1
|
Assari S, Najand B, Sheikhattari P. Household Income and Subsequent Youth Tobacco Initiation: Minorities' Diminished Returns. JOURNAL OF MEDICINE, SURGERY, AND PUBLIC HEALTH 2024; 2:100063. [PMID: 38425566 PMCID: PMC10900246 DOI: 10.1016/j.glmedi.2024.100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Introduction Household income, a prominent socioeconomic status (SES) indicator, is known to mitigate youth engagement in various health risk behaviors, including tobacco use. Nevertheless, the Minorities' Diminished Returns theory suggests that this protective effect may be less pronounced for racial and ethnic minorities compared to majority groups. This study aimed to investigate the protective role of high household income against tobacco use among youth and explore potential variations across different racial and ethnic groups. Methods Conducted as a longitudinal analysis, this study utilized data from the initial three years of the Adolescent Brain Cognitive Development (ABCD) Study spanning 2016-2022. The cohort consisted of 11,875 American youth aged 9-10 years, tracked over a three-year period. The dependent variable was tobacco initiation, irrespective of the product, while household income served as the independent variable. Covariates included youth age, gender, family education, structure, and employment, with race/ethnicity acting as the moderating variable. Results Out of the 8,754 American youth who were non-smokers at baseline, 3.1% (n = 269) initiated tobacco use during the 30-month follow-up, while 96.9% (n = 8,485) remained non-smokers. A family income exceeding $100,000 per year was associated with a lower hazard ratio for tobacco initiation (transitioning to ever-use) over the follow-up period (HR = 0.620, p = 0.022). However, household income of $50-100k exhibited significant interactions with race/ethnicity on tobacco initiation, indicating weaker protective effects for Black (HR for interaction = 7.860, p < 0.001) and Latino (HR for interaction = 3.461, p = 0.001) youth compared to non-Latino White youth. Conclusions Within the United States, the racialization and minoritization of youth diminish the protective effects of economic resources, such as high household income, against the transition to tobacco use. Non-Latino White youth, the most socially privileged group, experience greater protection from their elevated household income regarding tobacco initiation compared to Black and Latino youth, who face minoritization and racialization. Policymakers should address not only the SES gap but also the mechanisms contributing to the heightened risk of tobacco use among racialized and minoritized youth from affluent backgrounds.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- 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
- Marginalization-related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
| | - Babak Najand
- Marginalization-related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
| | - Payam Sheikhattari
- Department of Behavioral Health Science, School of Community Health and Policy, Morgan State University, Baltimore, MD, United States
- Prevention Sciences Research Center, Morgan State University, Baltimore, MD, United States
| |
Collapse
|
2
|
Barsha RAA, Assari S, Hossain MB, Apata J, Sheikhattari P. Black Americans' Diminished Return of Educational Attainment on Tobacco Use in Baltimore City. J Racial Ethn Health Disparities 2023; 10:3178-3187. [PMID: 37755685 PMCID: PMC10645619 DOI: 10.1007/s40615-023-01805-0] [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: 06/23/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Socioeconomic status (SES) indicators such as educational attainment are fundamental factors affecting health. One mechanism through which education affects health is by reducing the likelihood of engaging in high-risk behaviors such as smoking. However, according to the marginalization-related diminished returns (MDRs) theory, the association between education and health may be weaker for marginalized populations such as Black than White, primarily due to racism and discrimination. However, little is known about the racial variations in the differential associations between educational attainment and tobacco use in a local setting. AIM This study aimed to investigate the differential association between educational attainment and tobacco use among racial groups in a community sample in Baltimore City. METHODS This cross-sectional study used data from a community survey conducted in 2012-2013 in Baltimore City among adults aged 18 years or older. The participants were 3501 adults. Univariate, bivariate, and logistic regression analyses were performed using Stata to investigate the racial difference in the association between education and two outcomes: current smoking status and menthol tobacco product use. RESULTS The study found that adults with a graduate degree were less likely to be current smokers (adjusted odds ratio [AOR]: 0.10, 95% confidence interval [CI]: 0.08-0.13) and menthol tobacco users (AOR: 0.10, 95% CI: 0.07-0.14) compared to those with less than high school diploma. The inverse associations between educational attainment and current smoking (AOR: 1.83, 95% CI: 1.05-3.21) and menthol tobacco product use (AOR: 4.73, 95% CI: 2.07-10.80) were weaker for Back individuals than those who were White. CONCLUSION Due to MDRs of educational attainment, while highly educated White adults show a low risk of tobacco use, educated Black adults remain at a disproportionately increased risk. The study emphasizes the need for better policies and programs that address minorities' diminished return of education for tobacco use.
