Electronic Thesis/Dissertation


An Exploration of First-Generation College Graduate Health Outcomes in Early Adulthood Open Access

The purpose of this research was to explore the impact of first-generation college graduate status on health among college graduates in the United States. Chronic diseases and conditions such as heart disease, stroke, and obesity are among the most common, preventable illnesses in the U.S. Understanding the social and economic factors that influence individual and community health has become more important as growing evidence points to the effect of the interplay of the social, physical, health services, and structural environment on one’s health. Education is increasingly recognized as an important social determinant of health, with parental education shown to be associated with educational and occupational outcomes in children. Almost one-third of the undergraduate population is first-generation college students - those whose parents did not earn a postsecondary degree; they are an important, growing, but often hidden population.This research is a secondary analysis of a nationally representative sample of adolescents surveyed during the 1994-1995 academic year (WAVE I) as part of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The sample was drawn from those followed-up in 2007–2008 (WAVE IV) when individuals were aged 24-32. Univariate, bivariate, and multivariate analytical methods, including mediation analysis were used to generate a profile of first-generation college graduates and to investigate the impact of that status on health (measured by Body Mass Index and blood pressure), and potential mediators of the relationship – health behaviors, stress and social support.Approximately 44% of college graduates are first-generation and they were 1.6 times more likely to be from a minority group than their continuing generation peers (95% CI:1.27, 2.25) (p = 0.000). They were 3.91 times more likely to come from families with incomes below the median for college graduates ($51,000) than their peers (95% CI: 2.97, 5.15) (p = 0.000). First-generation college graduates had statistically significantly higher mean BMIs than their peers (28.41 and 26.62, respectively); first-generation college graduate status had a significant association to BMI, even while controlling individually for health behaviors, social support, and adolescent family income. Health behavior and social support did not mediate the relationship between first-generation college graduate status and health, but social support (received by, and provided to parents) differed significantly between first and continuing generation college graduates. For example, first-generation college graduates were 35% less likely to receive instrumental social support from parents or relatives. Findings from this innovative research demonstrate the significance of first-generation college graduate status to health outcomes, expanding the limited extant literature on first-generation college graduate outcomes. Findings have implications for policies concerned with support of first-generation college graduates while in college, and in the transition into early adulthood. They support re-thinking requirements for the college admissions process, as results indicated disparities in adolescent family income, suggesting disadvantage in access and ability to persist in college. This is the first study, to the author’s knowledge, to use a nationally representative dataset to generate a profile of first-generation college graduates and to explore health outcomes of first-generation college graduates in early adulthood.

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