Protective Effects of Parental Education Against Youth Cigarette Smoking: Diminished Returns of Blacks and Hispanics

Risk and Protective Factors for Vaping and Smoking Among High School Students in Maine

INTRODUCTION

Vaping rates are rising among adolescents across the country, and smoking rates remain high. Understanding risk and protective factors associated with vaping and smoking can guide public health interventions. This study examined risk and protective factors associated with vaping and smoking among high school students in Maine.

METHODS

We used 2019 Maine Integrated Youth Health Survey (MIYHS) data to examine risk and protective factors for vaping and smoking among Maine high school students. Our analytic sample consisted of 17,651 Maine high school students. In addition to bivariate analyses, we used unadjusted and adjusted logistic regression models to assess risk and protective factors.

RESULTS

Factors with the greatest effect on students' likelihood to vape, smoke, or do both were parental attitude toward adolescent smoking and depressive symptoms. Students who reported their parents feel it is a little wrong or not wrong at all if they smoked had 4.9 times higher adjusted odds of smoking and 4.6 times higher adjusted odds of vaping and smoking compared with students who said their parents feel it would be wrong or very wrong if they smoked. Students who reported depressive symptoms had 2.1 times higher adjusted odds of vaping, 2.7 times higher adjusted odds of smoking, and 3.0 times higher adjusted odds of vaping and smoking compared with students who did not report depressive symptoms.

CONCLUSION

Understanding risk and protective factors for smoking and vaping among high school students can help tailor adolescent-focused vaping and smoking public health interventions to increase effectiveness.

Race and Ethnic Differences in the Protective Effect of Parental Educational Attainment on Subsequent Perceived Tobacco Norms among US Youth

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.

Immigration Status, Educational Level, and Perceived Discrimination in Europe

BACKGROUND

Multiple studies have been conducted to test the moderating effect of immigration on the positive health results yielded through educational attainment. However, no study has been conducted to examine the role of immigration as a moderator in the association between educational level and perceived discrimination in Europe.

AIM

We aimed to study whether an inverse association exists between educational level and perceived discrimination in European countries and whether immigration status moderates the association between educational level and perceived discrimination.

METHODS

Data from the 10th round of the cross-sectional European Social Survey (ESS) were used in this cross-sectional study. A total of 17,596 participants between 15-90 years old who lived in European countries were included. The independent variable was educational level, a categorical variable, and the dependent variable was perceived discrimination. Immigration status was the moderator, and age and sex were confounders.

RESULTS

Of 17,596 participants, 16,632 (94.5%) were native-born and 964 were immigrants (5.5%). We found that higher levels of educational level were protective against perceived discrimination, which was also found in immigrant participants; however, the effect was weaker.

CONCLUSIONS

This study found that educational level was a protective factor against perceived discrimination. This effect, however, was more robust in the native-born participants than in their immigrant counterparts.

Differences among factors associated with tobacco product use among Black and White adolescents: A cross-sectional analysis of wave one of the PATH study 2013-2014

INTRODUCTION

Tobacco use remains a primary cause of health disparities between Black and White Americans. Current approaches have not improved tobacco-related racial health disparities. This study aimed to identify differences in factors associated with tobacco product use among Black and White adolescents.

METHODS

This cross-sectional design used data from Wave One (2013-2014) of the Population Assessment of Tobacco and Health Study. Adolescents aged 12-17 years who identified as non-Hispanic Black or African American (n=1800) or non-Hispanic White (n=6495) were included. Primary outcomes were the ever use and current use of any tobacco products. Sociocultural, household environment, psychological, and behavioral factors were included. Logistic regressions, stratified by race, were used to determine significance. Dominance analysis was used to rank significant factors by their level of importance.

RESULTS

Although there were many Black-White commonalities, there were also important differences. Black adolescents in the Northeast were more likely to have ever used tobacco compared to those in the South (OR=0.6; 95% CI: 0.6-0.7, p<0.001) and Midwest (OR=0.6; 95% CI: 0.5-0.7, p<0.001). White adolescents in the Northeast were less likely to use tobacco products than in other regions. Peer influences (OR=1.9; 95% CI: 1.1-3.2, p<0.05) were uniquely associated with ever use among Black adolescents. Access to tobacco in the home (OR=2.0; 95% CI: 1.4-3.0, p<0.001) and thinking that tobacco use would help reduce stress (OR=1.3; 95% CI: 1.1-1.6, p<0.01) were uniquely associated with current use among Black adolescents.

