1
|
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
|
2
|
França M, Dourado I, Grangeiro A, Greco D, Magno L. Racial HIV Testing Inequalities in Adolescent Men who have Sex with Men and Transgender Women in Three Brazilian Cities. AIDS Behav 2024:10.1007/s10461-024-04297-z. [PMID: 38526640 DOI: 10.1007/s10461-024-04297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/27/2024]
Abstract
Many barriers to human immunodeficiency virus (HIV) testing among Black people exist. This study analysed the association between race/skin colour and lifetime HIV testing among adolescent men who have sex with men (AMSM) and transgender women (ATGW) in three Brazilian cities. This cross-sectional study was nested within the PrEP1519 cohort, a multicentre study of AMSM and ATGW aged 15-19 years in Belo Horizonte, Salvador, and São Paulo, Brazil. The outcome variable was the lifetime HIV testing (no or yes). The main exposure variable was self-reported race/skin colour as White and a unique Black group (composed of Pardo-mixed colour and Black, according to the Brazilian classification). Descriptive statistics and bivariate and multiple logistic regression analyses were conducted to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) to determine the association between the main exposure and outcome, adjusted for covariates. White adolescents were tested more frequently than the unique Black group (64.0% vs. 53.7%, respectively; Ρ = 0.001). Multiple logistic regression analysis showed that the unique Black group of AMSM and ATGW had 26% (adjusted OR [aOR], 0.74; 95% CI, 0.55-0.98) and 38% (aOR, 0.62; 95% CI, 0.45-0.87) lower odds of being tested for HIV in a lifetime than Whites in model 1 and 2, respectively. Our findings highlight the role of racism in lifetime HIV testing among AMSM and ATGW. Therefore, an urgent need for advances exists in public policies to combat racism in Brazil.
Collapse
Affiliation(s)
- Marcus França
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Alexandre Grangeiro
- Faculdade de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Dirceu Greco
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
| |
Collapse
|
3
|
Tran MH, van Zwieten A, Kiely KM, Blyth FM, Naganathan V, Le Couteur DG, Handelsman DJ, Seibel MJ, Waite LM, Cumming RG, Khalatbari-Soltani S. Intra-generational social mobility and mortality among older men in the Concord Health and Ageing in Men Project: A cohort study. SSM Popul Health 2024; 25:101581. [PMID: 38264197 PMCID: PMC10803938 DOI: 10.1016/j.ssmph.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives We examined associations between intra-generational social mobility (reflected in life-course socioeconomic trajectories) and mortality, among older men. Methods Data came from a prospective Australian community-based cohort of older men. Social mobility was defined by socioeconomic indicators from three points in the life-course: educational attainment (late adolescence-early adulthood), occupation (mid-life), and current sources of income (older age). We defined indicators of social mobility trajectory (6 categories; reflecting the direction of social mobility) and social mobility status (2 categories; mobile or non-mobile). We used Cox regression to examine associations with mortality, adjusting for age, country of birth, and living arrangement. Results We followed 1568 men (mean age 76.8, SD 5.4) for a mean duration of 9.1 years, with 797 deaths recorded. Moving upward was the predominant social mobility trajectory (36.0%), followed by mixed trajectories (25.1%), downward (15.1%), stable low (12.2%), stable high (7.6%), and stable middle (4.0%). Men with downward (Hazard ratio 1.58, 95% CI 1.13 to 2.19) and stable low socioeconomic trajectories (1.77, 1.25 to 2.50) had higher mortality risks than men with stable high socioeconomic trajectories, while men with upward trajectories had similar risks to those with stable high trajectories. 76.2% of the participants were classified as having mobile status; no associations were evident between binary social mobility status and mortality. Discussions These findings suggest cumulative and persistent exposure to disadvantaged socioeconomic conditions across the life-course, rather than social mobility, is associated with increased mortality. For each stage of the life-course, addressing socioeconomic disadvantage may reduce inequities in mortality.
Collapse
Affiliation(s)
- Minh-Hoang Tran
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- NTT Hi-Tech Institute, Nguyen Tat Thanh University, HCMC, Viet Nam
| | - Anita van Zwieten
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Kim M. Kiely
- Ageing Futures Institute, University of New South Wales (UNSW), Sydney, (NSW), Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
- School of Health and Society and School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, (NSW), Australia
| | - Fiona M. Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - David G. Le Couteur
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Markus J. Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | - Louise M. Waite
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- Centre for Education and Research on Ageing, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation and General Hospital, Sydney Local Health District, Concord, New South Wales, Australia
| | - Robert G. Cumming
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
4
|
Siddiq H, Maharlouei N, Najand B, Rahmani A, Zare H. Immigration Status, Educational Level, and Perceived Discrimination in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2222. [PMID: 36767588 PMCID: PMC9915095 DOI: 10.3390/ijerph20032222] [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: 11/24/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
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.
Collapse
Affiliation(s)
- Hafifa Siddiq
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Najmeh Maharlouei
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Arash Rahmani
- Marginalization-Related Diminished Returns, 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, MD 20783, USA
| |
Collapse
|
5
|
Schweiger JI, Capraz N, Akdeniz C, Braun U, Ebalu T, Moessnang C, Berhe O, Zang Z, Schwarz E, Bilek E, Meyer-Lindenberg A, Tost H. Brain structural correlates of upward social mobility in ethnic minority individuals. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2037-2047. [PMID: 34383084 PMCID: PMC9477908 DOI: 10.1007/s00127-021-02163-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 07/31/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Perigenual anterior cingulate cortex (pACC) is a neural convergence site for social stress-related risk factors for mental health, including ethnic minority status. Current social status, a strong predictor of mental and somatic health, has been related to gray matter volume in this region, but the effects of social mobility over the lifespan are unknown and may differ in minorities. Recent studies suggest a diminished health return of upward social mobility for ethnic minority individuals, potentially due to sustained stress-associated experiences and subsequent activation of the neural stress response system. METHODS To address this issue, we studied an ethnic minority sample with strong upward social mobility. In a cross-sectional design, we examined 64 young adult native German and 76 ethnic minority individuals with comparable sociodemographic attributes using whole-brain structural magnetic resonance imaging. RESULTS Results showed a significant group-dependent interaction between perceived upward social mobility and pACC gray matter volume, with a significant negative association in the ethnic minority individuals. Post-hoc analysis showed a significant mediation of the relationship between perceived upward social mobility and pACC volume by perceived chronic stress, a variable that was significantly correlated with perceived discrimination in our ethnic minority group. CONCLUSION Our findings extend prior work by pointing to a biological signature of the "allostatic costs" of socioeconomic attainment in socially disadvantaged upwardly mobile individuals in a key neural node implicated in the regulation of stress and negative affect.
