Social
Attending Historically Black Colleges or Universities and all-mortality in US Black adults M. Maria Glymour* Marilyn Thomas Thomas Thomas Thomas Thomas Thomas Thomas Thomas University of California San Francisco
INTRODUCTION
Higher education strongly predicts reduced risk of mortality yet evidence suggests heterogeneity in health returns to education. Black adults may derive long-term health benefits from attendance at an Historically Black College or University (HBCU) compared to attending a Predominantly White Institution (PWI). No prior study has evaluated all-cause mortality in a nationwide sample.
METHODS
The REasons for Geographic and Racial Differences in Stroke (REGARDS) prospective study recruited Black and White US adults aged 45 and older during 2003-2007. The analytic sample included Black college-goers who attended high school in a state with an HBCU (N=1,960). In 2012, data collection was initiated on childhood, adult, and family factors. Participants retrospectively reported each college ever attended, which was classified as a PWI (reference) or HBCU. Every 6 months, interviews collected mortality information from next of kin or proxies. Adjusting for participant characteristics (e.g., age, gender) and early-life predictors (e.g., childhood health, school support), Cox proportional hazard models estimated adjusted mortality ratios (2012–2023) and effect modification by whether participants were college-aged before 1955 (during legal racial segregation), 1955-1964 (before the Civil Rights Act), or after 1964.
RESULTS
Mean age was 62 years (SD±8.2) and 35% attended an HBCU. HBCU versus PWI attendees had negligibly lower all-cause mortality (HR 0.99; CI 0.88, 1.12). Although CIs were wide, those college-aged during 1955-1964 had lower mortality (HR 0.87; CI 0.87, 1.06) but elevated mortality for those college-aged before 1955 (HR 1.03; CI 0.85, 1.24) and after 1964 (HR 1.46; CI 0.91, 2.33).
CONCLUSION
We found little evidence that HBCU attendance was associated with lower mortality yet could not rule out substantial protective or harmful effect modification by college-aged years. These results are inconsistent with prior findings related to other health outcomes.
