1
|
Assari S, Najand B, Khatami SM. High Systolic Blood Pressure of High-Income African American Children. J Racial Ethn Health Disparities 2024; 11:1994-2008. [PMID: 37418111 PMCID: PMC11236934 DOI: 10.1007/s40615-023-01668-5] [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: 04/11/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND According to the Minorities' Diminished Returns (MDRs) theory, racism may reduce the health returns of family socioeconomic status (SEP) resources such as family income for racial minorities, particularly African Americans, compared to Whites. However, we are unaware of any previous studies on racial variation in the protective effects of family income on children's blood pressure. AIM We conducted this study to compare the overall effects of family income on pre-adolescents' systolic and diastolic blood pressure, test racial variation in this effect, and investigate whether racial variation in this regard is due to racial differences in body mass index. METHODS In this cross-sectional study, we analyzed data from 4007 racially diverse US children 9-10 years old. The independent variable was family income measured as a three-level categorical variable: less than $50 K USD, 50-100 K USD, and 100 + K USD. The primary outcomes were systolic and diastolic blood pressure measured up to three times at 1-min time intervals. Body mass index was the mediator. Mixed-effects regression models were used for data analysis to adjust for data nested to the centers, families, and individuals. Age, gender, parental education, family structure, and Latino ethnicity were covariates. RESULTS In the pooled sample and in the absence of interaction terms in the model, family income did not show an inverse association with children's systolic (for 100 + K USD family income: β = - 0.71, p = 0.233 and for 50-100 K USD family income: β = 0.01, p = 0.989) or diastolic blood pressure (for 100 + K USD family income: β = - 0.66, p = 0.172 and for 50-100 K USD family income: β = 0.23, p = 0.600). However, race showed a significant interaction with family income on systolic blood pressure (for 50-100 K USD × African American: β = 2.75, p = 0.034), suggesting higher systolic blood pressure of African American adolescents from high-income backgrounds. Racial variation in the protective effect of family income on systolic BP was no more significant (for 50-100 K USD × African American: β = 2.14, p = 0.149) after we controlled for body mass index (BMI), which was higher for African American than White adolescents. CONCLUSION The association between high family income and reduced systolic blood pressure in pre-adolescence might be weaker for African Americans compared to Whites, a difference that African American adolescents' higher body mass index can explain.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, 1731 E 120Th St, Los Angeles, CA, 90059, USA.
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
- Marginalization-Related Diminished Returns (MDRs), Los Angeles, CA, USA.
| | - Babak Najand
- Marginalization-Related Diminished Returns (MDRs), Los Angeles, CA, USA
| | - Seyedeh Mohaddeseh Khatami
- Marginalization-Related Diminished Returns (MDRs), Los Angeles, CA, USA
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Assari S. Racial Differences in Biopsychosocial Pathways to Tobacco and Marijuana Use Among Youth. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02035-8. [PMID: 38807026 DOI: 10.1007/s40615-024-02035-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND The influence of socioeconomic disparities and multidimensional stressors on youth tobacco and marijuana use is recognized; however, the extent of these effects varies among different racial groups. Understanding the racial differences in the factors influencing substance use is crucial for developing tailored interventions aimed at reducing disparities in tobacco and marijuana use among adolescents. AIMS This study aims to explore the differential effects of socioeconomic disparities and multidimensional stressors on tobacco and marijuana use between Black and White adolescents. METHODS Utilizing longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, this research includes a cohort of pre-youth, monitored from the age of 9-10 years for a period of up to 36 months. We examined the impact of various socioeconomic status (SES) indicators and multidimensional stressors, including trauma, financial stress, racial discrimination, and family stress, alongside baseline average cortical thickness and the subsequent initiation of tobacco and marijuana use over the 36-month follow-up. RESULTS Overall, 10,777 participants entered our analysis. This included 8263 White and 2514 Black youth. Our findings indicate significant differences in the pathways from SES indicators through stress types to cortical thickness between Black and White youths. Notably, cortical thickness's impact on the future initiation of tobacco and marijuana use was present in both groups. CONCLUSION The study suggests that compared to White adolescents, Black adolescents' substance use and associated cortical thickness are less influenced by stress and SES indicators. This discrepancy may be attributed to the compounded effects of racism, where psychosocial mechanisms might be more diminished for Black youth than White youth. These findings support the theory of Minorities' Diminished Returns rather than the cumulative disadvantage or double jeopardy hypothesis, highlighting the need for interventions that address the unique challenges faced by Black adolescents.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R Drew University of Medicine and Science, 1731 E. 120th St., Los Angeles, CA, 90059, USA.