Collapse
Affiliation(s)
- Janina I Schweiger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany.
| | - Necip Capraz
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Ceren Akdeniz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Tracie Ebalu
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Zhenxiang Zang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Edda Bilek
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| |
Collapse
|
6
|
Camelo LV, Coelho CG, Chor D, Griep RH, Almeida MDCCD, Giatti L, Barreto SM. Racismo e iniquidade racial na autoavaliação de saúde ruim: o papel da mobilidade social intergeracional no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). CAD SAUDE PUBLICA 2022; 38:e00341920. [DOI: 10.1590/0102-311x000341920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/11/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo: Pretos e pardos apresentam grandes desvantagens de saúde, possuem menores chances de ascensão na hierarquia social no curso de vida e menores níveis socioeconômicos do que brancos como resultado do racismo estrutural. Entretanto, pouco se sabe sobre o papel mediador da mobilidade intergeracional na associação entre racismo e saúde. O objetivo do presente estudo foi investigar a associação entre racismo e a autoavaliação de saúde, e verificar em que medida a mobilidade social intergeracional media essa associação. Estudo transversal realizado com dados de 14.386 participantes da linha de base (2008-2010) do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Escolaridade materna, escolaridade do participante, classe sócio-ocupacional do chefe de família e classe sócio-ocupacional do participante compuseram os indicadores de mobilidade social intergeracional (educacional e sócio-ocupacional). Modelos de regressão logística foram utilizados. A prevalência de autoavaliação de saúde ruim foi de 15%, 24% e 28% entre brancos, pardos e pretos, respectivamente. Após ajustes por idade, sexo e centro de investigação foram encontradas maiores chances de autoavaliação de saúde ruim entre pretos (OR = 2,15; IC95%: 1,92-2,41) e pardos (OR = 1,82; IC95%: 1,64-2,01) quando comparados aos brancos. A mobilidade educacional e sócio-ocupacional intergeracional mediaram, respectivamente, 66% e 53% da associação entre a raça/cor e autoavaliação de saúde ruim em pretos, e 61% e 51% em pardos, respectivamente. Resultados confirmam a iniquidade racial na autoavaliação de saúde e apontam que a mobilidade social intergeracional desfavorável é um importante mecanismo para explicar essa iniquidade.
Collapse
|
7
|
Weissberger GH, Núñez RA, Tureson K, Gold A, Thames AD. Socioeconomic Mobility and Psychological and Cognitive Functioning in a Diverse Sample of Adults With and Without HIV. Psychosom Med 2021; 83:218-227. [PMID: 33793453 DOI: 10.1097/psy.0000000000000929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This cross-sectional study examined the effects of socioeconomic status (SES) mobility from childhood to adulthood on psychological and cognitive well-being in African American and non-Hispanic White HIV-positive (HIV+) and HIV-seronegative (HIV-) adults who are part of an ongoing study investigating psychosocial and neurobehavioral effects of HIV. METHODS Participants (N = 174, 24.1% female, 59.2% African American, 67.8% HIV+) were categorized into four groups (upward mobility, downward mobility, stable-not-poor, chronic-poverty) based on self-reported childhood and current community SES (which were correlated with objective measures of SES and proxies of childhood SES). SES groups were compared on self-report measures of psychological well-being, subjective executive functioning ratings, and performance across six cognitive domains. Primary analyses were stratified by HIV status. RESULTS For the HIV+ group, SES mobility was associated with psychological well-being (chronic burden of stress: F(7,101) = 3.17, mean squared error [MSE] = 49.42, p = .030, η2 = 0.14; depressive symptoms: F(7,101) = 4.46, MSE = 70.49, p = .006,η2 = 0.14), subjective ratings of executive dysfunction (F(7,101) = 6.11, MSE = 114.29, p = .001,η2 = 0.18), and objective performance in executive functioning (F(9,99) = 3.22, MSE = 249.52, p = .030, η2 = 0.15) and learning (F(9,99) = 3.01, MSE = 220.52, p = .034, η2 = 0.13). In the control group, SES mobility was associated with chronic stress burden (F(5,49) = 4.677, p = .025, η2 = 0.15); however, no other relationships between SES mobility and outcomes of interest were observed (all p values > .20). In general, downward mobility and chronic poverty were associated with worse ratings across psychological well-being measures and cognitive performance. CONCLUSIONS Findings within the HIV+ group are consistent with previous studies that report downward mobility to be associated with poor psychological outcomes. People living with HIV may be particularly vulnerable to the adverse effects of socioeconomic instability.
Collapse
Affiliation(s)
- Gali H Weissberger
- From the Department of Family Medicine (Weissberger), USC Keck School of Medicine, Alhambra, California; Interdisciplinary Department of Social Sciences (Weissberger), Bar Ilan University, Ramat Gan, Israel; Department of Psychology (Núñez, Tureson, Gold, Thames), USC Dornsife College of Letters, Arts, and Sciences; and Department of Psychiatry and Behavioral Sciences (Thames), USC Keck School of Medicine, Los Angeles, California
| | | | | | | | | |
Collapse
|
8
|
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
|
9
|
Savitsky B, Manor O, Lawrence G, Friedlander Y, Siscovick DS, Hochner H. Environmental mismatch and obesity in humans: The Jerusalem Perinatal Family Follow-Up Study. Int J Obes (Lond) 2021; 45:1404-1417. [PMID: 33762678 DOI: 10.1038/s41366-021-00802-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND According to the hypothesis of Gluckman and Hanson, mismatch between the developmental and postdevelopmental environments may lead to detrimental health impacts such as obesity. While several animal studies support the mismatch theory, there is a scarcity of evidence from human-based studies. OBJECTIVES Our study aims to examine whether a mismatch between the developmental and young-adult environments affect obesity in young adults of the Jerusalem Perinatal Family Follow-Up Study. METHODS Data from The Jerusalem Perinatal Family Follow-Up Study birth cohort was used to characterize early and late environments using offspring and parental sociodemographic and lifestyle information at birth, age 32 (n = 1140) and 42 (n = 404). Scores characterizing the early and late environments were constructed using factor analysis. To assess associations of mismatch with obesity, regression models were fitted using the first factor of each environment and adiposity measures at age 32 and 42. RESULTS Having a stable non-beneficial environment at birth and young-adulthood was most strongly associated with increased adiposity, while a stable beneficial environment was most favorable. The transition from a beneficial environment at birth to a less beneficial environment at young-adulthood was associated with higher obesity measures, including higher BMI (β = 0.979; 95% CI: 0.029, 1.929), waist circumference (β = 2.729; 95% CI: 0.317, 5.140) and waist-hip ratio (β = 0.017; 95% CI: 0.004, 0.029) compared with those experiencing a beneficial environment at both time points. Transition from a less beneficial environment at birth to a beneficial environment at adulthood was also associated with higher obesity measurements (BMI -β = 1.116; 95% CI: 0.085, 2.148; waist circumference -β = 2.736; 95% CI: 0.215, 5.256). CONCLUSIONS This study provides some support for the mismatch hypothesis. While there is indication that an accumulation of the effects of the non-beneficial environment has the strongest detrimental impact on obesity outcomes, our results also indicate that a mismatch between the developmental and later environments may result in maladaptation of the individual leading to obesity.
