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Sheikhattari P, Barsha RAA, Apata J, Assari S. Race by Education Intersectional Differences in Exposure to Tobacco Advertisement in Baltimore City. JOURNAL OF LUNG HEALTH AND DISEASES 2023; 7:9-17. [PMID: 38264144 PMCID: PMC10805540 DOI: 10.29245/2689-999x/2023/2.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Objective This study aimed to examine the intersectional effects of race and educational attainment on tobacco advertising exposure among adults in Baltimore, given the growing evidence on differential influence of education for Black and White populations. Methods A survey was conducted in Baltimore, collecting data on educational attainment, demographics, and tobacco advertising exposure among adults (n = 3028, 22.7% 18 - 29, 17.9% 30 - 39, 23.4% 40 - 49, 20.9% 50-59, and 11.1% 60+ years old). The sample included both Black and White adult individuals. Logistic regression analyses were employed to assess the association between educational attainment and tobacco advertising exposure, without and with interaction with race, adjusting for relevant covariates such as age, gender, and employment. Sensitivity analysis also controlled for smoking status. Results The study results indicated that while high educational attainment is associated with less exposure to tobacco ads, highly educated Black adults report significantly higher tobacco advertising exposure compared to highly educated White adults. Same results were observed after controlling for smoking status. Conclusion Educational attainment may not exhibit a large protective effect against environmental risks such as tobacco ad exposure for Black populations, possibly because of segregation and racism that hinder highly educated Black people ability to move to low-risk neighborhoods.
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Affiliation(s)
- Payam Sheikhattari
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Rifath Ara Alam Barsha
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
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Lee J, Sol K, Zaheed A, Morris E, Meister L, Palms J, Zahodne L. Coping Styles and Cognitive Function in Older Non-Hispanic Black and White Adults. J Gerontol B Psychol Sci Soc Sci 2023; 78:789-798. [PMID: 36630289 PMCID: PMC10174202 DOI: 10.1093/geronb/gbad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Coping styles refer to cognitive and behavioral patterns used to manage the demands of stressors, and effective coping represents a psychological resource. Some studies have linked coping styles to executive functioning, but less is known about coping styles and their associations with cognition across social groups known to differ in stress exposure and dementia risk. This study aimed to characterize associations between coping styles and cognitive functioning across non-Hispanic Black and non-Hispanic White older adults. METHODS Participants were drawn from the Michigan Cognitive Aging Project (N = 453; age mean (SD) = 63.6 (3.2); 53% non-Hispanic Black). Problem-focused and emotion-focused coping were measured using the Coping Orientation to Problems Experienced Inventory. Global cognition was a composite of 5 cognitive domain scores derived from comprehensive neuropsychological tests. Cross-sectional associations between coping styles and cognition were examined using race-stratified regressions controlling for demographic and health covariates. RESULTS Black older adults reported more emotion-focused coping than White older adults, but there were no race differences in problem-focused coping. Among Black older adults, less problem-focused coping and more emotion-focused coping were each associated with worse cognition. Among White older adults, emotion-focused coping was marginally linked to cognition. DISCUSSION Greater emotion-focused coping among Black older adults may reflect greater exposure to stressors that are uncontrollable. Patterns of racial differences in coping-cognition links are in line with the social vulnerabilities hypothesis. Coping style may be a particularly important psychosocial resource for cognitive health among Black older adults that could be incorporated into culturally relevant interventions.
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Affiliation(s)
- Ji Hyun Lee
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ketlyne Sol
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsey M Meister
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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Maglalang DD, Lyerly R, Scout N, Avila JC, Ahluwalia JS. Correlates of smoking during COVID-19 in the LGBTQI + cancer survivor population. J Cancer Surviv 2023:10.1007/s11764-023-01375-4. [PMID: 37012576 PMCID: PMC10069945 DOI: 10.1007/s11764-023-01375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Stressors brought on by the pandemic may have further encouraged lesbian, gay, bisexual, transgender, queer, and intersex plus (LGBTQI +) cancer survivors to smoke. The purpose of this study is to examine factors associated with smoking among LGBTQI + cancer survivors during the pandemic. METHODS We used a secondary data analysis of OUT: The National Cancer Survey. We conducted logistic regression analysis to examine the associations between psychological distress, binge drinking, and socio-demographic factors with ever use and current use of cigarettes, other tobacco, and nicotine products. RESULTS Of the 1629 participants in our sample, 53% used in their lifetime and 13% reported current use. Correlates of increased ever use included being of older age (AOR = 1.02; 95% CI: 1.01, 1.03) and binge drinking (AOR = 2.47; 95% CI: 1.17, 5.20) while correlates of decreased ever use were among those with a graduate or professional degree (AOR = 0.40; 95% CI: 0.23, 0.71). Correlates of increased current use included being of Latine descent (AOR = 1.89; 95% CI: 1.07, 3.36), binge drinking (AOR = 3.18; 95% CI: 1.56, 6.48), without health insurance (AOR = 2.37; 95% CI: 1.10, 5.10), and being disabled (AOR = 1.64; 95% CI: 1.19, 2.26) while correlates of decreased current use were among cisgender women (AOR = 0.30; 95% CI: 0.12, 0.77), being of younger age (AOR = 0.98; 95% CI: 0.96, 0.99), and having a graduate or professional degree (AOR = 0.33; 95% CI: 0.15, 0.70). CONCLUSIONS Our findings demonstrate that a proportion of LGBTQI + cancer survivors continue to smoke during the pandemic despite the increased risk involved with smoking. Furthermore, individuals with intersecting marginalized identities experience additional stressors that may have been further exacerbated by the conditions of the pandemic that encourage them to smoke. IMPLICATIONS FOR CANCER SURVIVORS Quitting smoking after a cancer diagnosis can decrease the chances of recurrence and a new primary malignancy. In addition, practitioners and researchers should advocate towards examining and addressing systemic forms of oppression in institutions that LGBTQI + cancer survivors navigate during the pandemic.
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Affiliation(s)
- Dale Dagar Maglalang
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 S. Main Street, Box G-S121, Providence, RI, 02912, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Reece Lyerly
- National LGBT Cancer Network, Providence, RI, USA
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nfn Scout
- National LGBT Cancer Network, Providence, RI, USA
| | - Jaqueline C Avila
- Department of Gerentology, University of Massachusetts, Boston, MA, USA
| | - Jasjit S Ahluwalia
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 S. Main Street, Box G-S121, Providence, RI, 02912, USA
- Department of Medicine, Alpert Medical School, Brown University, Providence, RI, USA
- Legoretta Cancer Center, Brown University, Providence, RI, USA
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Siddiq H, Darvishi M, Najand B. Self-Rated Health of US Older Adults in the General Social Survey (GSS) 1972-2021: Complexity of the Associations of Education and Immigration. Healthcare (Basel) 2023; 11:463. [PMID: 36832997 PMCID: PMC9956057 DOI: 10.3390/healthcare11040463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals. AIM Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association. METHODS This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972-2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis. RESULTS We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals. CONCLUSIONS This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants.
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Affiliation(s)
- Hafifa Siddiq
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mona Darvishi
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
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Adinkrah E, Najand B, Young-Brinn A. Parental Education and Adolescents' Asthma: The Role of Ethnicity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020267. [PMID: 36832395 PMCID: PMC9955909 DOI: 10.3390/children10020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
While high parental education is associated with better health, this association may be weaker for ethnic minority than for ethnic majority families. It is unknown whether the association between parental education and adolescents' asthma also varies by ethnicity. AIM To study the association between parental education and adolescents' asthma overall and by ethnicity. METHODS The current study used data from the Population Assessment of Tobacco and Health (PATH)-Adolescents study. All participants were 12 to 17-year-old non-smokers (n = 8652). The outcome of interest was adolescents' asthma. The predictor of interest was baseline parental education, the covariates were age, sex, and number of parents present at baseline, and the moderator was ethnicity. RESULTS According to logistic regression analyses, higher parental education was predictive of adolescents' asthma; however, this association was weaker for Latino than non-Latino adolescents (OR 1.771; CI 1.282-2.446). We did not find a significant difference in the effect of parental education on asthma of White and African American adolescents. Our stratified models also showed that higher parental education was associated with lower asthma for non-Latino but not for Latino adolescents. CONCLUSION The effect of high parental education on adolescents' asthma prevalence differs between Latino and non-Latino families, with Latino families showing weaker protective effects of parental education on adolescents' asthma. Future research should test the role of exposure to environmental pollutants, neighborhood quality, and prevalence of smoking in social network members as well as other contextual factors at home, in school, and in the neighborhood that may increase prevalence of asthma in Latino adolescents regardless of their parental education. Given that these potential causes are multi-level, potential causes of such disparities should be tested in future multi-level research.