CONCLUSIONS

There are significant Black-White differences in the factors associated with tobacco use. Factors uniquely associated with Black adolescent tobacco use should be considered in developing strategies to prevent adolescent tobacco use in Black communities.

Sociodemographic Patterns of Exclusive and Dual Combustible Tobacco and E-Cigarette Use among US Adolescents-A Nationally Representative Study (2017-2020)

This study assessed the sociodemographic predictors of exclusive and dual use of the most frequently used nicotine/tobacco products, e-cigarettes, and combustible tobacco among adolescents. Cross-sectional data was from the 2017-2020 Monitoring the Future nationally representative study of eighth, tenth, and twelfth-grade students. We coded past 30 day nicotine/tobacco use into four mutually exclusive categories: no use, e-cigarette use only, combustible use (cigarette or cigar) only, and dual use (e-cigarette and combustible). We pooled the 2017-2020 data to examine the relationship between sex, race/ethnicity, parental education, and each product-use category using multinomial logistic regression, stratified by grade level. Among eighth (N = 11,189), tenth (N = 12,882), and twelfth graders (N = 11,385), exclusive e-cigarette use was the most prevalent pattern (6.4%, 13.2%, 13.8%, respectively), followed by dual use (2.7%, 4.5%, 8.9%), and exclusive combustible use (1.5%, 2.5%, 5.3%). eighth and tenth-grade adolescents whose highest parental education was a 4-year college degree or more had lower odds of exclusive combustible and dual use when compared to adolescents whose highest parental education was less than a high school degree. Research should continue to monitor the differential use of combustible tobacco products and e-cigarettes among adolescents from low socioeconomic status backgrounds or racial/ethnic minority households to inform ongoing and future interventions or policies.

Cingulo-opercular and Cingulo-parietal Brain Networks Functional Connectivity in Pre-adolescents: Multiplicative Effects of Race, Ethnicity, and Parental Education

Introduction

A growing body of research has shown a diminished association between socioeconomic status (SES) indicators and a wide range of neuroimaging indicators for racial and ethnic minorities compared to majority groups. However, less is known about these effects for resting-state functional connectivity between various brain networks.

Purpose

This study investigated racial and ethnic variation in the correlation between parental education and resting-state functional connectivity between the cingulo-opercular (CO) and cingulo-parietal (CP) networks in children.

Methods

This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study; we analyzed the resting-state functional Magnetic Resonance Imaging (rsfMRI) data of 8,464 American pre-adolescents between the ages of 9 and 10. The main outcome measured was resting-state functional connectivity between the CO and CP networks calculated using rsfMRI. The independent variable was parental education, which was treated as a nominal variable. Age, sex, and family marital status were the study covariates. Race and ethnicity were the moderators. Mixed-effects regression models were used for data analysis, with and without interaction terms between parental education and race and ethnicity.

Results

Higher parental education was associated with higher resting-state functional connectivity between the CO and CP networks. Race and ethnicity both showed statistically significant interactions with parental education on children's resting-state functional connectivity between CO and CP networks, suggesting that the correlation between parental education and the resting-state functional connectivity was significantly weaker for Black and Hispanic pre-adolescents compared to White and non-Hispanic pre-adolescents.

Conclusions

In line with the Minorities' Diminished Returns theory, the association between parental education and pre-adolescents resting-state functional connectivity between CO and CP networks may be weaker in Black and Hispanic children than in White and non-Hispanic children. The weaker link between parental education and brain functional connectivity for Blacks and Hispanics than for Whites and non-Hispanics may reflect racism, racialization, and social stratification that collectively minimize the returns of SES indicators, such as parental education for non-Whites, who become others in the US.

Association Between Parental Educational Attainment and Children's Negative Urgency: Sex Differences

Background and aims

Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including, but not limited to, problematic substance use. Negative urgency is also shaped by family socioeconomic position (SEP), such as parental educational attainment (PEA). This study aimed to explore sex differences regarding protective effects of PEA on children's negative urgency in the US.

Methods

This cross-sectional study used the Adolescent Brain Cognitive Development (ABCD) study data. Baseline ABCD data included 10,535 American children in the age range of 9-10 years old. The independent variable was PEA, treated as a 5-level categorical variable. The primary outcome was negative urgency measured by the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-SS). Mixed-effects regression models were applied for data analysis.

Results

In sex-stratified regression models, high PEA was predictive of lower levels of negative urgency in female but not male children. In the overall sample, sex showed a statistically significant interaction with PEA on children's negative urgency, indicating a stronger protective effect of high PEA for female compared to male children.

