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Kim Y, Lee H, Lee H, Lee M, Kim S, Konlan KD. Social determinants of health of racial and ethnic minority adolescents: An integrative literature review. Heliyon 2023; 9:e20738. [PMID: 37916096 PMCID: PMC10616148 DOI: 10.1016/j.heliyon.2023.e20738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
Integration of adolescents with diverse cultural backgrounds into the country of residence is associated with some form of rejection and discrimination, predisposing them to undesirable health outcomes. In this regard, the aim of this study was to identify the social determinants of the health of racial and ethnic minority adolescents. In this integrative literature review, PubMed, EMBASE, Cochrane Library, and CINAHL databases were searched from 2016 to 2021 and studies were selected according to the PRISMA 2020 guidelines. Health status was limited to health outcomes according to the definition proposed by the World Health Organization and Healthy People 2020. The social determinants of health were classified according to the research framework of the National Institute on Minority Health and Health Disparities. Six types of health status were identified: self-rated health, obesity and overweight, global self-worth, emotional well-being, anthropometric measurement, and psychosocial adjustment. The social determinants of health were at the individual and interpersonal level, and the domains included the biological (gender, illness experience), psychological (acculturative stress), and sociocultural environment (e.g., socioeconomic status, parents' educational level, household death due to violence). Therefore, future research must prioritize their sociocultural environments to reduce the negative impact of discrimination and sociocultural and structural differences on racial and ethnic minority adolescents.
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Affiliation(s)
- Youlim Kim
- College of Nursing, Kosin University, Busan, South Korea
| | - Hyeonkyeong Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyeyeon Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Mikyung Lee
- Department of Nursing, Seojeong University, Yangju, South Korea
| | - Sookyung Kim
- School of Nursing, Soonchunhyang University, Cheonan, South Korea
| | - Kennedy Diema Konlan
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, Ghana
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Cheng TC, Lo CC. Testing the Multiple Disadvantage Model of Health with Ethnic Asian Children: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:483. [PMID: 36612803 PMCID: PMC9819056 DOI: 10.3390/ijerph20010483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/03/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
This study of ethnic Asian children in the United States asked whether their health exhibited relationship with any of six factors: social disorganization, social structural factors, social relationships, the health of their parents, their access to medical insurance, acculturation. The sample of 1350 ethnic Asian children was extracted from the 2018 National Survey of Children's Health. Logistic regression results showed that these children's excellent/very good/good health was associated positively with safe neighborhoods, family incomes, family cohesiveness, family support, and receipt of Temporary Assistance for Needy Families (TANF). In turn, health was associated negatively with single-mother households. Implications of the present results in terms of interventions promoting family support, TANF participation, safe neighborhoods, and professionals' cultural competency are discussed.
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Affiliation(s)
- Tyrone C. Cheng
- School of Social Work, University of Alabama, Little Hall, Tuscaloosa, AL 35401, USA
| | - Celia C. Lo
- Behavioral Research Manager, Peraton, Defense Personnel and Security Research Center, Seaside, CA 93955, USA
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Jeinie MHB, Guad RM, Hetherington MM, Gan SH, Aung YN, Seng WY, Lin CLS, George R, Sawatan W, Nor NM, Leik NKO, Mohd Daud MNB, Guad SF. Comparison of Nutritional Knowledge, Attitudes and Practices between Urban and Rural Secondary School Students: A Cross-Sectional Study in Sabah, East Malaysia. Foods 2021; 10:foods10092037. [PMID: 34574147 PMCID: PMC8465158 DOI: 10.3390/foods10092037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/29/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
Nutritional knowledge, attitudes and practice (KAP) may guide healthy meal choices. Here, nutritional KAP was compared across school students in Sabah based on locality and gender. A cross-sectional survey of students aged 15-19 years was conducted using multistage sampling. Nutritional KAP was measured via questionnaire. Anthropometric measures of weight and height were taken in person to calculate body mass index (BMI). Among the 994 participants, 80% were urban and 60% were female (mean age 16.5 ± 0.6 yr). Most were of Kadazan-Dusun (23%) ethnicity. Measured height for age Z score (HAZ) and BMI for age Z score (BAZ) differed between urban and rural students (-1.2 ± 0.8 versus -1.5 ± 0.7 for HAZ; p < 0.001; 0.2 ± 1.4 versus -0.1 ± 1.3; p = 0.02, respectively). No difference in nutritional knowledge was found, although urban students prioritized having a healthy/balanced diet (59.55% versus 48.50%, p = 0.03) and ate daily breakfast (57.4% versus 10.2%, p < 0.001) compared to rural. Females scored higher on nutritional knowledge than males (18.9 ± 2.8 vs. 18.1 ± 3.4, respectively, p = 0.0001), yet males selected more healthy/balanced foods (63.3% versus 53.3%, p = 0.041). The gap remains between nutritional KAP and translating this to healthy eating among adolescents, related to locality and gender.