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Affiliation(s)
- Edward Adinkrah
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA
- Correspondence:
| | - Babak Najand
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Angela Young-Brinn
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA
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Adinkrah E, Najand B, Young-Brinn A. Race and Ethnic Differences in the Protective Effect of Parental Educational Attainment on Subsequent Perceived Tobacco Norms among US Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2517. [PMID: 36767881 PMCID: PMC9916299 DOI: 10.3390/ijerph20032517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/10/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Although parental educational attainment is known to be associated with a lower prevalence of behaviors such as tobacco use, these effects are shown to be weaker for Black than White youth. It is important to study whether this difference is due to higher perceived tobacco use norms for Black youth. AIM To study the association between parental educational attainment and perceived tobacco use norms overall and by race/ethnicity among youth in the US. METHODS The current study used four years of follow-up data from the Population Assessment of Tobacco and Health (PATH-Youth) study conducted between 2013 and 2017. All participants were 12- to 17-year-old non-smokers at baseline and were successfully followed for four years (n = 4329). The outcome of interest was perceived tobacco use norms risk at year four. The predictor of interest was baseline parental educational attainment, the moderator was race/ethnicity, and the covariates were age, sex, and parental marital status at baseline. RESULTS Our linear regressions in the pooled sample showed that higher parental educational attainment at baseline was predictive of perceived disapproval of tobacco use at year four; however, this association was weaker for Latino than non-Latino youth. Our stratified models also showed that higher parental educational attainment was associated with perceived tobacco use norms for non-Latino but not for Latino youth. CONCLUSION The effect of high parental educational attainment on anti-tobacco norms differs between Latino and non-Latino youth. Latino youth with highly educated parents remain at risk of tobacco use, while non-Latino youth with highly educated parents show low susceptibility to tobacco use.
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Affiliation(s)
- Edward Adinkrah
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Angela Young-Brinn
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
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Connolly SD, Lloyd‐Jones DM, Ning H, Marino BS, Pool LR, Perak AM. Social Determinants of Cardiovascular Health in US Adolescents: National Health and Nutrition Examination Surveys 1999 to 2014. J Am Heart Assoc 2022; 11:e026797. [PMID: 36370007 PMCID: PMC9750083 DOI: 10.1161/jaha.122.026797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
Background Cardiovascular health (CVH) is suboptimal in US adolescents. Social determinants of health (SDOH) may affect CVH. We examined SDOH by race and ethnicity and assessed for associations between SDOH and CVH among US adolescents. Methods and Results We analyzed data from the National Health and Nutrition Examination Survey for 3590 participants aged 12 to 19 years from 1999 to 2014. SDOH variables were chosen and an SDOH score assigned (range, 0-7 points; higher=more favorable). CVH was classified according to American Heart Association criteria. We estimated population prevalence and used multivariable linear and polytomous logistic regression for associations between SDOH and CVH. SDOH varied by group, with the non-Hispanic White group (n=1155) having a higher/better mean SDOH score compared with non-Hispanic Black (n=1223) and Mexican American groups (n=1212). Associations between SDOH and CVH differed between racial and ethnic groups (interaction P<0.0001). For the non-Hispanic White group, each additional favorable SDOH variable was associated with a CVH score higher/better by 0.3 points (β, 0.3, P<0.0001), 20% higher odds for moderate (versus low) CVH (odds ratio [OR], 1.2 [95% CI, 1.1-1.4]), and 80% higher odds for high/favorable (versus low) CVH (1.8 [1.5-2.1]). Associations between SDOH and CVH were more modest among the Mexican American group (β, 0.12, P=0.001; OR 1.1 [1.0-1.2] for moderate CVH; OR, 1.3 [1.1-1.6] for high CVH) and were not significant among the non-Hispanic Black group (β, 0.07; P=0.464). Conclusions SDOH and CVH were more favorable for non-Hispanic White adolescents compared with non-Hispanic Black and Mexican American adolescents. SDOH were strongly associated with CVH among the non-Hispanic White group. Racially and culturally sensitive public policy approaches may improve CVH in US adolescents.
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Affiliation(s)
- Sean D. Connolly
- Department of CardiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoIL
- Department of CardiologyNemours Children’s HealthWilmingtonDE
| | - Donald M. Lloyd‐Jones
- Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Hongyan Ning
- Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Bradley S. Marino
- Department of CardiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoIL
- Present address:
Department of Pediatric CardiologyCleveland Children’s ClinicClevelandOH
| | - Lindsay R. Pool
- Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Amanda M. Perak
- Department of CardiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoIL
- Present address:
Department of Pediatric CardiologyCleveland Children’s ClinicClevelandOH
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Assari S, Boyce S. Family's Subjective Economic Status and Children's Matrix Reasoning: Blacks' Diminished Returns. RESEARCH IN HEALTH SCIENCE 2021; 6:1-23. [PMID: 33299959 DOI: 10.22158/rhs.v6n1p1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Due to a pattern known as Marginalization-related Diminished Returns (MDRs), historically oppressed non-Hispanic Black Americans show weaker effects of economic status on health and development, when compared to socially privileged non-Hispanic White Americans. Such MDRs are also documented for the effects of economic status on the school performance of non-Hispanic Black children. However, the existing knowledge is minimal on similar diminished returns on children's intelligence. AIM To compare racial and ethnic groups for the effect of subjective economic status on children's cognitive performance, we compared non-Hispanic White and non-Hispanic Black children for the effects of subjective economic status on children's matrix reasoning. METHODS This cross-sectional study included 7898 children from the Adolescent Brain Cognitive Development (ABCD) study. The predictor variable was subjective economic status, which was treated as a continuous measure. The primary outcome was children's matrix reasoning, a domain of cognitive performance, measured by the Wechsler Intelligence Scales for Children-IV (WISC-V) matrix reasoning total score. RESULTS Overall, high subjective economic status was associated with higher matrix reasoning score. Race showed a statistically significant interaction with subjective economic status on children's matrix reasoning score. This interaction suggested that high subjective economic status has a smaller boosting effect on increasing matrix reasoning score for non-Hispanic Black children relative to non-Hispanic White children. CONCLUSION The degree by which subjective economic status correlates with matrix reasoning score, an important domain of cognitive performance, depends on race and racialization. Non-Hispanic Black children may show weaker gains in matrix reasoning from their subjective economic status than their non-Hispanic White counterparts. To minimize the racial gap in cognitive performance, we need to address diminished returns that occur as a result of the racialization of racial and ethnic minority children. Not only should we equalize economic status, but also increase the marginal returns of economic status for racial minorities, particularly non-Hispanic Black families. Such efforts require public policies that go beyond access and also consider how we can empower non-Hispanic Black communities and families so they can more effectively leverage and utilize their economic resources to secure measurable and tangible outcomes. Structural and societal barriers such as residential and school segregation may hinder non-Hispanic Black children from receiving the full effects of their family-level economic status on a variety of outcomes, including their cognitive performance.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Assari S, Boyce S, Bazargan M, Thomas A, Cobb RJ, Hudson D, Curry TJ, Nicholson HL, Cuevas AG, Mistry R, Chavous TM, Caldwell CH, Zimmerman MA. Parental Educational Attainment, the Superior Temporal Cortical Surface Area, and Reading Ability among American Children: A Test of Marginalization-Related Diminished Returns. CHILDREN-BASEL 2021; 8:children8050412. [PMID: 34070118 PMCID: PMC8158386 DOI: 10.3390/children8050412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent studies have shown that parental educational attainment is associated with a larger superior temporal cortical surface area associated with higher reading ability in children. Simultaneously, the marginalization-related diminished returns (MDRs) framework suggests that, due to structural racism and social stratification, returns of parental education are smaller for black and other racial/ethnic minority children compared to their white counterparts. PURPOSE This study used a large national sample of 9-10-year-old American children to investigate associations between parental educational attainment, the right and left superior temporal cortical surface area, and reading ability across diverse racial/ethnic groups. METHODS This was a cross-sectional analysis that included 10,817 9-10-year-old children from the Adolescent Brain Cognitive Development (ABCD) study. Parental educational attainment was treated as a five-level categorical variable. Children's right and left superior temporal cortical surface area and reading ability were continuous variables. Race/ethnicity was the moderator. To adjust for the nested nature of the ABCD data, mixed-effects regression models were used to test the associations between parental education, superior temporal cortical surface area, and reading ability overall and by race/ethnicity. RESULTS Overall, high parental educational attainment was associated with greater superior temporal cortical surface area and reading ability in children. In the pooled sample, we found statistically significant interactions between race/ethnicity and parental educational attainment on children's right and left superior temporal cortical surface area, suggesting that high parental educational attainment has a smaller boosting effect on children's superior temporal cortical surface area for black than white children. We also found a significant interaction between race and the left superior temporal surface area on reading ability, indicating weaker associations for Alaskan Natives, Native Hawaiians, and Pacific Islanders (AIAN/NHPI) than white children. We also found interactions between race and parental educational attainment on reading ability, indicating more potent effects for black children than white children. CONCLUSION While parental educational attainment may improve children's superior temporal cortical surface area, promoting reading ability, this effect may be unequal across racial/ethnic groups. To minimize the racial/ethnic gap in children's brain development and school achievement, we need to address societal barriers that diminish parental educational attainment's marginal returns for middle-class minority families. Social and public policies need to go beyond equal access and address structural and societal barriers that hinder middle-class families of color and their children. Future research should test how racism, social stratification, segregation, and discrimination, which shape the daily lives of non-white individuals, take a toll on children's brains and academic development.