Collapse
Affiliation(s)
- B Savitsky
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel. .,Ashkelon Academic College, School of Health Sciences, Ashkelon, Israel.
| | - O Manor
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - G Lawrence
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Y Friedlander
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - H Hochner
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| |
Collapse
|
10
|
Assari S, Cochran SD, Mays VM. Money Protects White but Not African American Men against Discrimination: Comparison of African American and White Men in the Same Geographic Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052706. [PMID: 33800177 PMCID: PMC7967423 DOI: 10.3390/ijerph18052706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022]
Abstract
To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men’s cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men’s physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA;
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
| | - Susan D. Cochran
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1772, USA
- Department of Statistics, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1554, USA
| | - Vickie M. Mays
- UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA;
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1772, USA
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1563, USA
- Correspondence: ; Tel.: +1-310-206-5159
| |
Collapse
|
11
|
Assari S, Mardani A, Maleki M, Boyce S, Bazargan M. Black-White Achievement Gap: Role of Race, School Urbanity, and Parental Education. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:1-11. [PMID: 33442317 PMCID: PMC7797342 DOI: 10.2147/phmt.s238877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/02/2020] [Indexed: 11/23/2022]
Abstract
Background Recent research on Marginalization-related Diminished Returns (MDRs) has documented weaker boosting effects of parental educational attainment on educational outcomes of Black than White students. Such MDRs of parental education seem to contribute to the Black-White achievement gap. Given that Blacks are more likely than Whites to attend urban schools, there is a need to study if these MDRs can be replicated at both urban and suburban schools. Aim To test the contribution of diminished returns of parental educational attainment on the Black-White achievement gap in urban and suburban American high schools. Methods A cross-sectional study that used baseline Education Longitudinal Study (ELS-2002) data, a nationally representative study of 10th grade adolescents in the United States. This study analyzed 8315 youths who were either non-Hispanic White (n = 6539, 78.6%) or non-Hispanic Black (n = 1776, 21.4%) who were attending either suburban (n = 5188, 62.4%) or urban (n = 3127, 37.6%) schools. The outcome was standard math and reading grades. The independent variable was parental educational attainment. Gender, parental marital status, and school characteristics (% free lunch and relationship quality with the teacher) were the confounders. Race/ethnicity was the effect of modifier. School urbanity was the strata. Linear regression was used for data analysis. Results In urban and suburban schools, higher parental educational attainment was associated with higher math and reading test scores. In urban and suburban schools, Black students had considerably lower reading and math scores than White students. At urban but not suburban schools, significant interactions were found between race (Non-Hispanic Black) and parental education attainment (years of schooling) on reading and math scores, suggested that the protective effect of parental education on students’ reading and math scores (ie school achievement) is smaller for Non-Hispanic Black relative to Non-Hispanic White youth only in urban but not sub-urban schools. Conclusion Diminished returns of parental education (MDRs) contribute to the racial achievement gap in urban but not suburban American high schools. This result is important given Black students are more likely to attend urban schools than White students. As MDRs are not universal and depend on context, future research should study contextual characteristics of urban schools that contribute to MDRs.
Collapse
Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Abbas Mardani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Shanika Boyce
- Departments of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Departments of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.,Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| |
Collapse
|
12
|
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
|
13
|
Assari S, Ayoubian A, Caldwell CH. Comparison of European, African, Asian, and Other/Mixed Race American Children for the Association Between Household Income and Perceived Discrimination. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2020; 9:31-38. [PMID: 34307699 DOI: 10.34172/ijtmgh.2021.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction Perceived discrimination is one of the reasons behind racial/ethnic health disparities. However, less is known about racial and ethnic groups differ in social determinants of discrimination. This study aimed to compare the association between household income and perceived discrimination among American children of different racial/ethnic groups. Methods The Adolescent Brain Cognitive Development (ABCD) study, a national longitudinal study, followed 4383 children 9-10 years old who were either European American, African American, Asian American, or mixed/other race for one year. We compared racial and ethnic groups for the association between baseline household income and perceived discrimination at the end of one year follow up. We used ANOVA and linear regression for data analysis. The outcome was perceived discrimination. The predictor was household income. Covariates were age, gender, and parental marital status. The moderator was race/ethnicity. Results In the total sample, high household income was associated with less perceived discrimination. There was an interaction between race and household income, suggesting a difference in the association between household income and perceived discrimination between African American and European American children. The inverse association between household income and perceived discrimination was weaker for African American than European American children. Conclusion High-income African American children are not well protected against perceived discrimination. High exposure to perceived discrimination may explain the worse expected health and development of middle-class African American children. As discrimination is a major social determinant of health, the results have considerable implications for public and health policy.
Collapse
Affiliation(s)
- Shervin Assari
- 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
| | - Ali Ayoubian
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, University of Michigan, Ann Arbor, MI 48109, USA.,Center for Research on Ethnicity, Culture, and Health, University of Michigan, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|
14
|
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
|
15
|
Abstract
While increased household income is associated with overall decreased screen time for children, less is known about the effect of racial variation on this association. According to Minorities' Diminished Returns (MDRs) theory, family income and other economic resources show weaker association with children's developmental, behavioral, and health outcomes for racialized groups such as black families, due to the effect of racism and social stratification. In this study, we investigated the association, by race, between family income and children's screen time, as a proxy of screen time. This longitudinal study followed 15,022 American children aged 9-11 over a 1-year period. The data came from the baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was family income, and it was categorized as a three-level nominal variable. The dependent variable, screen time, was a continuous variable. Ethnicity, gender, parental education, and marital status were the covariates. The results showed that family income was inversely associated with children's screen time. However, there was a weaker inverse association seen in black families when compared with white families. This was documented by a significant statistical interaction between race and family income on children's screen time. Diminished association between family income and children's screen time for black families, compared with white families, is similar to MDRs and reflects a health risk to high-income black children. In a society where race and skin color determine opportunities and treatment by society, children from middle class black families remain at risk across multiple domains. We should not assume that income similarly promotes the health of all racial and ethnic groups. Addressing health and behavioral inequalities requires interventions that go beyond equalizing socioeconomic resources for black families. Marginalization, racism, and poverty interfere with the normal family income-related development of American children.
Collapse
|
16
|
Subjective Socioeconomic Status and Children's Amygdala Volume: Minorities' Diminish Returns. NEUROSCI 2020; 1:59-74. [PMID: 33103157 DOI: 10.3390/neurosci1020006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Considerable research has suggested that low socioeconomic status (SES) negatively influences brain structure, including but not limited to decreased amygdala volume. Considering race and ethnicity as sociological rather than biological constructs, this study was built on minorities' diminished returns (MDRs) to test if the effects of family SES on the total amygdala volume is weaker for black and Latino children than white and non-Latino children. We borrowed data from the Adolescent Brain Cognitive Development (ABCD) study, a national multi-center brain imaging investigation of childhood brain development in the US. The total sample was 9380 9-10-year-old children. The independent variables were subjective family SES and parental education. The primary outcome was total amygdala volume. High subjective SES and parental education were independently associated with larger total amygdala size. The association between high subjective SES and larger total amygdala volume was less pronounced for black and Latino children than white and non-Latino children. For American children, family SES has unequal effects on amygdala size and function, a pattern that is consistent with MDRs. This result suggests that SES loses some of its expected effects for racial and ethnic minority families.