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Affiliation(s)
- Mohammad Halim Bin Jeinie
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
- Correspondence: (M.H.B.J.); (R.M.G.)
| | - Rhanye Mac Guad
- Department of Biomedical Science and Therapeutics, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Correspondence: (M.H.B.J.); (R.M.G.)
| | | | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia;
| | - Yin Nwe Aung
- Faculty of Medicine & Health Sciences, UCSI University, Jalan Menara Gading, UCSI Heights, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Wu Yuan Seng
- Department of Biochemistry, School of Medicine, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom 42610, Selangor, Malaysia;
| | - Constance Liew Sat Lin
- Medical Based Department, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Ramlah George
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Waidah Sawatan
- Department of Nursing, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Norazmir Md Nor
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Puncak Alam 42300, Selangor, Malaysia;
| | - Nang Kham Oo Leik
- Department of Reproductive Health, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Mohd Nazri Bin Mohd Daud
- Department of Community and Family Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
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Ghani SB, Taneja K, Wills CCA, Tubbs AS, Delgadillo ME, Valencia D, Halane M, Killgore WDS, Grandner MA. Culturally-consistent diet among individuals of Mexican descent at the US-Mexico border is associated with sleep duration and snoring. BMC Nutr 2021; 7:53. [PMID: 34420524 PMCID: PMC8381582 DOI: 10.1186/s40795-021-00452-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Existing studies show that consuming food consistent with one's culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how Mexican food consumption by individuals of Mexican descent residing at the US-Mexico border, was associated with various measures of sleep, after accounting for acculturation. METHODS Data were provided by 100 adults between the ages of 18-60, in the city of Nogales, AZ. Questionnaires were provided in either Spanish or English. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II), with an additional question, asking how often "my family cooks Mexican foods." Frequency of cooking Mexican food was coded as either "yes" or "no." Sleep was assessed, using validated measures that include the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and sleep duration with the item "how many hours of actual sleep did you get at night?" Regression models estimated the associations between sleep health variables as outcomes and consumption of Mexican food as the independent variable. Covariates included age, sex, and acculturation scores. Parental education level was also included, as an indicator of childhood socioeconomic status and since food culture likely involves parents. RESULT We found that among individuals who identified as Mexican-Americans who consumed culturally-consistent foods, was associated with, on average, 1.41 more hours of sleep (95% CI 0.19, 2.62; p = 0.024) and were less likely to report snoring (OR: 0.25; 95% CI 0.07, 0.93; p = 0.039). Consuming Mexican food was not associated with sleep quality, insomnia severity or sleepiness. CONCLUSION Individuals of Mexican descent residing at the US-Mexico border who regularly consumed Mexican food, reported more sleep and less snoring. Mexican acculturation has been shown previously to improve sleep health. This is likely due to consumption of a culturally- consistent diet. Future studies should examine the role of acculturation in sleep health, dietary choices, and subsequent cardiometabolic risk.
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Affiliation(s)
- Sadia B Ghani
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA.
| | - Krishna Taneja
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
| | - Chloe C A Wills
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
| | - Andrew S Tubbs
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
| | - Marcos E Delgadillo
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
| | - Dora Valencia
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
| | - Mohamed Halane
- Medical University of the Americas, Nevis, Saint Kitts And Nevis
| | - William D S Killgore
- Department of Psychiatry, Social, Cognitive, and Affective Neuroscience (SCAN) Lab, University of Arizona, 1501 N Campbell Rd Suite 7303B, Tucson, AZ, 85724, USA
| | - Michael A Grandner
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona, 1501 N Campbell Rd Suite 7326, Tucson, AZ, 85724-5002, USA
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Overcash F, Reicks M. Diet Quality and Eating Practices among Hispanic/Latino Men and Women: NHANES 2011-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1302. [PMID: 33535565 PMCID: PMC7908517 DOI: 10.3390/ijerph18031302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
Dietary quality of Hispanic/Latino adults residing in homes with children may differ by gender, that in turn, may impact youth through role modeling and food availability. Using a nationally representative sample (n = 1039) from the National Health and Nutrition Examination Survey (2011-2016), adjusted regression analyses were used to examine food-related practices, food group intake, and dietary quality among Hispanic/Latino men and women in homes with children (6-17 years). Compared to women, men had lower total 2015 Healthy Eating Index (HEI) scores and component HEI scores for healthy food groups. Men also ate more meals that were not home prepared/week and purchased more foods from non-grocery stores than women. Negative food-related practices and working more hours/week may explain in part the lower dietary quality observed among Hispanic/Latino men than women. Interventions may be improved by targeting gender-specific food-related behaviors that could positively impact dietary quality of youth residing with them.
