Table 3.

Association of educational quality composite index with cardiovascular outcomes, by level of educational attainment (difference per standard deviation of index)

	High School Education or Less		More than High School Education		p-value on interaction term, testing difference by educational attainmentb
	Beta coefficient [95% CI]	Odds ratio [95% CI]	Beta coefficient [95% CI]	Odds ratio [95% CI]
Objective Health Outcomes
Systolic blood pressure	−0.95 [−2.21, 0.30]		−0.057 [−1.48, 1.36]		0.23
Diastolic blood pressure	−0.12 [−0.96, 0.71]		−1.66* [−2.63, −0.69]		0.58
Total cholesterol	−0.25 [−2.03, 1.53]		−0.68 [−4.18, 2.82]		0.68
HDL cholesterol	−0.14 [−1.36, 1.09]		1.37 [−0.50, 3.24]		0.001
Ln(Triglycerides)	0.0036 [−0.038, 0.046]		−0.059 [−0.13, 0.0092]		0.001
LDL cholesterol	−2.33 [−7.25, 2.59]		3.84 [−3.49, 11.2]		0.86
Ln(C-reactive protein)	0.045 [−0.040, 0.13]		−0.055 [−0.14, 0.028]		0.03
Ln(Telomere length)	0.0069 [−0.013, 0.027]		0.0050 [−0.017, 0.028]		0.006
Diabetes		0.98 [0.79, 1.21]		0.97 [0.68, 1.39]	0.01
Self-reported Health Outcomes
Heart attack		0.86 [0.71, 1.04]		1.17 [0.83, 1.66]	0.15
Hypertension		0.99 [0.90, 1.08]		1.06 [0.91, 1.24]	0.03
Diabetes		1.06 [0.94, 1.19]		0.99 [0.74, 1.31]	0.28
Smokes now		0.95 [0.83, 1.09]		0.66* [0.54, 0.80]	< 0.001

^*p<0.05

N = 34,770 overall, with smaller sample sizes for outcomes that were not collected in all waves or for all respondents (see Table 1). Study sample was drawn from repeated cross-sectional waves of the National Health and Nutrition Examination Survey, 1971–2012. Analyses involved multivariable regressions, with robust standard errors clustered by state of birth. Continuous outcomes were modeled using linear regressions, and binary outcomes were modeled using logistic regressions. All models adjust for race, birth year, and state of birth, as well as state percent black, percent foreign-born, manufacturing jobs per capita, and inflation adjusted manufacturing wages per manufacturing job.

^aFor serum testing of diabetes, earlier survey waves used 2-hour glucose testing, while later survey waves used hemoglobin A1c. For consistency, we transformed these laboratory measures into a binary measure of whether the level exceeded the cut-off for diabetes (i.e., glucose ≥ 200 or hemoglobin A1c ≥ 6.5).

^bTo determine whether the difference by educational attainment was statistically significantly different, we carried out each of the primary analyses while including an interaction term between educational quality and educational attainment. This column illustrates the p-value on this interaction term.