Collapse
Affiliation(s)
- Rifath Ara Alam Barsha
- 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.
| | - Mian B Hossain
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - 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
| |
Collapse
|
3
|
Moghadam TZ, Zandian H, Fazlzadeh M, Kalan ME, Pourfarzi F. Socioeconomic and environmental factors associated with waterpipe tobacco smoking among Iranian adults: a PERSIAN cohort-based cross-sectional study. BMC Public Health 2023; 23:1295. [PMID: 37407959 DOI: 10.1186/s12889-023-16176-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) is associated with several deleterious health outcomes. We sought to estimate the prevalence of WTS and explore socioeconomic inequalities associated with this culturally-rooted tobacco smoking practice among Iranian adults. METHODS A cross-sectional analysis was conducted among 20,460 adults (ages 18 and older) enrolled in the PERSIAN cohort study during 2020. Data were collected on socioeconomic status (SES), lifestyle, alcohol consumption, cigarette smoking, and several risk factors related to non-communicable diseases. The concentration curve and relative concentration index (RCI) were administered to assess and quantify the SES-based inequality in WTS. RESULTS Overall age-adjusted prevalence of past-month WTS was 5.1% (95%CI:4.6-5.8), with about 1% for women and 10.6 for men. Age-adjusted prevalence of WTS was higher among younger adults, men, cigarette smokers, obese adults, and those with higher SES. The RCI estimation showed that WTS is more popular among adults with high income and education. WTS was higher among younger adults, cigarette smokers, obese adults, and those with higher SES. CONCLUSION There is a clear socioeconomic inequality in WTS, with a higher prevalence among adults with higher income and education. The findings suggest the need for targeted interventions to address this inequality and reduce the prevalence of WTS among high-income communities.
Collapse
Affiliation(s)
- Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK.
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| |
Collapse
|
4
|
Heley K, Popova L, Moran MB, Ben Taleb Z, Hart JL, Wackowski OA, Westling E, Smiley SL, Stanton CA. Targeted tobacco marketing in 2020: the case of #BlackLivesMatter. Tob Control 2023; 32:530-533. [PMID: 34907090 PMCID: PMC9295306 DOI: 10.1136/tobaccocontrol-2021-056838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, Kentucky, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Sabrina L Smiley
- Tobacco Center of Regulatory Science, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Cassandra A Stanton
- Behavioral Health & Health Policy, Westat, Rockville, Maryland, USA
- Georgetown University Medical Center, Washington, District of Columbia, USA
| |
Collapse
|
5
|
Adinkrah E, Najand B, Young-Brinn A, Salimi S. Association between School Achievement and Tobacco Susceptibility among US Adolescents: Ethnic Differences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:327. [PMID: 36832456 PMCID: PMC9955712 DOI: 10.3390/children10020327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Although risky behaviors such as educational problems and tobacco use tend to co-occur, these associations may vary across diverse ethnic groups, in part because ethnic minorities tend to reside in worse neighborhoods and tend to attend worse schools than Non-Latino White adolescents. AIM To compare the association between baseline school achievement (student grades) and subsequent tobacco use susceptibility (openness to smoke in future) by ethnicity, we compared African American, Latino, and Non-Latino White adolescents in the US over a four-year period. METHODS This longitudinal study followed 3636 adolescents who were never smokers at baseline for a period of four years. Baseline and four-year data of the Population Assessment of Tobacco and Health (PATH) study were used for this analysis. All participants were 12 to 17 years old at baseline and were either Non-Latino White (Majority), African American (Minority), or Latino (Minority). The outcome was a tobacco use susceptibility score at wave 4 which was defined as openness to use tobacco in the future, measured at year four. The predictor was school achievement at wave 1, measured as grades from F to A+. The moderator was ethnicity (African American, Latino, Non-Latino White), and covariates were age, gender, parental education, and family structure. RESULTS Our linear regressions in the pooled sample showed an inverse association between baseline school achievement and subsequent tobacco use susceptibility four years later. However, this inverse association was weaker for ethnic minorities than for Non-Latino White adolescents, as documented by interaction effects between ethnic minority status and baseline school grades. CONCLUSION Higher educational success better correlates with lower tobacco use susceptibility of non-Latino White than African American and Latino adolescents, which may reflect some tobacco use susceptibility of Latino and African American adolescents with highly educated parents. Future research should investigate how social context such as high-risk school environment, neighborhood risk, peer risk, and other mechanisms increase behavioral risk of educationally successful African American and Latino adolescents.