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Affiliation(s)
- Francine Overcash
- Department of Food Science and Nutrition 1, University of Minnesota, Minneapolis, MN 55410, USA;
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Assari S, Boyce S, Bazargan M, Caldwell CH. African Americans' Diminished Returns of Parental Education on Adolescents' Depression and Suicide in the Adolescent Brain Cognitive Development (ABCD) Study. Eur J Investig Health Psychol Educ 2020; 10:656-668. [PMID: 32656052 PMCID: PMC7351357 DOI: 10.3390/ejihpe10020048] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To investigate racial and ethnic differences in the protective effects of parental education and marital status against adolescents' depressed mood and suicidal attempts in the U.S. As proposed by the Marginalization-related Diminished Returns (MDRs), parental education generates fewer tangible outcomes for non-White compared to White families. Our existing knowledge is very limited regarding diminished returns of parental education and marital status on adolescents' depressed mood and suicidal attempts. To compare racial groups for the effects of parental education and marital status on adolescents' depressed mood and suicidal attempt. This cross-sectional study included 7076 non-Hispanic White or African American 8-11 years old adolescents from the Adolescent Brain Cognitive Development (ABCD) study. The independent variables were parental education and marital status. The main outcomes were depressed mood and suicidal attempts based on parents' reports using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Age and gender were the covariates. Race was the moderator. Logistic regression was used to analyze the ABCD data. Overall, parental education was associated with lower odds of depressed mood (OR = 0.81; 95% CI = 0.67-0.99; p = 0.037) and having married parents was associated with lower odds of suicidal attempts (OR = 0.50; 95% CI = 0.28-0.91; p = 0.022). In the pooled sample, we found interaction terms between race with parental education and marital status on the outcomes, suggesting that the protective effect of having married parents against depressed mood (OR = 1.54; 95% CI = 1.00-2.37; p = 0.048) and the protective effect of having married parents against suicidal attempts (OR = 6.62; 95% CI = 2.21-19.86; p =0.001) are weaker for African Americans when compared to Whites. The protective effects of parent education and marital status against depressed mood and suicidal attempts are diminished for African American adolescents compared to White adolescents. There is a need for programs and interventions that equalize not only socioeconomic status (SES) but also the marginal returns of SES for racial minority groups. Such efforts require addressing structural and societal barriers that hinder African American families from translating their SES resources and human capital into tangible outcomes. There is a need for studies that can minimize MDRs for African American families, so that every individual and every family can benefit from their resources regardless of their skin color. To achieve such a goal, we need to help middle-class African American families secure tangible outcomes in the presence of SES resources.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Correspondence: ; Tel.: +1-734-232-0445; Fax: +1-734-615-8739
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
- Center for Research on Ethnicity, Culture, and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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Assari S, Boyce S, Caldwell CH, Bazargan M. Minorities' Diminished Returns of Parental Educational Attainment on Adolescents' Social, Emotional, and Behavioral Problems. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E49. [PMID: 32443584 PMCID: PMC7278850 DOI: 10.3390/children7050049] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/14/2020] [Accepted: 05/13/2020] [Indexed: 02/08/2023]
Abstract
Aim: To compare racial groups for the effect of parental educational attainment on adolescents' social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. The main outcomes were 1) anxious and depressed mood, 2) withdrawn and depressed affect, 3) somatic complaints, 4) social and interpersonal problems, 5) thought problems, 6) rule-breaking behaviors, 7) attention problems, and 8) violent and aggressive behaviors. These scores were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL). Race and ethnicity were the moderators. Linear regression was used to analyze the ABCD data. Results: Overall, high parental educational attainment was associated with lower scores across all domains. Race and ethnicity showed statistically significant interactions with parental educational attainment on adolescents' fewer social, emotional, and behavioral problems (all domains), net of all confounders, indicating smaller tangible gains from their parental educational attainment for Black and Hispanic compared to non-Hispanic White adolescents. Conclusion: The protective effects of parental education against social, emotional, and behavioral problems are systematically diminished for Hispanic and Black than non-Hispanic White adolescents.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA;
- Center for Research on Ethnicity, Culture, and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
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Mathematical Performance of American Youth: Diminished Returns of Educational Attainment of Asian-American Parents. EDUCATION SCIENCES 2020. [DOI: 10.3390/educsci10020032] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Marginalization-related Diminished Returns (MDR) phenomenon refers to the weaker effects of parental educational attainment for marginalized groups, particularly ethnic minorities. This literature, however, is limited to Blacks and Hispanics; thus, it is not clear if the MDR phenomenon also applies to the educational performance of Asian Americans or not. To explore ethnic differences in the association between parental educational attainment and youth mathematical performance among 10th-grade American high schoolers, this cross-sectional study used baseline data from the Education Longitudinal Study, a national survey of 10th-grade American youth. The analytical sample included a total number of 10,142 youth composed of 1460 (14.4%) Asian-American and 8682 (85.6%) non-Hispanic youth. The dependent variable was youth math performance (standard test score). The independent variable was parental education. Gender, both parents living in the same household, and school characteristics (% students receiving free lunch, urban school, and public school) were the covariates. Ethnicity was the moderating variable. Linear regression was used for data analysis. Overall, parental educational attainment was positively associated with math ability (test score). We observed a statistically significant interaction between ethnicity (Asian American) and parental education attainment on the results of math test scores, indicating that the boosting effect of high parental educational attainment on youth math function is smaller for Asian-American youth than for Non-Hispanic White youth. While high parental educational attainment contributes to youth educational outcomes, this association is weaker for Asian-American youth than non-Hispanic White youth. Diminished returns (weaker effects of parental education in generating outcomes for ethnic minorities) that are previously shown for Hispanics and Blacks also apply to Asian Americans.