Collapse
|
17
|
Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. Parental Human Capital and Adolescents' Executive Function: Immigrants' Diminished Returns. MEDICAL RESEARCH ARCHIVES 2020; 8:10.18103/mra.v8i10.2235. [PMID: 33251336 PMCID: PMC7695233 DOI: 10.18103/mra.v8i10.2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Racial minorities, particularly non-Hispanic Blacks in the US, experience weaker effects of family socioeconomic position (SEP) on tangible outcomes, a pattern called Minorities' Diminished Returns (MDRs). These MDRs are frequently shown for the effects of family SEP on immigrant adolescents' school performance. As a result of these MDRs, immigrant adolescents from high SEP families show worse than expected cognitive outcomes, including but not limited to poor school performance. However, the existing knowledge is minimal about the role of executive function in explaining diminished returns of family SEP on adolescents' outcomes. To investigate racial differences in the effects of parental human capital on adolescents' executive function, we compared non-Hispanic White non-immigrant and immigrant adolescents for the effect of parental human capital on adolescents' executive function. This was a cross-sectional analysis that included 2,723 non-twin non-Hispanic White adolescents from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental human capital (parental educational attainment), treated as a continuous measure with a higher score reflecting higher subjective socioeconomic status. The primary outcome was adolescents' executive function measured by the stop-signal task (SST). Age, sex, parental marital status, parental employment, family income, and financial difficulties. Immigration status was the effect modifier. Overall, high parental human capital was associated with higher task-based executive function. Immigration status showed statistically significant interactions with parental human capital on adolescents' executive function outcomes. This interaction term suggested that high parental human capital has a smaller effect on increasing immigrants' executive function compared to non-immigrant adolescents. The boosting effect of parental human capital on executive function is diminished for immigrants compared to non-immigrant adolescents. To minimize the inequalities in executive function-related outcomes such as school performance, we need to address the diminishing returns of existing resources for immigrants. Not only should we equalize groups based on their SEP but also equalize the marginal returns of their existing SEP. Such efforts require public policies that aim for equal processes. As such, social policies should address structural and societal barriers such as xenophobia, segregation, racism, and discrimination that hinder immigrant families' ability to effectively utilize their resources. In a fair society, immigrant and non-immigrant families should be equally able to leverage their SEP resources and turn them into tangible outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Golnoush Akhlaghipour
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
18
|
Assari S. Social Epidemiology of Perceived Discrimination in the United States: Role of Race, Educational Attainment, and Income. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2020; 7:136-141. [PMID: 33094165 DOI: 10.34172/ijer.2020.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background and aims This study aimed to compare non-Hispanic Black (NHB) and non-Hispanic White (NHW) American adults for the associations of educational attainment and household income with perceived racial discrimination. Methods The 2010 National Alcohol Survey (NAS N12), a nationally representative study, included 2635 adults who were either NHB (n = 273) or NHW (n = 2362). We compared NHBs and NHWs for the associations between education, income, and perceived racial discrimination. We used linear regression for data analysis. Outcome was perceived racial discrimination; the predictors were educational attainment and household income; covariates were age and gender; and moderator was race. Results In the total sample, high income was associated with lower levels of perceived racial discrimination, while educational attainment was not significantly associated with perceived racial discrimination. There was also an interaction between race and education but not household income, suggesting a difference in the association between educational attainment and perceived racial discrimination between NHB and NHW individuals. For NHW individuals, household income was inversely associated with perceived racial discrimination. For NHB individuals, however, household income was not related to perceived racial discrimination. For NHB but not NHW individuals, educational attainment was correlated with more not less perceived racial discrimination. Conclusion High income protects NHW but not NHB individuals against perceived racial discrimination, and NHB individuals with high education levels report more not less perceived racial discrimination.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
19
|
Maternal Education at Birth and Youth Breakfast Consumption at Age 15: Blacks' Diminished Returns. J 2020; 3:313-323. [PMID: 33015572 DOI: 10.3390/j3030024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
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.
Collapse
|
20
|
Assari S. Protective Effects of Maternal Education against Low Birth Weight Deliveries: Blacks' Diminished Returns. ACTA ACUST UNITED AC 2020; 5:1-17. [PMID: 33117952 DOI: 10.22158/rhs.v5n4p1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Racial and economic disparities in low birth weight (LBW) deliveries is among the most well-established differences between Blacks and Whites. As LBW is an established risk factor for chronic diseases such as asthma and diabetes, it is particularly important to understand drivers of racial and economic disparities in LBW deliveries in urban areas. Aims Built on the Minorities' Diminished Returns framework, which argues that educational attainment generates fewer positive health outcomes for Black than White Americans, we conducted this study with three aims: 1) to test the association between mothers' educational attainment and LBW of babies born in urban areas, 2) to compare Blacks and Whites for the effect of mothers' educational attainment on LBW, and 3) to test whether LBW is predictive of future chronic diseases 15 years later. Methods Data came from the Fragile Families and Child Well-being / included a random sample of births in cities larger than 200,000 population. For the aims 1 and 2, we analyzed data of 2,922 births to Black (n = 2,146) or White (n = 776) mothers. For aim 3, we analyzed data of a subsample of 1,604 Black or White newborns who were followed to age 15. The presence or absence of chronic diseases was determined at age 15. Logistic regression was used for data analysis. Results Maternal educational attainment was inversely associated with LBW overall. We, however, found a significant interaction between maternal educational attainment and race, suggesting that the inverse association between maternal education and LBW is weaker for Black than White babies. At the same time, LBW increased the odds of chronic disease 15 years later. Conclusions Diminished returns of maternal educational attainment contribute to racial disparities in LBW, which in turn contributes to future racial inequalities in chronic diseases in urban settings. That is, smaller protective effects of maternal education on reducing LBW for Black than White children contribute to the high prevalence of chronic diseases among adolescents in urban settings. Health disparities are not just due to racial differences in socioeconomic status but also diminishing returns of socioeconomic status indicators such as education for racial and ethnic minorities. Research should study contextual factors that reduce Blacks' ability to translate their human capital to health outcomes in urban settings.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA.,Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA
| |
Collapse
|
21
|
Assari S, Boyce S, Bazargan M. Subjective Family Socioeconomic Status and Adolescents' Attention: Blacks' Diminished Returns. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7080080. [PMID: 32718077 PMCID: PMC7464278 DOI: 10.3390/children7080080] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/26/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023]
Abstract