Conclusion

PEA was a more salient determinant of negative urgency in female children than male ones. Our results also showed that American boys tend to have high levels of negative urgency, which is a risk factor of drug use, at all parental education levels.

Resting-State Functional Connectivity between Putamen and Salience Network and Childhood Body Mass Index

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.

Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children?

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.

Parental Education, Household Income, and Cortical Surface Area among 9-10 Years Old Children: Minorities' Diminished Returns

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.

Maternal Education at Birth and Youth Breakfast Consumption at Age 15: Blacks' Diminished Returns

Background

Based on the Marginalization-related Diminished Returns (MDRs) framework, high socioeconomic status (SES) such as parental education shows weaker effects for Blacks than Whites. For example, high SES Black individuals report a high level of depression, anxiety, suicide, chronic disease, smoking, and mortality. Limited knowledge exists on MDRs of parental education on dietary behavior.

Aims

Built on the MDRs framework, we tested the hypothesis of whether the effect of parental education on eating breakfast differs for Black compared to White families. We hypothesized that there is an association between mothers' educational attainment and eating breakfast and compared Blacks and Whites for the effect of mothers' educational attainment on the frequency of eating breakfast.

Methods

The Fragile Families and Child Wellbeing Study is a 15-year follow up study of a random sample of births in cities larger than 200,000 population. The predictor was parental education at birth. The outcome was the frequency of eating breakfast at age 15. Linear regression was used for data analysis.

Results

Maternal educational attainment at birth was positively associated with youth frequency of eating breakfast among Whites, not Blacks. We also found a significant interaction between maternal educational attainment at birth and race, suggesting that the association between maternal education and youth frequency of eating breakfast at age 15 was weaker for Black than White families.

Conclusions

Diminished returns of maternal educational attainment on healthy youth diet may contribute to the racial disparities in poor health of high SES Black families. That is, a smaller protective effect of maternal education on changing health behaviors for Black than White youth may be one of the mechanisms by which health is worse than expected in high SES Black families. The health disparities are not only due to racial differences in SES but also the diminishing returns of socioeconomic status indicators such as education for racial minorities. Research should study contextual and structural factors that reduce Black families' ability to mobilize their human capital and secure health outcomes in urban settings.

Parental Education and Spanking of American Children: Blacks' Diminished Returns

Background

Based on the Minorities' Diminished Returns (MDRs) framework, high socioeconomic status (SES) indicators such as parental education shows weaker protective effects against adverse experiences for Blacks than Whites. For example, Black children with highly educated parents report high levels of depression, anxiety, suicide, smoking, obesity, and chronic disease. Limited knowledge exists on MDRs of parental education on the child's exposure to spanking by the mother.

Aims

Built on the MDRs framework, we tested the hypothesis of whether the effect of parental education on the child's exposure to spanking by the mother differs in Black and White families. We hypothesized that: 1) there is an inverse association between mothers' educational attainment and child spanking, and 2) the effect of mothers' educational attainment on mothers' spanking of the child is weaker for Black than White families.

Methods

We used data from the Fragile Families and Child Well-being Study (FFCWS), a 9-year follow up study of a random sample of births in cities larger than 200,000 population. In this analysis, 2722 Black or White families were followed. The main predictor was parental educational attainment at birth. The outcomes were exposure to spanking at ages 3, 5, and 9. Logistic regression was used for data analysis.

Results

Higher parental educational attainment at birth was inversely associated with the child's exposure to spanking by the mother among Whites, not Blacks. We also found a significant interaction between parental educational attainment at birth and race, suggesting that the associations between parental education and child exposure to spanking by the mother at ages 3, 5, and 9 were weaker for Black than White families.

Conclusions

Diminished returns of parental educational attainment in terms of reducing children's exposure to trauma and stress may be a mechanism that contributes to racial health disparities, particularly poor health of children in highly educated Black families. That is a smaller protective effect of parental education on reducing undesired exposures for Black than White children may be one of the mechanisms that may explain why children develop worse than expected physical, mental, and behavioral health in high SES Black families. Not all health disparities are due to racial differences in SES, but some of them are also secondary to the diminishing returns of socioeconomic status indicators such as parental education for racial minorities. Research should study contextual, structural, family, and behavioral factors that reduce Black families' ability to mobilize their human capital and secure health outcomes for themselves and their children.

Diminished Protective Effects of Household Income on Internalizing Symptoms among African American than European American Pre-Adolescents

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.