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Assari S, Boyce S, Bazargan M, Mincy R, Caldwell CH. Unequal Protective Effects of Parental Educational Attainment on the Body Mass Index of Black and White Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3641. [PMID: 31569829 PMCID: PMC6801712 DOI: 10.3390/ijerph16193641] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Parental educational attainment is shown to be protective against health problems; the Minorities' Diminished Returns theory, however, posits that these protective effects tend to be smaller for socially marginalized groups particularly blacks than whites. AIMS To explore racial differences in the effect of parental educational attainment on body mass index (BMI) in a national sample of US adolescents. METHODS In this cross-sectional study, we used baseline data of 10,701 (8678 white and 2023 black) 12-17 years old adolescents in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the predictor. Youth BMI (based on self-reported weight and height) was the dependent variable. Age, gender, ethnicity, and family structure were covariates. Race was the focal moderator. RESULTS Overall, higher parental educational attainment was associated with lower youth BMI. Race, however, moderated the effect of parental educational attainment on BMI, suggesting that the protective effect of parental educational attainment on BMI is significantly smaller for black than white youth. CONCLUSIONS In the United States, race alters the health gains that are expected to follow parental educational attainment. While white youth who are from highly educated families are fit, black youth have high BMI at all levels of parental educational attainment. This means, while the most socially privileged group, whites, gain the most health from their parental education, blacks, the least privileged group, gain the least. Economic, social, public, and health policymakers should be aware that health disparities are not all due to lower socioeconomic status (SES) of the disadvantaged group but also diminished returns of SES resources for them. Black-white health disparities exist across all high socioeconomic status (SES) levels.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Ron Mincy
- Center for Research on Fathers, Children, and Family Well-Being, Columbia University, New York, NY 10027-5927, USA.
- Columbia Population Research Center (CPRC), Columbia University, New York, NY 10027-5927, USA.
- Columbia University School of Social Work, Columbia University, New York, NY 10027-5927, USA.
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
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Assari S, Bazargan M, Caldwell C. Parental Educational Attainment and Chronic Medical Conditions among American Youth; Minorities' Diminished Returns. CHILDREN-BASEL 2019; 6:children6090096. [PMID: 31454956 PMCID: PMC6770143 DOI: 10.3390/children6090096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Background: Parental educational attainment is protective against chronic medical conditions (CMCs). According to the minorities’ diminished returns (MDRs) theory, however, the health effects of socioeconomic status (SES) indicators are smaller for socially marginalized groups such as racial and ethnic minorities rather than Whites. Aims: To explore racial and ethnic differences in the effect of parental educational attainment on CMCs in a nationally representative sample of American youth. Methods: In this cross-sectional study, we used baseline data of 10,701 12–17 years old youth in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the independent variable. The dependent variable was the number of CMCs in youth. Age, gender, and family structure were covariates. Race and ethnicity were the focal moderators. Linear and multinomial regression were applied to analyze the data. Results: Overall, higher parental educational attainment was associated with a lower number of CMCs. Race and ethnicity, however, showed significant interactions with parental educational attainment on a number of CMCs as well as 2+ CMCs, suggesting that the effect of parenting educational attainment on CMCs is significantly smaller for Black and Hispanic than White youth. Conclusions: In the United States, race and ethnicity alter the health gains that are expected to follow parental educational attainment. While White youth who are from highly educated families are most healthy, Black and Hispanic youth from highly educated families remain at higher risk for CMCs. That means, while the most socially privileged group, Whites, gain the most health from their parental education, Blacks and Hispanics, the least privileged groups, gain the least. The result is a disproportionately high number of CMCs in middle-class Blacks and Hispanics. Economic, social, public, and health policy makers should be aware that health disparities are not all due to lower SES of the disadvantaged group but also diminished returns of SES resources for them. Youth physical health disparities due to race and ethnicity exist across all SES levels.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra Caldwell
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
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