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Affiliation(s)
- Shervin Assari
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Correspondence:
| | - Shanika Boyce
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- 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
| | - Alvin Thomas
- Human Development and Family Studies Department, School of Human Ecology, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Ryon J. Cobb
- Department of Sociology, University of Georgia, Athens, GA 30602, USA;
| | - Darrell Hudson
- Brown School, Washington University, St. Louis, MO 63130, USA;
| | - Tommy J. Curry
- Department of Philosophy, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh EH8 9JS, UK;
| | - Harvey L. Nicholson
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL 32611-7330, USA;
| | - Adolfo G. Cuevas
- Psychosocial Determinants of Health (PSDH) Lab, Tufts University, Boston, MA 02155, USA;
- Department of Community Health, Tufts University, Boston, MA 02155, USA
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
| | - Tabbye M. Chavous
- School of Education, University of Michigan, Ann Arbor, MI 48109-2029, USA;
- National Center for Institutional Diversity, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
- Prevention Research Center, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
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Assari S. Parental Education and Children’s Sleep Problems: Minorities’ Diminished Returns. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2021. [DOI: 10.34172/ijer.2021.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups such as Blacks and Latinos than non-Latino Whites, which is due to racism and social stratification. In this study, we investigated the association between parental education and children’s sleep problems, as a proxy of sleep problems, by race. Methods: This cross-sectional study included 11718 American children aged 9-10. All participants were recruited to the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education, a five-level nominal variable. The dependent variable – sleep problems, was a continuous variable. Race/ethnicity was the effect modifier. Age, sex, and marital status were the covariates. Mixed-effects regression models were used for data analysis. Results: Parental education was associated with children’s sleep problems. However, there was a weaker inverse association seen in non-Latino Black and Latino families compared to non-Latino White families. This was documented by a significant statistical interaction between race and ethnicity and parental education on children’s sleep problems. Conclusion: Diminished protective effect of parental education on children’s sleep problems for non-Latino Black and Latino families compared to non-Latino White families is similar to the MDRs in other domains. Worse than expected sleep may contribute to higher-than-expected health risks of middle-class Black and Latino children.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
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Assari S, Boyce S. Resting-State Functional Connectivity between Putamen and Salience Network and Childhood Body Mass Index. Neurol Int 2021; 13:85-101. [PMID: 33806587 PMCID: PMC8006001 DOI: 10.3390/neurolint13010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: Although the putamen has a significant role in reward-seeking and motivated behaviors, including eating and food-seeking, minorities’ diminished returns (MDRs) suggest that individual-level risk and protective factors have weaker effects for Non-Hispanic Black than Non-Hispanic White individuals. However, limited research is available on the relevance of MDRs in terms of the role of putamen functional connectivity on body mass index (BMI). Purpose: Building on the MDRs framework and conceptualizing race and socioeconomic status (SES) indicators as social constructs, we explored racial and SES differences in the associations between putamen functional connectivity to the salience network and children’s BMI. Methods: For this cross-sectional study, we used functional magnetic resonance imaging (fMRI) data of 6473 9–10-year-old Non-Hispanic Black and Non-Hispanic White children from the Adolescent Brain Cognitive Development (ABCD) study. The primary independent variable was putamen functional connectivity to the salience network, measured by fMRI. The primary outcome was the children’s BMI. Age, sex, neighborhood income, and family structure were the covariates. Race, family structure, parental education, and household income were potential moderators. For data analysis, we used mixed-effect models in the overall sample and by race. Results: Higher right putamen functional connectivity to the salience network was associated with higher BMI in Non-Hispanic White children. The same association was missing for Non-Hispanic Black children. While there was no overall association in the pooled sample, a significant interaction was found, suggesting that the association between right putamen functional connectivity to the salience network and children’s BMI was modified by race. Compared to Non-Hispanic White children, Non-Hispanic Black children showed a weaker association between right putamen functional connectivity to the salience network and BMI. While parental education and household income did not moderate our association of interest, marital status altered the associations between putamen functional connectivity to the salience network and children’s BMI. These patterns were observed for right but not left putamen. Other/Mixed Race children also showed a pattern similar to Non-Hispanic Black children. Conclusions: The association between right putamen functional connectivity to the salience network and children’s BMI may depend on race and marital status but not parental education and household income. While right putamen functional connectivity to the salience network is associated with Non-Hispanic White children’s BMI, Non-Hispanic Black children’ BMI remains high regardless of their putamen functional connectivity to the salience network. This finding is in line with MDRs, which attributes diminished effects of individual-risk and protective factors for Non-Hispanic Black children to racism, stratification, and segregation.
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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
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Correspondence:
| | - Shanika Boyce
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
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Cardarelli K, Westneat S, Dunfee M, May B, Schoenberg N, Browning S. Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project. BMC Public Health 2021; 21:270. [PMID: 33530976 PMCID: PMC7856720 DOI: 10.1186/s12889-021-10334-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/25/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior. METHODS A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015-2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed. RESULTS MAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51-2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking. CONCLUSIONS Despite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use.
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Affiliation(s)
- Kathryn Cardarelli
- College of Public Health, University of Kentucky, Lexington, KY, USA.
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA.
| | - Susan Westneat
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Madeline Dunfee
- College of Public Health, University of Kentucky, Lexington, KY, USA
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Beverly May
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Nancy Schoenberg
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Steven Browning
- College of Public Health, University of Kentucky, Lexington, KY, USA
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
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Assari S, Malek-Ahmadi MR, Caldwell CH. Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children? ACTA ACUST UNITED AC 2020; 7:19-37. [PMID: 34307868 DOI: 10.22158/jepf.v7n1p19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim We compared the effects of parental education and household income on children's body mass index (BMI) in Hispanic White (HW) and non-Hispanic White (NHW) families. Methods In this cross-sectional study, we borrowed data from the Adolescent Brain Cognitive Development (ABCD) study and analyzed data of 5100 children between the ages of 9 and 10. The independent variables were parental education and household income. The primary outcome was BMI value. Ethnicity was the moderating variable. Confounders were age, sex, and family structure. Three mixed-effects regression models were used for data analysis. Results Overall, higher parental education and household income were associated with lower BMI levels in children. While an interaction was found between ethnicity and parental education, no interaction was noted between ethnicity and household income regarding BMI. The interaction indicated weaker protective effects of high parental education on BMI in HW children than NHW children. Household income showed similar protective effects on children's BMI in HW and NHW families. Conclusion Parental education but not household income loses some of its protective effects on childhood BMI among HW families compared to NHW families. Distal social determinants of health may be more vulnerable to the MDRs (minorities' diminished returns) than proximal ones. As a result, closing the income gap may be a good strategy towards closing the childhood BMI gap between highly educated HW and NHW families. Policies that raise the minimum wage and those that help HW families save money (e.g., earned income tax policies) maybe more promising strategies to eliminate the ethnic gap in BMI than increasing the education level of ethnic minority families.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Cleopatra H Caldwell
- Department of Health Behaviors and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Parental Education, Household Income, and Cortical Surface Area among 9-10 Years Old Children: Minorities' Diminished Returns. Brain Sci 2020; 10:brainsci10120956. [PMID: 33317053 PMCID: PMC7763341 DOI: 10.3390/brainsci10120956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Although the effects of parental education and household income on children's brain development are well established, less is known about possible variation in these effects across diverse racial and ethnic groups. According to the Minorities' Diminished Returns (MDRs) phenomenon, due to structural racism, social stratification, and residential segregation, parental educational attainment and household income show weaker effects for non-White than White children. Purpose: Built on the MDRs framework and conceptualizing race as a social rather than a biological factor, this study explored racial and ethnic variation in the magnitude of the effects of parental education and household income on children's whole-brain cortical surface area. Methods: For this cross-sectional study, we used baseline socioeconomic and structural magnetic resonance imaging (sMRI) data of the Adolescent Brain Cognitive Development (ABCD) study. Our analytical sample was 10,262 American children between ages 9 and 10. The independent variables were parental education and household income. The primary outcome was the children's whole-brain cortical surface area. Age, sex, and family marital status were covariates. Race and ethnicity were the moderators. We used mixed-effects regression models for data analysis as participants were nested within families and study sites. Results: High parental education and household income were associated with larger children's whole-brain cortical surface area. The effects of high parental education and high household income on children's whole-brain cortical surface area were modified by race. Compared to White children, Black children showed a diminished return of high parental education on the whole-brain cortical surface area when compared to White children. Asian American children showed weaker effects of household income on the whole-brain cortical surface area when compared to White children. We could not find differential associations between parental education and household income with the whole-brain cortical surface area, when compared to White children, for non-Hispanic and Hispanic children. Conclusions: The effects of parental educational attainment and household income on children's whole-brain cortical surface area are weaker in non-White than White families. Although parental education and income contribute to children's brain development, these effects are unequal across racial groups.
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Assari S. Household Income and Children's Depressive Symptoms: Immigrants' Diminished Returns. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 8:157-164. [PMID: 34036110 DOI: 10.34172/ijtmgh.2020.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction Relative to socially privileged groups, socially marginalized people experience weaker health effects of household income and other economic resources, a pattern known as Minorities' Diminished Returns (MDRs). These MDRs are frequently seen in racial and ethnic minorities, but less is known about the relevance of such MDRs in immigrant families. To investigate the MDRs of household income on children's depression as a function of immigration, we compared non-immigrant and immigrant children for the effect of household income on children's depressive symptoms. Methods This cross-sectional study was conducted across multiple cities in the United States. Baseline data from the Adolescent Brain Cognitive Development (ABCD) study collected in 2018 was used. A total of 6,412 children between the ages of 9-10-year-old were included. The predictor variable was household income. The primary outcome was children's depression measured by the Child Behavior Checklist (CBCL). Race, ethnicity, age, sex, parental marital status, parental employment, and financial difficulties were the covariates. Immigration status was the effect modifier. Results Overall, high household income was associated with lower children's depressive symptoms. Immigration status showed a statistically significant interaction with household income on children's depression. This interaction term suggested that high household income has a smaller protective effect against depression for immigrant children than non-immigrant children. Conclusion The protective effect of household income against children's depression is diminished for immigrant than non-immigrant children.