Collapse
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, 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
| | | |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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.
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, 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
| |
Collapse
|
8
|
Khayat S, Navaee M, Fanaei H, Khojasteh F. Waterpipe Smoking in Pregnant Women of Zahedan City in 2020: Prevalence and Associated Factors. Int J Prev Med 2022; 13:128. [PMID: 36452469 PMCID: PMC9704486 DOI: 10.4103/ijpvm.ijpvm_703_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/09/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Waterpipe smoking is associated with maternal and fetal complications, and valid data contribute to evidence-based planning. This study was conducted to determine the prevalence and factors related with waterpipe smoking among pregnant women of Zahedan city in 2020. METHODS This cross-sectional study was conducted in 2020, and 400 pregnant women in the third trimester of pregnancy who lived in Zahedan participated in it by single stage randomized cluster sampling. A questionnaire was used to measure awareness of waterpipe complications, and another one investigated the status of waterpipe smoking to collect data. For data analysis, descriptive statistics and multiple logistic regression were used through SPSS 21. RESULTS The findings indicated that the prevalence of waterpipe smoking was 18.8%. In the waterpipe smoking group, 46.6% smoked every day, 89.3% had tried to reduce the smoking, and 64.8% reported fetal death as their main motivation to reduce smoking. Only 5.6% of subjects stated receiving training as the reason for reduction of their waterpipe smoking. The women's level of education, economic status, ethnicity, and awareness of the risks of waterpipe smoking were the predictors for waterpipe smoking (P < 0.05, P = 0.03, P = 0.006, and P < 0.001, respectively). CONCLUSIONS The results of this study show the high prevalence of waterpipe smoking in pregnant women of Zahedan. Further investigation and training in this regard are essential for pregnancy as well as pre-pregnancy care. Special attention should be paid to groups with better economic status and level of education, Baluch women, and those with low level of awareness.
Collapse
Affiliation(s)
- Samira Khayat
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran,Address for correspondence: Dr. Samira Khayat, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. E-mail:
| | - Maryam Navaee
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamed Fanaei
- Department of Physiology, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farnoosh Khojasteh
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
9
|
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
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Assari S, Boyce S, Caldwell CH, Bazargan M. Parent Education and Future Transition to Cigarette Smoking: Latinos' Diminished Returns. Front Pediatr 2020; 8:457. [PMID: 32974240 PMCID: PMC7466764 DOI: 10.3389/fped.2020.00457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 06/30/2020] [Indexed: 12/15/2022] Open
Abstract
Background: High parent education is protective against youth health risk behaviors such as tobacco use. According to the Minorities' Diminished Returns theory, however, higher parent education seems to exert less protection for the ethnic minority relative to the majority groups. Objectives: To explore ethnic differences in the effects of parent education on the transition to cigarette smoking in a national sample of American never-smoker adolescents. Methods: This longitudinal study used data of waves 1 and 4 of the Population Assessment of Tobacco and Health (PATH 2013-2018). This analysis included 5,021 American youth who were never smokers at baseline (2013) and were followed for 4 years. Transition to cigarette smoking was the dependent variable. Parent education was the independent variable. Youth age, youth gender, and family structure were the covariates. Ethnicity was the moderating variable. Results: From the 5,021 American youth who were never smokers at baseline (2013), 89.4% continued as never smokers, and 10.6% became ever-smokers. Overall, 4.0% were current smokers at wave 4. Overall, a higher parent education was associated with lower odds of transitioning to ever and current cigarette smoker at the end of the 4th year. Parent education, however, showed significant interaction with Latino ethnicity on both outcomes suggesting smaller protective effects of high parent education against transitioning to tobacco use for Latino than for non-Latino youth. Conclusions: In the U.S., ethnicity alters the magnitude of the protective effect of parent education against youth transition to tobacco use. While high parent education is protective against transitioning to become a cigarette smoking overall, non-Latinos (a socially privileged group) gain more and Latino youth (a socially marginalized group) gain least from such a resource. In addition to addressing the SES gap, policymakers should identify and address mechanisms by which ethnic minority youth remain at risk of tobacco use, even when they are from highly educated families.
Collapse
Affiliation(s)
- Shervin Assari
- College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Shanika Boyce
- College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Mohsen Bazargan
- College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States.,Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|