical functioning and perceived health, controlling for sociodemographic status (age, sex, marital status, parental education) in general population. They also found that of the three aspects of education, years of schooling had the largest effects on SPH, attributable to its correlation with work and economic condition, psycho-social resources, and healthy lifestyles.
Some comparative or cross-ethnic studies also have explored differences in educational attainment and health across the ethnic groups (Dressler et al., 2005; Mirowsky & Ross, 1980; Mossakowski, 2008; Williams & Collins, 1995; Williams & Sternthal, 2010). Cross-ethnic studies also have found that lower educational attainment of the minority ethnic groups compared to the white in Western countries is significantly associated with poor health, mediating through lower SES, unhealthy lifestyle, and poor psychosocial status (low social support and low self-esteem). For example, Mossakowski (2008) found that lower educated young adult Blacks and Hispanics had significantly higher levels of depressive symptoms than the whites via lower SES, poverty, and family disruption in the USA.
Taken together, theory and research reviewed suggest that relationship of lower education with poorer health among people in general and minority ethnic people in particular are remarkable, mediating through SES, sociodemographic factors, and health lifestyle. Although cross-ethnic studies in Bangladesh have mainly focused on the linking of sociocultural status to social stress (Uddin, 20011a) and mental health or sociodemographic status to arrack drinking among Muslim, Hindu, Santal and Oraon ethnic men (Uddin, 20011a), there is no particular study on SES and lifestyle that mediate the relations between education and health among Muslim, Hindu and Santal Men in Bangladesh. Based on human capital theory of learned effectiveness and research (Mirowsky et al., 2003) this chapter examined and compared relationships between education and health via SES and lifestyle among the ethnic Muslim, Hindu, and Santal men in Bangladesh.