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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.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
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Assari S. Mental Rotation in American Children: Diminished Returns of Parental Education in Black Families. Pediatr Rep 2020; 12:130-141. [PMID: 33233814 PMCID: PMC7717656 DOI: 10.3390/pediatric12030028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 01/07/2023] Open
Abstract
Background: While parental education and family socioeconomic status (SES) are associated with an increase in children's cognitive functioning, and less is known about racial variation in these effects. Minorities' Diminished Returns (MDRs) suggest that, under racism and social stratification, family SES and particularly parental education show weaker effects on children's tangible outcomes for marginalized, racialized, and minoritized families, particularly Blacks, compared to Whites. Aim: We conducted this study to compare the effect of parental education on children's mental rotation abilities, as an important aspect of cognitive function, by race. Methods: This cross-sectional study included 11,135 9-10-year-old American children. Data came from baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education. The dependent variable, mental rotation, was measured by the Little Man Task. Ethnicity, gender, age, marital status, and household income were the covariates. Results: Parental education was positively associated with mental rotation. However, parental education showed a weaker association with mental rotation in Black than in White families. This was documented by a significant interaction between race and parental education on children's efficiency score. Conclusion: Parental education shows a weaker correlation with mental rotation of Black rather than White children, which is probably because of racism, social stratification, and discrimination. This finding is in line with the MDRs phenomenon and suggests that marginalization and racism may interfere with the influences of parental assets and resources and Black American children's development.
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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; ; Tel.: +1-734-232-0445; Fax: +1-734-615-8739
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
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Assari S, Akhlaghipour G. Not Race or Age but Their Interaction Predicts Pre-Adolescents' Inhibitory Control. ACTA ACUST UNITED AC 2020; 3:50-71. [PMID: 33283174 DOI: 10.22158/ct.v3n2p50] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background African American pre-adolescents are at a higher risk of risky behaviors such as aggression, drug use, alcohol use, and subsequent poor outcomes compared to Caucasian pre-adolescents. All these high-risk behaviors are connected to low levels of inhibitory control (IC). Aim We used the Adolescent Brain Cognitive Development (ABCD) data to compare Caucasian and African American pre-adolescents for the effect of age on pre-adolescents IC, a driver of high-risk behaviors. Methods This cross-sectional analysis included 4,626 pre-adolescents between ages 9 and 10 from the ABCD study. Regression was used to analyze the data. The predictor variable was age measured in months. The main outcome was IC measured by a stop-signal task (SST). Race was the effect modifier. Results Overall, age was associated with IC. Race also showed a statistically significant interaction with age on pre-adolescents' IC, indicating weaker effects of age on IC for African American than Caucasian pre-adolescents. Conclusion Age-related changes in IC are more pronounced for Caucasian than African American pre-adolescents. To eliminate the racial gap in brain development between African American and Caucasian pre-adolescents, we should address structural and societal barriers that alter age-related development for racial minority pre-adolescents. Social and public policies, rather than health policies, are needed to address structural and societal barriers that hinder African American adolescents' brain development. Interventions should add resources to the urban areas that many African American families live in so their children can have better age-related brain development. Such changes would be essential given IC in pre-adolescents is a predictor of a wide range of behaviors.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA.,Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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Abstract
While increased household income is associated with overall decreased screen time for children, less is known about the effect of racial variation on this association. According to Minorities' Diminished Returns (MDRs) theory, family income and other economic resources show weaker association with children's developmental, behavioral, and health outcomes for racialized groups such as black families, due to the effect of racism and social stratification. In this study, we investigated the association, by race, between family income and children's screen time, as a proxy of screen time. This longitudinal study followed 15,022 American children aged 9-11 over a 1-year period. The data came from the baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was family income, and it was categorized as a three-level nominal variable. The dependent variable, screen time, was a continuous variable. Ethnicity, gender, parental education, and marital status were the covariates. The results showed that family income was inversely associated with children's screen time. However, there was a weaker inverse association seen in black families when compared with white families. This was documented by a significant statistical interaction between race and family income on children's screen time. Diminished association between family income and children's screen time for black families, compared with white families, is similar to MDRs and reflects a health risk to high-income black children. In a society where race and skin color determine opportunities and treatment by society, children from middle class black families remain at risk across multiple domains. We should not assume that income similarly promotes the health of all racial and ethnic groups. Addressing health and behavioral inequalities requires interventions that go beyond equalizing socioeconomic resources for black families. Marginalization, racism, and poverty interfere with the normal family income-related development of American children.
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Assari S. Youth Social, Emotional, and Behavioral Problems in the ABCD Study: Minorities' Diminished Returns of Family Income. JOURNAL OF ECONOMICS AND PUBLIC FINANCE 2020; 6:1-19. [PMID: 33123624 DOI: 10.22158/jepf.v6n4p1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND To investigate ethnic differences in the protective effects of family income against youth social, emotional, and behavioral problems in the US. As proposed by the Marginalization-related Diminished Returns (MDRs), family income may generate fewer tangible outcomes for ethnic minority compared to NHW families. Our existing knowledge is minimal about diminished returns of family income on parental reports of youth social, emotional, and behavioral outcomes. AIM To compare ethnic groups for the effects of family income on parental reports of youth social, emotional, and behavioral problems. MATERIALS AND METHODS In this cross-sectional study, data from wave 1 of the Adolescent Brain Cognitive Development (ABCD) study were included. The ABCD, an ongoing national cohort of American youth brain development, included 10,762 American youth between ages 8 and 11 years old. The independent variable was family income. The primary 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 outcomes were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL). RESULTS Overall, high family income was associated with lower levels of parental reports of youth social, emotional, and behavioral problems across all domains (p <0.05 for all beta coefficients across multivariable regression models). Ethnicity showed statistically significant interactions with family income on youth fewer social, emotional, and behavioral problems (all domains), net of all confounders (p <0.05 for all beta coefficients that reflected interaction terms across multivariable regression models), indicating smaller tangible gains from their family income for NHB and HW compared to NHW youth. CONCLUSION The protective effects of family income against behavioral problems are systematically diminished for HW and NHB youth compared to NHW youth. To minimize the ethnic gap in youth social, behavioral, and emotional problems, diminished returns of family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder HW and NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB and HW families. Thus, SES can similarly secure tangible outcomes in the presence of SES resources.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
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Nguyen-Grozavu FT, Pierce JP, Sakuma KLK, Leas EC, McMenamin SB, Kealey S, Benmarhnia T, Emery SL, White MM, Fagan P, Trinidad DR. Widening disparities in cigarette smoking by race/ethnicity across education level in the United States. Prev Med 2020; 139:106220. [PMID: 32693179 PMCID: PMC7494609 DOI: 10.1016/j.ypmed.2020.106220] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 01/07/2023]
Abstract
Reducing tobacco use is an important public health objective. It is the largest preventable cause of death and disease, yet inequalities remain. This study examines combined educational and racial/ethnic disparities in the United States related to cigarette smoking for the three largest racial/ethnic groups (African Americans, Hispanics/Latinos, and non-Hispanic Whites). Data included nine Tobacco Use Supplements to the Current Population Surveys (TUS-CPS) conducted in the United States from 1992/1993-2018 for four smoking metrics: ever smoking rates, current smoking rates, consumption (cigarettes per day), and quit ratios. Across all TUS-CPS samples, there were 9.5% African Americans, 8.8% Hispanics/Latinos, and 81.8% non-Hispanic Whites who completed surveys. Findings revealed that lower educational attainment was associated with increased ever and current smoking prevalence over time across all racial/ethnic groups, and education-level disparities within each race/ethnicity widened over time. Disparities in ever and current smoking rates between the lowest and highest categories of educational attainment (less than a high school education vs. completion of college) were larger for African Americans and non-Hispanic Whites than Hispanics/Latinos. Non-Hispanic Whites had the highest cigarette consumption across all education levels over time. College graduates had the highest quit ratios for all racial/ethnic groups from 1992 to 2018, with quit ratios significantly increasing for Hispanics/Latinos and non-Hispanic Whites, but not African Americans. In conclusion, educational disparities in smoking have worsened over time, especially among African Americans and Hispanics/Latinos. Targeted tobacco control efforts could help reduce these disparities to meet public health objectives, although racial/ethnic disparities may persist regardless of educational attainment.