- 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.
- Marginalization-Related Diminished Returns, Los Angeles, CA, USA.
| |
Collapse
|
3
|
Zare H, Najand B, Fugal A, Assari S. Allostatic load in the US general population: Race and educational intersection. PUBLIC HEALTH IN PRACTICE 2023; 6:100425. [PMID: 37711501 PMCID: PMC10498186 DOI: 10.1016/j.puhip.2023.100425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023] Open
Abstract
Objectives Educational attainment is a protective factor against poor health, but high educational attainment has a weaker effect on black people than on white people; this pattern has been called marginalization-related diminished returns (MDRs). Using a national sample of white people and black people 25 years and above, this study estimates the association between high educational attainment and allostatic load between black people and white people, and within each group. Study design This cross-sectional study uses data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016, including 2761 black people and 7058 white people. The outcome variable of interest was the Allostatic Load Scale (AL). We created the allostatic load scale by using 8 biomarkers, then created a binary variable (if ALS≥4 as 1 and ALS<4 as 0) to present elevated AL. Methods We used several weighted modified Poisson regression models controlling for educational attainment (a predictor) and race (a moderator variable), age, sex, and marital status. We also controlled the models for smoking and drinking status as health behavior variables. As a sensitivity analysis, we ran several sets of regression analysis using the AL scale as a continuous outcome variable. Results We found an inverse association between AL and educational attainment. The interaction between race and education has resulted in an inverse association between AL and educational attainment, with a weaker association in black people than in white people. We found similar findings by running regression models with AL as a continuous variable. Conclusions We observed a weaker association between educational attainment and AL in black people than in white people, suggesting that educational attainment has more robust protection against allostatic load for white people than black people.
Collapse
Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, 20774, USA
| | - Babak Najand
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Adriele Fugal
- Utah Valley University, 800 W University Pkwy, Orem, UT, 84058, USA
| | - Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
4
|
Adinkrah E, Najand B, Rahmani A, Maharlouei N, Ekwegh T, Cobb S, Zare H. Social Determinants of Mental, Physical, and Oral Health of Middle-Aged and Older African Americans in South Los Angeles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16765. [PMID: 36554645 PMCID: PMC9779480 DOI: 10.3390/ijerph192416765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/10/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans. AIM We investigated the separate and joint effects of education, income, and financial difficulties on mental, physical, and oral self-rated health (SRH) outcomes in African American middle-aged and older adults. METHODS This cross-sectional study enrolled 150 middle-aged and older African Americans residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics (education, income, and financial difficulties), and self-rated health (mental, physical, and oral health) were collected. Three linear regression models were used to analyze the data. RESULTS Higher education and income were associated with a lower level of financial strain in a bivariate analysis. However, according to multivariable models, only financial difficulties were associated with poor mental, physical, and oral health. As similar patterns emerged for all three health outcomes, the risk associated with financial difficulties seems robust. CONCLUSIONS According to our multivariable models, financial strain is a more salient social determinant of health within African American communities than education and income in economically constrained urban environments such as South Los Angeles. While education and income lose some protective effects, financial strain continues to deteriorate the health of African American communities across domains.
