Influence of grandparent schooling on adult health status, smoking, and obesity

Background: Despite persistent education-related health disparities in the U.S. across generations, little is known about multigenerational effects of schooling on adult health. As it becomes more common for grandparents and grandchildren to share lifespans, direct influences of grandparent schooling on grandchild health may become increasingly important. Methods: We used multigenerational data spanning 41 years on a national sample of U.S. families to investigate effects of grandparent educational attainment on global health status, smoking, and obesity in adults aged 25–55 years. We used marginal structural models to estimate direct effects of grandparent schooling unmediated by parent and participant schooling. Results: After accounting for parent and participant schooling, there were graded inverse associations among Whites between grandparent schooling and poor health status, smoking, and obesity. For example, prevalence ratios (PR) of obesity compared to all grandparents having less than a high school education were PR = 0.85 (95% confidence interval 0.68–1.05) for a grandparent with a high school degree, PR = 0.81 (0.64–1.03) for some college education, and PR = 0.73 (0.56–0.94) for a college degree. Estimates among Blacks were similar to among Whites for smoking but minimal for health status and obesity (e.g., PR of obesity was 1.02 (0.74–1.39) for a grandparent with a college degree). Conclusion: Higher grandparent schooling may be beneficial for grandchildren's adult health through pathways unmediated by parent and grandchild schooling, but these benefits may be unequally distributed among racial groups. These differences may contribute to racial health disparities across generations.