Background: Racial minorities, particularly non-Hispanic blacks (NHBs) in the US, experience weaker effects from their families' socioeconomic status on tangible outcomes, a pattern called the Minorities' Diminished Returns (MDRs) theory. These MDRs are frequently shown in the effects of the families' socioeconomic status (SES) on NHB adolescents' school performance. As a result of these MDRs, NHB adolescents from high SES families show a worse than expected school performance. The existing knowledge is, however, minimal about the role of attention in explaining the diminished returns of the families' SES with regard to the adolescents' outcomes. Aim: To investigate the racial differences in the effects of the subjective family SES on adolescents' attention, we compared non-Hispanic white (NHW) and NHB adolescents to assess the effect of the subjective family SES on adolescents' attention. Methods: This was a cross-sectional analysis that included 4188 adolescents from the Adolescent Brain Cognitive Development (ABCD) Study. The independent variable was the subjective family SES. The primary outcome was the adolescents' attention to be measured by the stop-signal task (SST). The attention domain of the Child Behavior Checklist (CBCL) was also measured. Results: Overall, a high subjective family SES was associated with a higher task-based and CBCL-based attention. Race showed statistically significant interactions with subjective family SES in terms of adolescents' attention outcomes. These interactions suggested that a high subjective family SES has smaller tangible effects on increasing the attention of NHB than NHW adolescents. Conclusion: The boosting effect of subjective family SES on attention is diminished for NHB rather than NHW adolescents. To minimize the racial gap in attention-related behaviors, such as school performance, we need to address the diminished returns of resources in the lives of NHB families. Not only should we equalize SES, but also increase the marginal returns of SES for racial minorities, particularly NHB families. Such efforts require public policies that empower NHB families to better leverage their SES resources and turn them into tangible outcomes. In addition, social policies should directly aim to alter the societal barriers that limit NHB families' ability to effectively utilize their resources. Discrimination, segregation, and racism should be targets of our policy solutions.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Correspondence: ; Tel.: +1-734-232-0445; Fax: +1-734-615-8739
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Department of Family Medicine, University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
22
|
Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. African American Children's Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E75. [PMID: 32660094 PMCID: PMC7401867 DOI: 10.3390/children7070075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
Background: Reward sensitivity (fun-seeking) is a risk factor for a wide range of high-risk behaviors. While high socioeconomic status (SES) is known to reduce reward sensitivity and associated high-risk behaviors, less is known about the differential effects of SES on reward sensitivity. It is plausible to expect weaker protective effects of family SES on reward sensitivity in racial minorities, a pattern called Minorities' Diminished Returns (MDRs). Aim: We compared Caucasian and African American (AA) children for the effects of subjective family SES on children's fun-seeking. Methods: This was a cross-sectional analysis of 7061 children from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was subjective family SES. The main outcome was children's fun-seeking measured by the behavioral approach system (BAS) and behavioral avoidance system (BIS). Age, gender, marital status, and household size were the covariates. Results: In the overall sample, high subjective family SES was associated with lower levels of fun-seeking. We also found a statistically significant interaction between race and subjective family SES on children's fun-seeking in the overall sample, suggesting that high subjective family SES is associated with a weaker effect on reducing fun-seeking among AA than Caucasian children. In race-stratified models, high subjective family SES was protective against fun-seeking of Caucasian but not AA children. Conclusion: Subjective family SES reduces the fun-seeking for Caucasian but not AA children.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Cleopatra H. Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA;
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
23
|
Cuevas AG, Greatorex-Voith S, Abuelezam N, Eckert N, Assari S. Educational mobility and telomere length in middle-aged and older adults: testing three alternative hypotheses. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 66:220-235. [PMID: 34583600 DOI: 10.1080/19485565.2021.1983760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Critical period, social mobility, and social accumulation are three hypotheses that may explain how educational mobility impacts health. Thus far, there is little evidence on how these processes are associated with biological aging as measured by telomere length. Using cross-sectional data from the 2008 Health and Retirement Study, we examined the association between educational mobility (parental education and contemporaneous education) and telomere length. The final model is adjusted for sociodemographic factors and socioeconomic status, childhood adversity, and health behaviors/risk factors, as well as depressive symptoms. A total of 1,894 participants were included in the main analyses. High parental education was associated with longer telomere length in a fully adjusted model (B = 0.03, CI [0.002,0.07]). Downwardly mobile individuals (high parental education and low contemporaneous education) had longer telomere length compared to stably low individuals in a fully adjusted model (B = 0.05, CI [0.004,0.09]). There was support for the critical period hypothesis and partial support for the change hypothesis. There was no evidence to support the social accumulation hypothesis. Prospective studies are needed to understand the mechanism that can help further explain the association between educational mobility and telomere length.
Collapse
Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, Medford, MA
| | | | - Nadia Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, Ma, USA
| | - Natalie Eckert
- Department of Community Health, Tufts University, Medford, MA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| |
Collapse
|
24
|
Assari S. Parental Education and Spanking of American Children: Blacks' Diminished Returns. ACTA ACUST UNITED AC 2020; 7:19-44. [PMID: 32734000 DOI: 10.22158/wjer.v7n3p19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
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.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
| |
Collapse
|
25
|
Abstract
Background Based on the Minorities' Diminished Returns (MDRs) framework, indicators of high socioeconomic status (SES), such as high maternal educational attainment, show weaker protective effects on various developmental, behavioral, and health outcomes for Black than White families. As a result of these MDRs, families and individuals with high educational attainment still report high levels of depression, smoking, obesity, and chronic disease. Limited knowledge exists on MDRs of maternal education on indicators of wealth such as home ownership and home value. Aims Built on the MDRs framework, we tested the hypothesis of whether the effects of maternal educational attainment at birth on home ownership and home value, as proxies of wealth, vary between Black and White families. We hypothesized that: 1) high maternal education would be associated with more wealth 15 years later, and 2) compared to Whites, Blacks would be less likely to accumulate wealth (own a house) across all educational levels, given a weaker boosting effect of maternal educational attainment on wealth for Black than White families. Methods The Fragile Families and Child Well-being Study, is a 15-year follow up study of a random sample of births in cities larger than 200,000 population in the US. A total number of 2004 White or Black youth were included and were followed from birth to the age of 15. The predictor of interest was maternal educational attainment at birth, treated as a categorical variable (college graduation). The outcomes were home ownership and home value (worth - owed) 15 years later, as proxies of wealth. Logistic and linear regression were used for data analysis. Results High maternal education at birth was associated with home ownership and higher value of owned home at age 15. We also found that maternal educational attainment at birth and race interact with each other, suggesting that the effects of high maternal educational attainment at birth on home ownership/value at age 15 were weaker for Black than White families. Conclusions Diminished returns of maternal educational attainment at birth on wealth accumulation in Black families may be a mechanism that contributes to racial health disparities in high socioeconomic status and also poor outcomes of high SES Black families. That is, a smaller effect of maternal educational attainment on changing the real lives of Black than White youth may be one of the mechanisms by which health remains worse than expected in high SES Black families. Not all of the health, behavioral, and developmental disparities are due to the racial gap in SES but also diminishing returns of socioeconomic status indicators such as maternal educational attainment for racial minorities. Research should study how social stratification, discriminatory mortgage and banking, residential segregation, family formation, employment, and occupational prestige reduce Black families' ability to mobilize their human capital and secure tangible economic and non-economic outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