Collapse
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 (MDRs) Center, Los Angeles, CA 90059, USA
| | - Arash Rahmani
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| | - Najmeh Maharlouei
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| | - Tavonia Ekwegh
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Sharon Cobb
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, Garden City, NY 20783, USA
| |
Collapse
|
5
|
Siddiq H, Najand B. Immigration Status, Socioeconomic Status, and Self-Rated Health in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15657. [PMID: 36497731 PMCID: PMC9735665 DOI: 10.3390/ijerph192315657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
The literature has established a protective effect of socioeconomic status (SES) indicators on health. However, at least in the US, these SES indicators tend to generate fewer health gains for marginalized groups including immigrants. As this literature mainly originated in the US, it is necessary to study whether these indicators similarly correlate with the health of foreign-born and native-born individuals in Europe. The current study was based on the Marginalization-related Diminished Returns (MDRs) theory and compared the effects of three SES indicators, namely parental education, own education and income, on self-rated health (SRH) of immigrant and native-born individuals. We used data from the European Social Survey 2020 (ESS 2020). Participants included 14,213 individuals who identified as either native-born (n = 9052) or foreign-born (n = 508). Education, income, and parental education were the independent variables. Self-rated health (SRH) was the outcome. Age and sex were covariates. Linear regression and logistic regression were used for data analysis. Overall, high education, income, and parental education were associated with lower odds of poor SRH. We documented a statistical interaction between immigration status and parental education, indicating a weaker inverse association between parental education and poor SRH for foreign-born than native-born individuals. The links between some but not all SES indicators vary across foreign-born and native-born individuals in Europe. Host countries seem to undervalue the parental educational attainment of foreign-born families. Future research should explore the role of time, period, cohort and country of origin as well as host country and associated policies in equalizing returns of SES indicators on the health of population subgroups. The results are important given that most studies on MDRs are developed in the US, and less is known about Europe. The results are also very important given the growing anti-immigrant sentiment and nationalist movements in Europe and the rest of the world.
Collapse
Affiliation(s)
- Hafifa Siddiq
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA 90095, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| |
Collapse
|
6
|
Assari S. Cingulo-opercular and Cingulo-parietal Brain Networks Functional Connectivity in Pre-adolescents: Multiplicative Effects of Race, Ethnicity, and Parental Education. ACTA ACUST UNITED AC 2021; 6:76-99. [PMID: 34734154 DOI: 10.22158/rhs.v6n2p76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
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.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, College of 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.,Marginalization-related Diminished Returns (MDRs) Research Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Race, Family Conflict and Suicidal Thoughts and Behaviors among 9-10-Year-Old American Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105399. [PMID: 34070158 PMCID: PMC8158501 DOI: 10.3390/ijerph18105399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023]
Abstract
Family conflict is known to operate as a major risk factor for children’s suicidal thoughts and behaviors (STBs). However, it is unknown whether this effect is similar or different in Black and White children. Objectives: We compared Black and White children for the association between family conflict and STBs in a national sample of 9–10-year-old American children. Methods: This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study. This study included 9918 White or Black children between the ages of 9 and 10 living in married households. The predictor variable was family conflict. Race was the moderator. The outcome variable was STBs, treated as a count variable, reflecting positive STB items that were endorsed. Covariates included ethnicity, sex, age, immigration status, family structure, parental education, and parental employment, and household income. Poisson regression was used for data analysis. Results: Of all participants, 7751 were Whites, and 2167 were Blacks. In the pooled sample and in the absence of interaction terms, high family conflict was associated with higher STBs. A statistically significant association was found between Black race and family conflict, suggesting that the association between family conflict and STBs is stronger in Black than White children. Conclusion: The association between family conflict and STBs is stronger in Black than White children. Black children with family conflict may be at a higher risk of STBs than White children with the same family conflict level. These findings align with the literature on the more significant salience of social relations as determinants of mental health of Black than White people. Reducing family conflict should be regarded a significant element of suicide prevention for Black children in the US.
Collapse
|
9
|
Race, Socioeconomic Status, and Cerebellum Cortex Fractional Anisotropy in Pre-Adolescents. ADOLESCENTS 2021; 1:70-94. [PMID: 34095893 DOI: 10.3390/adolescents1020007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction Cerebellum cortex fractional anisotropy is a proxy of the integrity of the cerebellum cortex. However, less is known about how it is shaped by race and socioeconomic status (SES) indicators such as parental education and household income. Purpose In a national sample of American pre-adolescents, this study had two aims: to test the effects of two SES indicators, namely parental education and household income, on cerebellum cortex fractional anisotropy, and to explore racial differences in these effects. Methods Using data from the Adolescent Brain Cognitive Development (ABCD) study, we analyzed the diffusion Magnetic Resonance Imaging (dMRI) data of 9565, 9-10-year-old pre-adolescents. The main outcomes were cerebellum cortex fractional anisotropy separately calculated for right and left hemispheres using dMRI. The independent variables were parental education and household income; both treated as categorical variables. Age, sex, ethnicity, and family marital status were the covariates. Race was the moderator. To analyze the data, we used mixed-effects regression models without and with interaction terms. We controlled for propensity score and MRI device. Results High parental education and household income were associated with lower right and left cerebellum cortex fractional anisotropy. In the pooled sample, we found significant interactions between race and parental education and household income, suggesting that the effects of parental education and household income on the right and left cerebellum cortex fractional anisotropy are all significantly larger for White than for Black pre-adolescents. Conclusions The effects of SES indicators, namely parental education and household income, on pre-adolescents' cerebellum cortex microstructure and integrity are weaker in Black than in White families. This finding is in line with the Marginalization-related Diminished Returns (MDRs), defined as weaker effects of SES indicators for Blacks and other racial and minority groups than for Whites.