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Affiliation(s)
- France T Nguyen-Grozavu
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America.
| | - John P Pierce
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Kari-Lyn K Sakuma
- Oregon State University, College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Corvallis, OR, United States of America
| | - Eric C Leas
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Sara B McMenamin
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Sheila Kealey
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Tarik Benmarhnia
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Sherry L Emery
- University of Chicago, NORC, 1155 East 60th Street, 2nd Floor, Chicago, IL, United States of America
| | - Martha M White
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
| | - Pebbles Fagan
- University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Department of Health Behavior and Health Education, Little Rock, AR, United States of America
| | - Dennis R Trinidad
- University of California, San Diego, Family Medicine and Public Health, La Jolla, CA, United States of America
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Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. Parental Human Capital and Adolescents' Executive Function: Immigrants' Diminished Returns. MEDICAL RESEARCH ARCHIVES 2020; 8:10.18103/mra.v8i10.2235. [PMID: 33251336 PMCID: PMC7695233 DOI: 10.18103/mra.v8i10.2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Racial minorities, particularly non-Hispanic Blacks in the US, experience weaker effects of family socioeconomic position (SEP) on tangible outcomes, a pattern called Minorities' Diminished Returns (MDRs). These MDRs are frequently shown for the effects of family SEP on immigrant adolescents' school performance. As a result of these MDRs, immigrant adolescents from high SEP families show worse than expected cognitive outcomes, including but not limited to poor school performance. However, the existing knowledge is minimal about the role of executive function in explaining diminished returns of family SEP on adolescents' outcomes. To investigate racial differences in the effects of parental human capital on adolescents' executive function, we compared non-Hispanic White non-immigrant and immigrant adolescents for the effect of parental human capital on adolescents' executive function. This was a cross-sectional analysis that included 2,723 non-twin non-Hispanic White adolescents from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental human capital (parental educational attainment), treated as a continuous measure with a higher score reflecting higher subjective socioeconomic status. The primary outcome was adolescents' executive function measured by the stop-signal task (SST). Age, sex, parental marital status, parental employment, family income, and financial difficulties. Immigration status was the effect modifier. Overall, high parental human capital was associated with higher task-based executive function. Immigration status showed statistically significant interactions with parental human capital on adolescents' executive function outcomes. This interaction term suggested that high parental human capital has a smaller effect on increasing immigrants' executive function compared to non-immigrant adolescents. The boosting effect of parental human capital on executive function is diminished for immigrants compared to non-immigrant adolescents. To minimize the inequalities in executive function-related outcomes such as school performance, we need to address the diminishing returns of existing resources for immigrants. Not only should we equalize groups based on their SEP but also equalize the marginal returns of their existing SEP. Such efforts require public policies that aim for equal processes. As such, social policies should address structural and societal barriers such as xenophobia, segregation, racism, and discrimination that hinder immigrant families' ability to effectively utilize their resources. In a fair society, immigrant and non-immigrant families should be equally able to leverage their SEP resources and turn them into tangible outcomes.
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Affiliation(s)
- Shervin Assari
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Golnoush Akhlaghipour
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | - Cleopatra H Caldwell
- 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, Boyce S, Bazargan M, Caldwell CH. A Dream Deferred: African American Women's Diminished Socioeconomic Returns of Postponing Childbearing from Teenage to Adulthood. ACTA ACUST UNITED AC 2020; 1:62-76. [PMID: 32803191 DOI: 10.3390/reprodmed1020005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Brookings Institution has identified postponing childbirth from teenage to adulthood as a major strategy that is needed for upward social mobility of women. However, according to the Minorities' Diminished Returns (MDRs), the associations between aspirations, investments, behaviors, and socioeconomic position (SEP) may be diminished for marginalized groups such as African Americans. Objective To extend the existing knowledge on the MDRs, the current study had two aims: First to compare White and African American women for the association between postponing childbearing to adulthood and SEP in a national sample of American women. Second, to test correlates of postponing childbearing to adulthood and SEP at birth with long term outcomes 15 years later when the child was 15 years old. Methods For this longitudinal study, data came from the Fragile Families and Child Well-being Study (FFCWS), a national longitudinal prospective study in the United States (US) that followed an ethnically diverse sample of women from childbirth for 15 years from 1998 to 2016. For the first aim, this study included 2679 women composed of 723 Whites and 1956 African Americans. For the second aim, among 1842 individuals who had available data 15 years later, we measured various economic, behavioral, and mental health outcomes when the child was 15 years old. For aim 1 we ran linear regression. Postponing childbearing to adulthood was the independent variable. The dependent variable, SEP (poverty) was treated as a continuous measure with higher score indicating more poverty. Confounders included marital status and delivery characteristics. For the aim 2, we ran Pearson correlation test (exploratory analysis) to test if baseline SEP correlates with future outcomes. Results Postponing childbearing from adolescence to adulthood was associated with higher SEP in adulthood, net of all confounders including marital status and education. We found a significant interaction between postponing childbearing from adolescence to adulthood and race on SEP, suggesting that the economic reward of postponing childbearing may be weaker for African American women than for White women. Conclusions Although postponing the age at childbirth is a recommended strategy for women who wish to maximize their chance of upward social mobility, this strategy may be associated with smaller economic returns for African American women than White women. The results can also be interpreted as MDRs in investments in terms of a postponing childbearing. In a fair society, the same investment should be similarly rewarded across diverse racial groups. In the reality, however, the US society differently rewards White and African American women who postpone childbearing. Research should explore the roles of social stratification, blocked opportunities, and concentrated poverty in explaining the unequal return of such an investment for African American and White women.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles Drew University, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI 48109-2029, USA
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Assari S, Cobb S, Saqib M, Bazargan M. Economic Strain Deteriorates While Education Fails to Protect Black Older Adults Against Depressive Symptoms, Pain, Self-rated Health, Chronic Disease, and Sick Days. ACTA ACUST UNITED AC 2020; 4:49-62. [PMID: 32724902 DOI: 10.29245/2578-2959/2020/2.1203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background A large body of empirical evidence on Minorities' Diminished Returns (MDRs) suggests that educational attainment shows smaller health effects for Blacks compared to Whites. At the same time, economic strain may operate as a risk factor for a wide range of undesired mental and physical health outcomes in Black communities. Aim The current study investigated the combined effects of education and economic strain on the following five health outcomes in Black older adults in underserved areas of South Los Angeles: depressive symptoms, number of chronic diseases, pain intensity, self-rated health, and sick days. Methods This cross-sectional study included 619 Black older adults residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics, economic strain, health insurance, living arrangement, marital status, health behaviors, depressive symptoms, pain intensity, number of chronic diseases, sick days, and self-rated health were collected. Five linear regressions were used to analyze the data. Results Although high education was associated with less economic strain, it was the economic strain, not educational attainment, which was universally associated with depressive symptoms, pain intensity, self-rated health, chronic diseases, and sick days, independent of covariates. Similar patterns emerged for all health outcomes suggesting that the risk associated with economic strain and lack of health gain due to educational attainment are both robust and independent of type of health outcome. Conclusion In economically constrained urban environments, economic strain is a more salient social determinant of health of Black older adults than educational attainment. While education loses some of its protective effects, economic strain deteriorates health of Black population across domains. There is a need for bold economic and social policies that increase access of Black communities to cash at times of emergency. There is also a need to improve the education quality in the Black communities.
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Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, Charles R Drew University of Medicine and Science
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Mohammed Saqib
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Mohsen Bazargan
- Departments of Family Medicine, Charles R Drew University of Medicine and Science.,Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
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Assari S, Perez MU, Johnson N, Williams NR, Carrillo E, Garcia L, Hollis XT. Education Level and Self-rated Health in the United States: Immigrants' Diminished Returns. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 8:116-123. [PMID: 32905455 DOI: 10.34172/ijtmgh.2020.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction Although education is among the major socioeconomic status (SES) resources that influence populations' and individuals' health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. Methods With a cross-sectional design, this study employed data from the 2015 National Health Interview Survey (NHIS), a survey that had enrolled 33,654 adults who were either immigrants (n = 6225; 18.5%) or non-immigrants (n = 27 429; 81.5%). The independent variable was education level, treated as a categorical variable. The dependent variable was SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Results Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. Conclusion In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Maryver U Perez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Nay'Air Johnson
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Nikesha R Williams
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Esmeralda Carrillo
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Leslye Garcia
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Xiaxiang T Hollis
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Assari S, Boyce S, Bazargan M. Subjective Family Socioeconomic Status and Adolescents' Attention: Blacks' Diminished Returns. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7080080. [PMID: 32718077 PMCID: PMC7464278 DOI: 10.3390/children7080080] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/26/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023]
Abstract
Background: Racial minorities, particularly non-Hispanic blacks (NHBs) in the US, experience weaker effects from their families' socioeconomic status on tangible outcomes, a pattern called the Minorities' Diminished Returns (MDRs) theory. These MDRs are frequently shown in the effects of the families' socioeconomic status (SES) on NHB adolescents' school performance. As a result of these MDRs, NHB adolescents from high SES families show a worse than expected school performance. The existing knowledge is, however, minimal about the role of attention in explaining the diminished returns of the families' SES with regard to the adolescents' outcomes. Aim: To investigate the racial differences in the effects of the subjective family SES on adolescents' attention, we compared non-Hispanic white (NHW) and NHB adolescents to assess the effect of the subjective family SES on adolescents' attention. Methods: This was a cross-sectional analysis that included 4188 adolescents from the Adolescent Brain Cognitive Development (ABCD) Study. The independent variable was the subjective family SES. The primary outcome was the adolescents' attention to be measured by the stop-signal task (SST). The attention domain of the Child Behavior Checklist (CBCL) was also measured. Results: Overall, a high subjective family SES was associated with a higher task-based and CBCL-based attention. Race showed statistically significant interactions with subjective family SES in terms of adolescents' attention outcomes. These interactions suggested that a high subjective family SES has smaller tangible effects on increasing the attention of NHB than NHW adolescents. Conclusion: The boosting effect of subjective family SES on attention is diminished for NHB rather than NHW adolescents. To minimize the racial gap in attention-related behaviors, such as school performance, we need to address the diminished returns of resources in the lives of NHB families. Not only should we equalize SES, but also increase the marginal returns of SES for racial minorities, particularly NHB families. Such efforts require public policies that empower NHB families to better leverage their SES resources and turn them into tangible outcomes. In addition, social policies should directly aim to alter the societal barriers that limit NHB families' ability to effectively utilize their resources. Discrimination, segregation, and racism should be targets of our policy solutions.
