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BMC Public Health· 2026Q1

Educational attainment and type 2 diabetes mellitus in the United States: Effect modification by race/ethnicity and sex in the 2022 Behavioral Risk Factor Surveillance System

Heather F. McClintock, Elizabeth J. Pantesco

Short summary

Higher educational attainment is linked to lower Type 2 Diabetes Mellitus (T2DM) rates in Hispanic and non-Hispanic White adults, with a stronger protective effect for Hispanics, particularly Hispanic men compared to non-Hispanic White men. No association was found for Black, Asian, or Native American adults.

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Key points

  • Higher education is associated with lower T2DM rates in Hispanic and non-Hispanic White adults.
  • The protective effect of education on T2DM is stronger in Hispanic adults compared to non-Hispanic White adults.
  • Hispanic men showed a stronger protective effect from education against T2DM than non-Hispanic White men.
  • No association between educational attainment and T2DM was found for non-Hispanic Black, non-Hispanic Asian, or non-Hispanic American Indian/Alaska Native adults.

AI-generated from the title and abstract; the full text is not read.

Abstract

Abstract Background Type 2 diabetes mellitus (T2DM) is a leading cause of death and excess healthcare expenditures in the United States. Higher educational attainment is associated with reduced risk for both diabetes onset and diabetes-related mortality. The purpose of this study was to investigate whether the relationship between educational attainment and rates of T2DM varies by race/ethnicity and sex in the United States. Methods We evaluated whether the relationship between educational attainment and rates of T2DM in the U.S. 2022 Behavioral Risk Factor Surveillance System ( n = 277,940) was moderated by race/ethnicity. Follow-up analyses examined moderation by sex. Models were adjusted for sociodemographic factors, body mass index, and health behaviors. Results In both non-Hispanic (NH) White and Hispanic adults, higher educational attainment was associated with lower rates of T2DM. The protective effects of education were stronger in Hispanics compared to Whites, especially in Hispanic men versus NH White men. There was no association between education and T2DM among individuals who identified as NH Black, NH Asian, or NH American Indian or Alaska Native. Conclusions These findings are consistent with previous research demonstrating racial/ethnic heterogeneity in the educational gradient in health outcomes. Further work is needed to better understand and develop interventions to address racial/ethnic disparities in the influence of educational attainment on T2DM.

The authors' abstract, as published at the source. BMC Public Health, 2026 · DOI ↗

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