Collapse
|
10
|
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.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
11
|
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.
Collapse
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;
| |
Collapse
|
12
|
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.
Collapse
|
13
|
Parental Education, Household Income, Race, and Children's Working Memory: Complexity of the Effects. Brain Sci 2020; 10:brainsci10120950. [PMID: 33297546 PMCID: PMC7762416 DOI: 10.3390/brainsci10120950] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/01/2020] [Accepted: 12/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background. Considerable research has linked social determinants of health (SDoHs) such as race, parental education, and household income to school performance, and these effects may be in part due to working memory. However, a growing literature shows that these effects may be complex: while the effects of parental education may be diminished for Blacks than Whites, household income may explain such effects. Purpose. Considering race as sociological rather than a biological construct (race as a proxy of racism) and built on Minorities' Diminished Returns (MDRs), this study explored complexities of the effects of SDoHs on children's working memory. Methods. We borrowed data from the Adolescent Brain Cognitive Development (ABCD) study. The total sample was 10,418, 9- and 10-year-old children. The independent variables were race, parental education, and household income. The primary outcome was working memory measured by the NIH Toolbox Card Sorting Test. Age, sex, ethnicity, and parental marital status were the covariates. To analyze the data, we used mixed-effect regression models. Results. High parental education and household income were associated with higher and Black race was associated with lower working memory. The association between high parental education but not household income was less pronounced for Black than White children. This differential effect of parental education on working memory was explained by household income. Conclusions. For American children, parental education generates unequal working memory, depending on race. This means parental education loses some of its expected effects for Black families. It also suggests that while White children with highly educated parents have the highest working memory, Black children report lower working memory, regardless of their parental education. This inequality is mainly because of differential income in highly educated White and Black families. This finding has significant public policy and economic implications and suggests we need to do far more than equalizing education to eliminate racial inequalities in children's cognitive outcomes. While there is a need for multilevel policies that reduce the effect of racism and social stratification for middle-class Black families, equalizing income may have more returns than equalizing education.
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
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.
Collapse
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
| | | |
Collapse
|
16
|
Assari S. Social Determinants of Delayed Gratification among American Children. CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES 2020; 6:181-189. [PMID: 33215045 DOI: 10.32598/cjns.6.22.2] [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
BACKGROUND A wide array of socioeconomic status (SES) indicators tend to show differential effects for members of diverse social groups. Limited knowledge exists on ethnic variation in the effects of family income on delay discounting which is predictor of risk behaviors. OBJECTIVES This study tested whether the effect of family income on delayed gratification differs between Latino and non-Latino children. METHODS AND MATERIALS In this cross-sectional analytical study, data came from wave one of the Adolescent Brain Cognitive Development (ABCD) study which included 3903 non-Latino or Latino Black or White American children between ages 9 and 10 years old. The predictor was family income. Data were collected in 21 sits in the US in 2018. The outcome was children's delay discounting. We measured delay discounting, which reflected individuals' tendency to assign less value to remote outcomes and rewards (inversely correlated with delayed gratification). Using SPSS 22.0, linear regression was used for data analysis. RESULTS According to our pooled sample regression, higher family income was associated with lower children delay discounting (Beta= -0.05, p = .021). We found a significant interaction between family income and ethnicity, suggesting that the association between family income and delay discounting is stronger for Latino than non-Latino children (Beta= -0.09, p = .043). CONCLUSIONS Not all ethnic disparities are due to SES gaps; differential returns of socioeconomic status indicators, such as family income, across diverse social groups also contribute to ethnic disparities in health.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
| |
Collapse
|