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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, CA 90095, USA
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Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. African American Children's Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E75. [PMID: 32660094 PMCID: PMC7401867 DOI: 10.3390/children7070075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
Background: Reward sensitivity (fun-seeking) is a risk factor for a wide range of high-risk behaviors. While high socioeconomic status (SES) is known to reduce reward sensitivity and associated high-risk behaviors, less is known about the differential effects of SES on reward sensitivity. It is plausible to expect weaker protective effects of family SES on reward sensitivity in racial minorities, a pattern called Minorities' Diminished Returns (MDRs). Aim: We compared Caucasian and African American (AA) children for the effects of subjective family SES on children's fun-seeking. Methods: This was a cross-sectional analysis of 7061 children from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was subjective family SES. The main outcome was children's fun-seeking measured by the behavioral approach system (BAS) and behavioral avoidance system (BIS). Age, gender, marital status, and household size were the covariates. Results: In the overall sample, high subjective family SES was associated with lower levels of fun-seeking. We also found a statistically significant interaction between race and subjective family SES on children's fun-seeking in the overall sample, suggesting that high subjective family SES is associated with a weaker effect on reducing fun-seeking among AA than Caucasian children. In race-stratified models, high subjective family SES was protective against fun-seeking of Caucasian but not AA children. Conclusion: Subjective family SES reduces the fun-seeking for Caucasian but not AA children.
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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;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, 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;
| | - 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, Boyce S, Bazargan M, Caldwell CH. Diminished Returns of Parental Education in Terms of Youth School Performance: Ruling out Regression toward the Mean. CHILDREN-BASEL 2020; 7:children7070074. [PMID: 32645933 PMCID: PMC7401872 DOI: 10.3390/children7070074] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
Abstract
Background: Minorities’ Diminished Returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES) indicators on various developmental, behavioral, and health outcomes of ethnic minorities compared to non-Hispanic (non-Latino) Whites. Similar MDRs also exist for the effects of parental education on the school performance of ethnic minority youth. Aim: To assess whether regression toward the mean (RTM) has any role in explaining the diminished effects of parental education on the school performance of Black and Hispanic youth relative to non-Hispanic White youth. Materials and methods: Data for this cross-sectional study came from the Monitoring the Future survey (MTF, 2017), a nationally representative survey of American youth in 12th grade. The sample included 10,262 youth who were 12th graders (typically 17–18 years old). The independent variable was parental education with five categories: Some high school, High school graduate, Some college, College graduate, and Graduate school. The outcome was self-reported school performance measured as grade point average (GPA). Ethnicity was the effect modifier. Analysis of variance (ANOVA) and the Tukey Post Hoc test was used to analyze the data. Data visualization (line graphs) was used to visualize the shape of youth GPA as a function of parental education levels across ethnic groups. Results: While a perfect stepwise increase was seen in youth school performance as a result of parental education improvement, this pattern differed considerably across ethnic groups. Such a perfect stepwise increase in youth school performance as a result of the incremental increase in parental education was missing for Black and Hispanic youth. The shape of the association between parental education and youth school performance ruled out regression toward the mean (RTM) as an explanation for the observed diminished effects of parental education on the school performance of Black and Hispanic youth. Conclusion: Diminished returns of parental education on the school performance of Black and Hispanic youth cannot be explained by regression toward the mean. Other factors and contextual processes, such as segregation, discrimination, racism, and poor quality of schools in urban areas, should be investigated in future research.
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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.: +(734)-232-0445; Fax: +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, UCLA Health, Los Angeles, CA 90095, USA
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI 48109, USA;
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Assari S, Boyce S, Akhlaghipour G, Bazargan M, Caldwell CH. Reward Responsiveness in the Adolescent Brain Cognitive Development (ABCD) Study: African Americans' Diminished Returns of Parental Education. Brain Sci 2020; 10:E391. [PMID: 32575523 PMCID: PMC7349244 DOI: 10.3390/brainsci10060391] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 02/08/2023] Open
Abstract
(1) Background: Reward responsiveness (RR) is a risk factor for high-risk behaviors such as aggressive behaviors and early sexual initiation, which are all reported to be higher in African American and low socioeconomic status adolescents. At the same time, parental education is one of the main drivers of reward responsiveness among adolescents. It is still unknown if some of this racial and economic gap is attributed to weaker effects of parental education for African Americans, a pattern also called minorities' diminished returns (MDRs). (2) Aim: We compared non-Hispanic White and African American adolescents for the effects of parent education on adolescents RR, a psychological and cognitive construct that is closely associated with high-risk behaviors such as the use of drugs, alcohol, and tobacco. (3) Methods: This was a cross-sectional analysis that included 7072 adolescents from the adolescent brain cognitive development (ABCD) study. The independent variable was parent education. The main outcome as adolescents' RR measured by the behavioral inhibition system (BIS) and behavioral activation system (BAS) measure. (4) Results: In the overall sample, high parent education was associated with lower levels of RR. In the overall sample, we found a statistically significant interaction between race and parent education on adolescents' RR. The observed statistical interaction term suggested that high parent education is associated with a weaker effect on RR for African American than non-Hispanic White adolescents. In race-stratified models, high parent education was only associated with lower RR for non-Hispanic White but not African American adolescents. (5) Conclusion: Parent education reduces RR for non-Hispanic White but not African American adolescents. To minimize the racial gap in brain development and risk-taking behaviors, we need to address societal barriers that diminish the returns of parent education and resources in African American families. We need public and social policies that target structural and societal barriers, such as the unequal distribution of opportunities and resources. To meet such an aim, we need to reduce the negative effects of social stratification, segregation, racism, and discrimination in the daily lives of African American parents and families. Through an approach like this, African American families and parents can effectively mobilize their resources and utilize their human capital to secure the best possible tangible outcomes for their 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;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, 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
- 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. Prostate Cancer Screening in Middle-Aged and Older American Men: Combined Effects of Ethnicity and Years of Schooling. HOSPITAL PRACTICES AND RESEARCH 2020; 5:64-69. [PMID: 32783022 PMCID: PMC7416895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Prostate cancer screening is more commonly utilized by highly educated people. As shown by marginalization-related diminished returns (MDRs), the effects of socioeconomic status (SES) such as education on the health outcomes are considerably smaller for ethnic minorities than for Whites. The role of MDRs as a source of ethnic health disparities is, however, still unknown. OBJECTIVES The current study had two aims: first, to explore the association between years of schooling and having taken a prostate-specific antigen (PSA) test among men in the US, and second, to explore ethnic differences in this association. METHODS This study was a secondary analysis of data from the National Health Interview Survey (NHIS-2015). The data of 5,053 men aged 55 years or older who were either Latino, non-Latino, African-American, or White were analyzed. Years of schooling was the independent variable. The dependent variable was taking a PSA test sometime during one's lifetime. Age, region, and employment were the control variables. Ethnicity was the focal moderating variable. Binary logistic regression was used for data analysis. RESULTS A higher number of years of schooling was associated with higher odds of having taken a PSA test, net of all confounders. Ethnicity showed a significant statistical interaction with years of schooling on having taken a PSA test. This interaction was suggestive of a smaller slope for Latino men than non-Latino men. White and African American men did not show differential effects of years of schooling on having taken a PSA test. CONCLUSION Similar to the MDRs patterns in other domains, non-Latino White men show more health gain from their years of schooling than Latino men. Highly educated Latino men still need programs to encourage their use of prostate cancer screening.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7060057. [PMID: 32503310 PMCID: PMC7346200 DOI: 10.3390/children7060057] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Minorities' diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. AIM To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8-11 years old. MATERIALS AND METHODS In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8-11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. RESULTS Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. CONCLUSION The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources.
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Assari S, Mistry R, Caldwell CH, Bazargan M. Protective Effects of Parental Education Against Youth Cigarette Smoking: Diminished Returns of Blacks and Hispanics. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2020; 11:63-71. [PMID: 32547284 PMCID: PMC7250177 DOI: 10.2147/ahmt.s238441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/08/2020] [Indexed: 11/23/2022]
Abstract
Background High parental educational attainment is protective against youth health risk behaviors such as tobacco use. According to the Marginalization-related Diminished Returns (MDRs) theory, however, higher parental education is less protective for marginalized groups relative to non-Hispanic Whites. Objective To explore race/ethnic differences in the effects of parental educational attainment on cigarette smoking in a national sample of American adolescents. Methods In a cross-sectional study, we used baseline data of 10,878 American youth who had participated in the Population Assessment of Tobacco and Health (PATH 2013). The independent variable was parental educational attainment. The dependent variables were lifetime cigarette smoking, current (past 30-day) cigarette moking, and daily cigarette smoking. Youth age, youth gender, and parental marital status were the covariates. Race/ethnicity was the moderating variable. Logistic regression model was used for data analysis. Results Overall, a higher parental educational attainment was associated with a lower lifetime cigarette smoking, current (past 30-day) cigarette smoking, and daily cigarette smoking. Parental educational attainment showed significant interaction with race/ethnicity suggesting smaller protective effects of parental educational attainment on youth tobacco outcomes for Black and Hispanic than for non-Hispanic White youth. Conclusion For American youth, race/ethnicity limits the health gains that are expected to follow parental educational attainment. While high parental educational attainment is protective against smoking overall, non-Hispanic Whites (the most socially privileged group) gain most and Blacks and Hispanics (the least socially privileged groups) gain least from such resource. In addition to addressing low SES, researchers and policymakers should identify and address mechanisms by which high SES minority youth remain at risk of tobacco use.