| |
Collapse
|
26
|
Assari S, Boyce S, Akhlaghipour G, Bazargan M, Caldwell CH. Reward Responsiveness in the Adolescent Brain Cognitive Development (ABCD) Study: African Americans' Diminished Returns of Parental Education. Brain Sci 2020; 10:E391. [PMID: 32575523 PMCID: PMC7349244 DOI: 10.3390/brainsci10060391] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 02/08/2023] Open
Abstract
(1) Background: Reward responsiveness (RR) is a risk factor for high-risk behaviors such as aggressive behaviors and early sexual initiation, which are all reported to be higher in African American and low socioeconomic status adolescents. At the same time, parental education is one of the main drivers of reward responsiveness among adolescents. It is still unknown if some of this racial and economic gap is attributed to weaker effects of parental education for African Americans, a pattern also called minorities' diminished returns (MDRs). (2) Aim: We compared non-Hispanic White and African American adolescents for the effects of parent education on adolescents RR, a psychological and cognitive construct that is closely associated with high-risk behaviors such as the use of drugs, alcohol, and tobacco. (3) Methods: This was a cross-sectional analysis that included 7072 adolescents from the adolescent brain cognitive development (ABCD) study. The independent variable was parent education. The main outcome as adolescents' RR measured by the behavioral inhibition system (BIS) and behavioral activation system (BAS) measure. (4) Results: In the overall sample, high parent education was associated with lower levels of RR. In the overall sample, we found a statistically significant interaction between race and parent education on adolescents' RR. The observed statistical interaction term suggested that high parent education is associated with a weaker effect on RR for African American than non-Hispanic White adolescents. In race-stratified models, high parent education was only associated with lower RR for non-Hispanic White but not African American adolescents. (5) Conclusion: Parent education reduces RR for non-Hispanic White but not African American adolescents. To minimize the racial gap in brain development and risk-taking behaviors, we need to address societal barriers that diminish the returns of parent education and resources in African American families. We need public and social policies that target structural and societal barriers, such as the unequal distribution of opportunities and resources. To meet such an aim, we need to reduce the negative effects of social stratification, segregation, racism, and discrimination in the daily lives of African American parents and families. Through an approach like this, African American families and parents can effectively mobilize their resources and utilize their human capital to secure the best possible tangible outcomes for their adolescents.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra H. Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA;
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
27
|
Martinez-Escudero JA, Villarejo S, Garcia OF, Garcia F. Parental Socialization and Its Impact across the Lifespan. Behav Sci (Basel) 2020; 10:E101. [PMID: 32560214 PMCID: PMC7349393 DOI: 10.3390/bs10060101] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
Classical studies have found that parental warmth combined with parental strictness is the best parental strategy to promote children's psychosocial development. Nevertheless, a growing set of emergent studies has questioned the benefits of parental strictness. The present study examined parental socialization and its short- and long-term impact on the psychosocial development of adolescents and adult children. The sample consisted of 2150 Spanish participants, 623 adolescents (12-18 years), 619 young adults (19-35 years), 502 middle-aged adults (35-59 years), and 406 older adults (60 years or older). Families were classified into one of four typologies (indulgent, authoritative, authoritarian, and neglectful). Psychosocial development was examined with five indicators (physical and family self-concept, nervousness, empathy, and internalization of social values of benevolence). The results show a common short- and long-term pattern between parenting styles and psychosocial development: the indulgent style equaled or even surpassed the authoritative style, whereas the neglectful and authoritarian styles were associated with low scores. The present findings were discussed by considering the importance of the cultural context in family socialization. Additionally, the long-term impact of parental socialization seems to be crucial, even in adulthood.
Collapse
Affiliation(s)
- Jose Antonio Martinez-Escudero
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (J.A.M.-E.); (S.V.); (F.G.)
| | - Sonia Villarejo
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (J.A.M.-E.); (S.V.); (F.G.)
| | - Oscar F. Garcia
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - Fernando Garcia
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (J.A.M.-E.); (S.V.); (F.G.)
| |
Collapse
|
28
|
Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7060057. [PMID: 32503310 PMCID: PMC7346200 DOI: 10.3390/children7060057] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Minorities' diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. AIM To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8-11 years old. MATERIALS AND METHODS In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8-11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. RESULTS Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. CONCLUSION The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources.
Collapse
|
29
|
Assari S, Boyce S, Caldwell CH, Bazargan M, Mincy R. Family Income and Gang Presence in the Neighborhood: Diminished Returns of Black Families. URBAN SCIENCE (BASEL, SWITZERLAND) 2020; 4:29. [PMID: 32671278 PMCID: PMC7363405 DOI: 10.3390/urbansci4020029] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Based on the Minorities' Diminished Returns (MDRs) framework, indicators of high socioeconomic status, such as higher family income, show weaker protective effects on various developmental, behavioral, and health outcomes for Black than White families. As a result of these MDRs, Black families who access education and income still report high levels of depression, smoking, obesity, and chronic disease. Limited knowledge exists on MDRs of income on neighborhood quality. AIMS Built on the MDRs framework, this study tested the hypothesis of whether the effect of family income and maternal education at birth on neighborhood gang presence varies between Black and White families. The hypotheses were that: (1) higher income families would report lower gang presence in their neighborhood, and (2) compared to Whites, Blacks would show weaker protective effects of family income on gang presence in their neighborhood. METHODS The Fragile Families and Child Wellbeing Study is a 15-year follow up study of a random sample of births in cities with larger than 200,000 population. Two thousand nine hundred and nineteen White or Black families were included and were followed from birth of their child for 15 years. The predictors were family income and maternal education at birth, treated as categorical variables. The outcome was gang presence in the neighborhood at age 15. Logistic regression was used for data analysis. RESULTS Higher maternal education at birth was inversely associated with gang presence in the neighborhoods, while family income at birth did not show an effect on reducing gang presence in the neighborhood at age 15. Family income at birth and race interact, suggesting that the association between family income at birth and gang presence in the neighborhood at age 15 was weaker for Black than White families. Our race-stratified models also showed an inverse effect of family income at birth on gang presence in the neighborhood at age 15 in White but not Black families. CONCLUSIONS Diminished returns of family income at birth on neighborhood safety and social disorder may be a mechanism that contributes to racial health disparities in higher socioeconomic status and also poor outcomes for Black families across socioeconomic status (SES) levels. That is, a smaller protective effect of family income on changing the real lives of Black compared to White families may be one of the mechanisms by which health is worse than expected in Black families, across the entire SES spectrum. The health, behavioral, and developmental disparities are not only due to the racial gap in SES but also diminishing returns of socioeconomic status indicators such as family income 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.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI 48104, USA