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Affiliation(s)
- Shervin Assari
- College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Mohsen Bazargan
- College of 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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Parental Education on Youth Inhibitory Control in the Adolescent Brain Cognitive Development (ABCD) Study: Blacks' Diminished Returns. Brain Sci 2020; 10:brainsci10050312. [PMID: 32455841 PMCID: PMC7287691 DOI: 10.3390/brainsci10050312] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-Hispanic Black (NHB) youth are at a higher risk of high-risk behaviors compared to non-Hispanic White (NHW) youth. Some of this racial gap is shown to be due to weaker effects of parental educational attainment on reducing the prevalence of behavioral risk factors such as impulsivity, substance use, aggression, obesity, and poor school performance for NHBs, a pattern called Minorities' Diminished Returns. These diminishing returns may be due to lower than expected effects of parental education on inhibitory control. AIM We compared NHW and NHB youth for the effect of parental educational attainment on youth inhibitory control, a psychological and cognitive construct that closely predicts high-risk behaviors such as the use of drugs, alcohol, and tobacco. METHODS This was a cross-sectional analysis that included 4188 youth from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental educational attainment. The main outcome was youth inhibitory control measured by the stop-signal task (SST), which was validated by parent reports on the Child Behavior Checklist (CBCL). RESULTS In race/ethnicity-stratified models, high parental educational attainment was associated with a higher level of inhibitory control for NHB than NHW youth. In the pooled sample, race/ethnicity showed a statistically significant interaction with parental educational attainment on youth inhibitory control suggesting that high parental educational attainment has a smaller boosting effect on inhibitory control for NHB than NHW youth. CONCLUSION Parental educational attainment boosts inhibitory control for NHW but not NHB youth. To minimize the racial gap in youth brain development, we need to address societal barriers that diminish the returns of family economic and human resources, particularly parental educational attainment, for racial and ethnic minority youth. Social and public policies should address structural and societal barriers such as social stratification, segregation, racism, and discrimination that hinder NHB parents' abilities to effectively mobilize their human resources and secure tangible outcomes for their developing youth.
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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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Assari S. Socioeconomic Status and Current Cigarette Smoking Status: Immigrants' Diminished Returns. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 8:66-72. [PMID: 32656271 DOI: 10.34172/ijtmgh.2020.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction Although socioeconomic status (SES) resources influence population and individual health behaviors, socially marginalized groups gain significantly less health from their SES indicators, such as education and income, compared to the socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). However, most of the MDRs literature is derived from studies that have defined marginalization based on race and ethnicity. As a result, more research is needed on MDRs due to immigration. To extend what is known about MDRs due to immigration, the current study compared a national sample of immigrants and non-immigrants for the effects of education and income on current cigarette smoking of adults in the United States. Methods This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14,149 individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12,166; 86.0%). The independent variables (IV) were education and income that were treated as categorical variables. The dependent variable was current cigarette smoking. Age, gender, race, ethnicity, marital status, employment, and region were confounders. Immigration was the moderator. Logistic regression was used for data analysis. Results High education and income were associated with lower odds of current cigarette smoking. However, immigration showed significant statistical interactions with both education and income. These interactions were suggestive of smaller protective effects of high education and income on current cigarette smoking for immigrant than non-immigrant adults. Conclusion In line with the MDRs, the effects of education and income on tobacco use is weaker for immigrant than non-immigrant adults.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Assari S, Boyce S, Bazargan M, Caldwell CH, Zimmerman MA. Place-Based Diminished Returns of Parental Educational Attainment on School Performance of Non-Hispanic White Youth. FRONTIERS IN EDUCATION 2020; 5:30. [PMID: 32596626 DOI: 10.3389/feduc.2020.00030] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Youth educational outcomes are a function of a wide range of factors including parental education level. This effect, however, is shown to be smaller for African American, Hispanic, and Asian American youth, a pattern called Marginalization-related Diminished Returns (MDRs). It is, however, unknown if it is race/ethnicity or other conditions associated with race/ethnicity (e.g., poor neighborhood quality) which reduces the marginal returns of parental education for youth. AIM To explore whether MDRs are only due to race/ethnicity or if they also remain for non-Hispanic Whites in poor neighborhoods, we compared the association between parental education level and adolescents' school performance based on neighborhood quality in a nationally representative sample of non-Hispanic Whites in the United States. METHODS This cross-sectional study used wave 1 of the Add Health study, an ongoing nationally representative cohort, 1994-2019. Participants included 849 non-Hispanic White adolescents between the ages of 12 and 21 years and their parents. The independent variable was parental education level, which was treated as a continuous measure. Age, grade, gender, and parental marital status were the covariates. The dependent variable was school performance (sum of school grades in Math, English, History, and Science). Linear regression models were used for data analysis. RESULTS Overall, worse neighborhood quality was associated with worse school performance. Parental education level, however, was not directly associated with youth school performance. We found a statistically significant interaction between parental education level and neighborhood quality suggesting that the strength of the association between parental education and youth school performance weakens as neighborhood quality declines. CONCLUSION Parental education level is a more salient determinant of youth educational outcomes in better neighborhoods. The result suggests that MDRs may not be solely due to race/ethnicity but contextual factors that commonly covary with marginalization and poverty. These contextual factors may include segregation, concentration of poverty, and social and physical neighborhood disorder.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Shanika Boyce
- Department of Pediatrics, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Mohsen Bazargan
- Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Cleopatra H Caldwell
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marc A Zimmerman
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Assari S. Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants' Diminished Returns. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 8:37-43. [PMID: 32266301 DOI: 10.34172/ijtmgh.2020.06] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction Although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (SES) resources compared to socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). Most of the existing knowledge on MDRs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. As a result, very limited information exists on whether similar MDRs can be observed for middle-aged and older immigrants or not. Building on the MDRs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the United States. Methods This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14 149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12 166; 86.0%). The independent variable (IV) was income that was treated as a continuous variable. The dependent variable was mental well-being, also treated as a continuous variable. Age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. Immigration (nativity status) was the moderator. Logistic regression was applied for data analysis. Results High income was associated with higher odds of good mental well-being in middle-aged and older adults. However, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults. Conclusion In line with MDRs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. There is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. Such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Assari S, Caldwell C, Bazargan M. Parental educational attainment and relatives' substance use of American youth: Hispanics Diminished Returns. JOURNAL OF BIOSCIENCES AND MEDICINES 2020; 8:122-134. [PMID: 32123689 PMCID: PMC7051012 DOI: 10.4236/jbm.2020.82010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Research on Minorities' Diminished Returns (MDRs) has shown higher than expected substance use (tobacco and alcohol use) in middle-class Hispanic and Black youth and adults. In theory, some of this more than expected risk might be due to the high substance use problem of the social network. To better understand the role of social network as an explanatory mechanism behind higher than expected substance use of middle-class Hispanic and Black youth, this study tested MDRs of parental educational attainment on substance use involvement of biological relatives in Hispanic and Black middle-class youth, we compared ethnic groups for effects of parental educational attainment on the substance use involvement of biological relatives among American youth. METHODS Current longitudinal study used waves 1 and wave 4 data of the Population Assessment of Tobacco and Health- Adolescents (PATH; 2013-2018) study. The sample included 4264 nationally representative American youth who were followed for 4 years. The independent variable was parental educational attainment. The dependent variable was substance use involvement of biological relatives. Age, gender, and marital status of the family were the covariates. Ethnicity was the moderator. Linear regression was used to analyze the data. RESULTS Parental educational attainment was inversely associated with substance use involvement of biological relatives in the pooled sample (OR = 1.36, 95% CI = 1.13 -1.63 for high school graduation and OR = 0.65, 95% CI = 0.53- 0.80 for college graduation). Hispanic ethnicity showed statistically significant interactions with parental educational attainment (OR = 2.26, 95% CI = 1.49 -3.44 for high school graduation and OR = 2.98, 95% CI =1.80 - 4.93 for college graduation), suggesting that the protective effect of parental educational attainment against substance use involvement of biological relatives is smaller for Hispanic youth than for non-Hispanic youth. CONCLUSIONS While high parental educational attainment reduces substance use involvement of biological relatives, this protective effect is weaker for Hispanic than non-Hispanic youth. That means, substance use involvement of biological relatives is still high in middle-class Hispanic youth, which increases their risk of substance use. Future research should explore societal and contextual factors that cayuse MDRs of parental educational attainment on substance use of middle-class Hispanic families.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | | | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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Assari S. Understanding America: Unequal Economic Returns of Years of Schooling in Whites and Blacks. WORLD JOURNAL OF EDUCATIONAL RESEARCH (LOS ANGELES, CALIF.) 2020; 7:78-92. [PMID: 32582861 PMCID: PMC7314384 DOI: 10.22158/wjer.v7n2p78] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Higher schooling is associated with higher economic wellbeing. Marginalization-related Diminished Returns (MDRs) framework, however, refers to smaller returns of schooling for non-Hispanic Blacks (NHBs) compared to non-Hispanic Whites (NHWs). AIM Using a national sample of American adults, the current study compared NHBs and NHWs for the effects of each incremental increase in the years of schooling (gradient of educational level) on economic wellbeing of American adults. METHODS Data came from the Understanding America Study (UAS), a national online survey with a nationally representative sample. A total of 5715 adults (18+ years old) were included. From this number, 4,826 (84.4%) were NHWs, and 889 (15.6%) were NHBs. Years of schooling was the independent variable. Economic wellbeing was the main outcome. Age and gender were the covariates. Race was the moderator. RESULTS Overall, each additional year of schooling was associated with higher economic wellbeing, net of age, and gender. A statistically significant interaction was found between race and years of schooling on the outcome, indicating a smaller boosting effect of any incremental increase in the years of education on the economic wellbeing of NHBs compared to NHWs. CONCLUSION In line with MDRs, highly educated Black people experience low economic wellbeing. The MDRs of education on economic wellbeing may be why highly educated, and middle-class Black Americans still report poor health. Policy solutions should address multi-level causes of MDR-related health disparities.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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Assari S. Age-Related Decline in Children's Reward Sensitivity: Blacks' Diminished Returns. RESEARCH IN HEALTH SCIENCE 2020; 5:112-128. [PMID: 33274304 DOI: 10.22158/rhs.v5n3p112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND It is important to study the correlates of reward sensitivity since it predicts high-risk behaviors. While ageing reduces children's reward sensitivity and its associated risk taking, there is more to find out about racial differences in regard to the effect of age on reward sensitivity. Minorities' Diminished Returns (MDRs) suggest that resources and assets show weaker effects on Black children than White children. AIM We compared White children to Black children as for the effects of age on reward sensitivity. METHODS This cross-sectional study included 10533 American children who participated in the baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was age, while the dependent variable was reward sensitivity as captured by the behavioral approach/behavioral avoidance system (BAS-BIS). Gender, parental education, marital status, parental education, and household income were the covariates. RESULTS Higher age was associated with less reward sensitivity. A significant interaction was found between race and age when it comes to children's reward sensitivity. It suggested that age is associated with a smaller gain in terms of reduced reward sensitivity in Black children than White children. CONCLUSION Age is more likely to reduce reward sensitivity in White children than Black children. This finding is in line with MDRs, and may be due to social racism, segregation, stratification, and discrimination.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Assari S. Dimensional Change Card Sorting of American Children: Marginalization-Related Diminished Returns of Age. CHILDREN AND TEENAGERS 2020; 3:72-92. [PMID: 33299967 DOI: 10.22158/ct.v3n2p72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND While age is associated with an increase in cognitive flexibility and executive functioning as a result of normal development during childhood, less is known about the effect of racial variation in children's age-related cognitive development. The Marginalization-related Diminished Returns (MDRs) phenomenon suggests that, under racism, social stratification, segregation, and discrimination, individual-level economic and non-economic resources and assets show weaker effects on children's development for marginalized, racialized, and minoritized families. AIM We conducted this study to compare racial groups of children for age-related changes in their card sorting abilities. METHODS This cross-sectional study included 10,414 9-10-year-old American children. Data came from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was age, a continuous variable measured in months. The dependent variable was dimensional change card sort (DCCS) score, which reflected cognitive flexibility, and was measured by the NIH Dimensional Change Card Sort. Ethnicity, sex, parental education, and marital status were the covariates. RESULTS Older age was associated with higher DCCS score, reflecting a higher card-sorting ability and cognitive flexibility. However, age showed a weaker association with DCCS for Black than for White children. This was documented by a significantly negative interaction between race and age on children's DCCS scores. CONCLUSION Age shows a weaker correlation with the cognitive flexibility of Black than of White children. A similar pattern can be seen when comparing low-income with high-income children. Conceptualizing race as a social factor that alters normal childhood development is a finding that is in line with MDRs. Marginalization due to social stratification and racism interfere with the normal age-related cognitive development of American children.
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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.,Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
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Assari S. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander Children's Body Mass Index: Diminished Returns of Parental Education and Family Income. ACTA ACUST UNITED AC 2020; 5:64-84. [PMID: 34308086 DOI: 10.22158/rhs.v5n1p64] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Socioeconomic status (SES) is associated with several health-related outcomes, such as obesity and body mass index (BMI). However, we do not know whether SES is associated differently with children's BMI from American Indian and Alaska Native and Native Hawaiian and Pacific Islander (AIAN/NHPI) families when compared to non-Hispanic White (NHW) families. Aim To compare AIAN/NHPI and NHW families for associations between parental education, family income, and children's BMI in the United States (U.S). Methods This cross-sectional investigation used the Adolescent Brain Cognitive Development (ABCD) study data. Participants (n = 8580) included 63 AIAN/NHPI and 8517 NHW children between ages 9 and 10. The independent variables were parental education and family income. The primary outcome was BMI. Race was the moderator. Age, sex, and family structure were covariates. Mixed-effects regression models were used for data analysis. Results In the pooled sample, higher parental education and family income were associated with lower children's BMI. We found interactions between race and parental education and family income indicating weaker associations between parental education and family income and children's BMI in AIAN/NHPI families than in NHW families. Conclusion The salience of parental education and family income as social determinants of children's BMI is diminished for AIAN/NHPI families than NHW families. As a result, AIAN/NHPI children with high SES remain at risk for high BMI, while high-SES NHW children show the lowest BMI. Future research should test if obesogenic environments, food options, and physical activity-friendly neighborhoods can explain higher-than-expected BMI in high-SES AIAN/NHPI children. In other terms, more research is needed to understand if residential segregation, discrimination, and historical trauma explain the observed differences in the social patterning of childhood BMI in AIAN/NHPI and NHW communities.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA.,Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA
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Assari S, Islam S. Diminished Protective Effects of Household Income on Internalizing Symptoms among African American than European American Pre-Adolescents. JOURNAL OF ECONOMICS, TRADE AND MARKETING MANAGEMENT 2020; 2:38-56. [PMID: 33241230 DOI: 10.22158/jetmm.v2n4p38] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To investigate the differential role of race on the effect of household income on pre-adolescents' internalizing symptoms in a national sample of U.S. pre-adolescents. METHODS This is a cross-sectional study that used data from the Adolescent Brain Cognitive Development (ABCD) study. Wave 1 ABCD data included 5,913 adolescents between ages 9 and 10 years old. The independent variable was household income. The primary outcome was internalizing symptoms measured by the teacher report of the Brief Problem Monitor (BPM) scale. RESULTS Overall, high household income was associated with lower levels of pre-adolescents internalizing symptoms. Race showed statistically significant interaction with household income on pre-adolescents' internalizing symptoms, controlling for all confounders, indicating weaker protective effect of high household income on internalizing symptoms for African American than European pre-adolescents. CONCLUSION High household income is a more salient protective factor against internalizing symptoms of socially privileged European American pre-adolescents than of historically marginalized African Americans pre-adolescents. Elimination of internalizing behavioral gaps across racial groups requires more than equalizing socioeconomic status. Future research should study the moderating role of institutional and structural racism experienced by African American families across all income levels. Such research may explain why pre-adolescent African Americans with high household income remain at high risk of internalizing symptoms.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Sondos Islam
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Assari S, Cobb S, Cuevas AG, Bazargan M. Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States. Front Psychiatry 2020; 11:535624. [PMID: 33329080 PMCID: PMC7728619 DOI: 10.3389/fpsyt.2020.535624] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: Marginalization-related diminished returns (MDRs) refer to weaker health effects of educational attainment for socially marginalized groups compared to the socially privileged groups. Most of the existing literature on MDRs, however, has focused on marginalization due to race, ethnicity, and sexual orientation. Thus, very limited information exists on MDRs of educational attainment among immigrant populations in the United States. Aims: Building on the MDRs framework and using a nationally representative sample of US adults, we compared immigrant and native-born adults for the effects of educational attainment on psychological distress, self-rated health (SRH), and chronic diseases (CDs). Methods: The 2015 National Health Interview Survey (NHIS) has enrolled 33,672 individuals who were either immigrant (n = 6,225; 18.5%) or native born (n = 27,429; 81.5%). The independent variable (IV) was educational attainment, which was treated as a categorical variable. The dependent variables included psychological distress, SRH, and CDs, all of which were dichotomous variables. Age, gender, race, ethnicity, and region were confounders. Immigration (nativity status) was the moderator. Results: Higher educational attainment was associated with lower odds of psychological distress, poor SRH, and CDs. However, immigration showed a significant statistical interaction with college graduation on all outcomes, which were suggestive of smaller protective effects of college graduation on psychological distress, poor SRH, and CDs for immigrant than native-born adults. Conclusions: In the US, the associations between educational attainment and psychological distress, SRH, and CDs are all weaker for immigrant than native-born adults. To prevent health disparities, it is essential to decompose health inequalities that are due to low educational attainment from those that are due to diminished returns of educational attainment (i.e., MDRs). There is a need to help highly educated immigrant adults secure positive health outcomes, similar to their native-born counterparts. Such changes may require bold and innovative economic, public, and social policies that help immigrant adults to more effectively mobilize their educational attainment to secure tangible outcomes. Elimination of health disparities in the US requires efforts that go beyond equalizing access to education.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Adolfo G Cuevas
- Department of Community Health, Tufts University, Boston, MA, United States
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
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