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Ron Mincy
- Center for Research on Fathers, Children, and Family Well-Being, Columbia University, New York, NY 10027-5927, USA
- Columbia Population Research Center (CPRC), Columbia University, New York, NY 10027-5927, USA
- Columbia University School of Social Work, Columbia University, New York, NY 10027-5927, USA
| |
Collapse
|
30
|
Parental Education on Youth Inhibitory Control in the Adolescent Brain Cognitive Development (ABCD) Study: Blacks' Diminished Returns. Brain Sci 2020; 10:brainsci10050312. [PMID: 32455841 PMCID: PMC7287691 DOI: 10.3390/brainsci10050312] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-Hispanic Black (NHB) youth are at a higher risk of high-risk behaviors compared to non-Hispanic White (NHW) youth. Some of this racial gap is shown to be due to weaker effects of parental educational attainment on reducing the prevalence of behavioral risk factors such as impulsivity, substance use, aggression, obesity, and poor school performance for NHBs, a pattern called Minorities' Diminished Returns. These diminishing returns may be due to lower than expected effects of parental education on inhibitory control. AIM We compared NHW and NHB youth for the effect of parental educational attainment on youth inhibitory control, a psychological and cognitive construct that closely predicts high-risk behaviors such as the use of drugs, alcohol, and tobacco. METHODS This was a cross-sectional analysis that included 4188 youth from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental educational attainment. The main outcome was youth inhibitory control measured by the stop-signal task (SST), which was validated by parent reports on the Child Behavior Checklist (CBCL). RESULTS In race/ethnicity-stratified models, high parental educational attainment was associated with a higher level of inhibitory control for NHB than NHW youth. In the pooled sample, race/ethnicity showed a statistically significant interaction with parental educational attainment on youth inhibitory control suggesting that high parental educational attainment has a smaller boosting effect on inhibitory control for NHB than NHW youth. CONCLUSION Parental educational attainment boosts inhibitory control for NHW but not NHB youth. To minimize the racial gap in youth brain development, we need to address societal barriers that diminish the returns of family economic and human resources, particularly parental educational attainment, for racial and ethnic minority youth. Social and public policies should address structural and societal barriers such as social stratification, segregation, racism, and discrimination that hinder NHB parents' abilities to effectively mobilize their human resources and secure tangible outcomes for their developing youth.
Collapse
|
31
|
Assari S, Cobb S, Saqib M, Bazargan M. Diminished Returns of Educational Attainment on Heart Disease among Black Americans. Open Cardiovasc Med J 2020; 14:5-12. [PMID: 32399080 DOI: 10.2174/1874192402014010005] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Mohammed Saqib
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Family Medicine, UCLA, Los Angeles, CA, USA
| |
Collapse
|
32
|
Assari S. Combined Effects of Ethnicity and Education on Burden of Depressive Symptoms over 24 Years in Middle-Aged and Older Adults in the United States. Brain Sci 2020; 10:E209. [PMID: 32252391 PMCID: PMC7225993 DOI: 10.3390/brainsci10040209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 12/20/2022] Open
Abstract
Ethnicity and educational attainment are among the major social determinants of depression in the general population. While high education credentials protect individuals against depressive symptoms, this protection may be weaker for ethnic minority groups such as Hispanic Whites compared to the majority group (non-Hispanic Whites). Built on marginalization-related diminished returns (MDRs), the current study used 24-year follow-up data from a nationally representative sample of middle-aged and older adults to explore ethnic variation in the protective effect of education levels against the burden of depressive symptoms over time. Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study. HRS followed 8314 middle-aged and older adults (50+ years old) for up to 24 years. From this number, 763 (9.2%) were Hispanic White, and 7551 (90.8%) were non-Hispanic White Americans. Education level was the independent variable. We had two outcomes. Firstly, using cluster analysis, individuals were categorized to low- and high-risk groups (regarding the burden of depressive symptoms over 24 years); secondly, average depressive symptoms were observed over the 24 years of follow up. Age and gender were the covariates. Ethnicity was the moderator. Linear and logistic regression were used for analysis. Logistic regression showed that, overall, high educational credentials reduced the odds of chronic depressive symptoms over the 24 years of follow-up. Linear regression also showed that higher years of education were associated with lower average depressive symptoms over time. Both models showed statistically significant interactions between ethnicity and graduation, indicating a smaller protective effect of high education against depressive symptoms over the 24 years of follow-up time among Hispanic with respect to non-Hispanic White people. In line with the MDRs, highly educated Hispanic White Americans remain at high risk for depressive symptoms, a risk that is unexpected given their education. The burden of depressive symptoms, however, is lowest for highly educated non-Hispanic White Americans. Policies that exclusively focus on equalizing educational gaps across ethnic groups may fail to eliminate the ethnic gap in the burden of chronic depressive symptoms, given the diminished marginal health return of education for ethnic minorities. Public policies must equalize not only education but also educational quality across ethnic groups. This aim would require addressing structural and environmental barriers that are disproportionately more common in the lives of ethnic minorities across education levels. Future research should test how contextual factors, residential segregation, school segregation, labor market practices, childhood poverty, and education quality in urban schools reduce the health return of educational attainment for highly educated ethnic minorities such as Hispanics.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA
| |
Collapse
|
33
|
Assari S, Chalian H, Bazargan M. Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S. RESEARCH IN HEALTH SCIENCE 2020; 5:48-63. [PMID: 32226910 PMCID: PMC7100893 DOI: 10.22158/rhs.v5n1p48] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs. PURPOSE Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults. METHODS In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health (PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate =3) and income (living out of poverty =1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data. RESULTS Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. CONCLUSIONS Education and income better reduce the risk of CLDs among Whites than Hispanics and Blacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Hamid Chalian
- Department of Radiology, Duke University Medical Center, Durham, NC
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
- Department of Family Medicine, UCLA, Los Angeles, CA
| |
Collapse
|
34
|
Assari S, Caldwell C, Bazargan M. Parental educational attainment and relatives' substance use of American youth: Hispanics Diminished Returns. JOURNAL OF BIOSCIENCES AND MEDICINES 2020; 8:122-134. [PMID: 32123689 PMCID: PMC7051012 DOI: 10.4236/jbm.2020.82010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Research on Minorities' Diminished Returns (MDRs) has shown higher than expected substance use (tobacco and alcohol use) in middle-class Hispanic and Black youth and adults. In theory, some of this more than expected risk might be due to the high substance use problem of the social network. To better understand the role of social network as an explanatory mechanism behind higher than expected substance use of middle-class Hispanic and Black youth, this study tested MDRs of parental educational attainment on substance use involvement of biological relatives in Hispanic and Black middle-class youth, we compared ethnic groups for effects of parental educational attainment on the substance use involvement of biological relatives among American youth. METHODS Current longitudinal study used waves 1 and wave 4 data of the Population Assessment of Tobacco and Health- Adolescents (PATH; 2013-2018) study. The sample included 4264 nationally representative American youth who were followed for 4 years. The independent variable was parental educational attainment. The dependent variable was substance use involvement of biological relatives. Age, gender, and marital status of the family were the covariates. Ethnicity was the moderator. Linear regression was used to analyze the data. RESULTS Parental educational attainment was inversely associated with substance use involvement of biological relatives in the pooled sample (OR = 1.36, 95% CI = 1.13 -1.63 for high school graduation and OR = 0.65, 95% CI = 0.53- 0.80 for college graduation). Hispanic ethnicity showed statistically significant interactions with parental educational attainment (OR = 2.26, 95% CI = 1.49 -3.44 for high school graduation and OR = 2.98, 95% CI =1.80 - 4.93 for college graduation), suggesting that the protective effect of parental educational attainment against substance use involvement of biological relatives is smaller for Hispanic youth than for non-Hispanic youth. CONCLUSIONS While high parental educational attainment reduces substance use involvement of biological relatives, this protective effect is weaker for Hispanic than non-Hispanic youth. That means, substance use involvement of biological relatives is still high in middle-class Hispanic youth, which increases their risk of substance use. Future research should explore societal and contextual factors that cayuse MDRs of parental educational attainment on substance use of middle-class Hispanic families.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | | | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| |
Collapse
|
35
|
Assari S. Parental Education and Nucleus Accumbens Response to Reward Anticipation: Minorities' Diminished Returns. ACTA ACUST UNITED AC 2020; 2:132-153. [PMID: 34308362 DOI: 10.22158/assc.v2n4p132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Considerable research has documented the effects of race and socioeconomic status (SES) on reward-seeking behaviors; however, less is known about the multiplicative effects of race and family SES on brain response to reward anticipation. Marginalization-related Diminished Returns (MDRs) suggest that family SES would show weaker effects on brain development of children in non-White families than in White families. Objective To test race by SES variation in Nucleus Accumbens (NAcc) response to reward anticipation (NAcc-RA) among American children. Methods For this cross-sectional analysis, data came from the Adolescent Brain Cognitive Development (ABCD) study which included 6,419, 9-10 year old children. The independent variable was parental education. The moderator was race. The primary outcome was the right NAcc-RA. Age, sex, ethnicity, household income, and family structure were the covariates. We used mixed effects regression models that adjusted for the nested nature of the ABCD data. Results While high parental education was associated with a higher amount of right NAcc-RA, this effect was stronger for White than non-White children. This finding was evident in the observed interactions between race and parental education on the right NAcc-RA. Discussion For American children, NAcc-RA is not shaped by race or family SES, but by their intersection. As a result of the interaction between race and SES (diminished return of SES for non-Whites), middle-class racial minority children may remain susceptible to high-risk behaviors. Disparities in high-risk behaviors in children should not be reduced to economic disparities. Structural inequalities may reduce the return of SES resources for non-White families.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA.,Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA
| |
Collapse
|
36
|
Assari S. Blacks' Diminished Health Returns of Educational Attainment: Health and Retirement Study. JOURNAL OF MEDICAL RESEARCH AND INNOVATION 2020; 4. [PMID: 34966877 DOI: 10.32892/jmri.212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Education level reduces the risk of health problems such as poor self-rated health (SRH), high body mass index (BMI), and depressive symptoms (DS). Marginalization - related Diminished Returns (MDRs), however, refer to smaller health benefits of socioeconomic status (SES) indicators particularly educational attainment for the members of racial minority groups such as non-Hispanic Blacks compared to the majority group (non-Hispanic Whites). It is not known, however, if MDRs also hold for middle-age and older adults over a long period of time. AIMS The current study used a nationally representative data set to explore racial variation in the predictive utility of baseline education level on protecting people against poor SRH, BMI, and DS. METHODS Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study that followed 10,023 middle-aged and older adults (50+ years old) for up to 26 years. From this number, 1877 (18.7%) were non-Hispanic Black Americans, and 8,146 (81.3%) were non-Hispanic White Americans. Education level was the independent variable. We used cluster analysis to categorize individuals to low and high-risk groups (outcome) based on SRH, BMI, and DS over 26 years. Age and gender were the covariates. Race was the moderator. RESULTS Overall, high education level reduced the odds of poor SRH, BMI, and DS over the 26 years of follow up. Interactions were observed between race and education on all three health outcomes indicating smaller protective effects of baseline educational attainment on poor health over time, regardless of the outcome. CONCLUSIONS In line with the MDRs, highly educated non-Hispanic Black Americans remain at high risk for poor health across domains, a risk which is unexpected given their education. The risk of all health outcomes, however, is lowest for non-Hispanic White Americans with highest education. Policies that exclusively focus on equalizing racial gaps in SES (e.g., education) may fail to eliminate the racial and ethnic health inequalities because of the racial inequalities in the marginal health return of education. Public policies must equalize education quality and address structural and environmental barriers that are disproportionately more common in the lives of non-Hispanic Black Americans, even at high education levels. Future research should test how contextual factors, segregation, labor market practices, childhood poverty, and education quality reduces the health return of education for highly educated non-Hispanic Black Americans.
Collapse
|
37
|
Assari S, Akhlaghipour G, Saqib M, Boyce S, Bazargan M. Prefrontal Cortex Response to Threat: Race by Age Variation in 9-10 Year Old Children. JOURNAL OF MENTAL HEALTH & CLINICAL PSYCHOLOGY 2020; 4:1-12. [PMID: 33241232 DOI: 10.29245/2578-2959/2020/4.1209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Considerable research has suggested that race and age are two major determinants of brain development, including but not limited to development of the prefrontal cortex (PFC). Minorities' Diminished Returns (MDRs), however, suggests that race (as a proxy of racism) may interact with various determinants of human and brain development. Minimal knowledge, however, exists on whether age and race also interact on shaping PFC response to threat among American children. PURPOSE Using data from a task-based functional brain imaging study and considering race as a sociological rather than a biological construct, we investigated combined effects of race and age on prefrontal cortical (PFC) response to threat. We explored racial heterogeneities in the association between age and PFC response to threat by comparing Black and White children. METHODS This study used the task-based functional Magnetic Resonance Imaging (fMRI) data from the Adolescents Brain Cognitive Development (ABCD) study, a national, landmark, multi-center brain imaging investigation of 9-10 years old children in the US. The primary outcomes were mean beta weights of n-back runs measuring PFC response to threating versus neutral face contrast in the following regions of interest (ROIs): left hemisphere-lateral orbito-frontal, left hemisphere -superior-frontal, right hemisphere -caudal middle frontal, and right hemisphere -superior frontal cortex. The independent variable was age. Covariates were sex, ethnicity, family socioeconomic status, and neighborhood socioeconomic status. Race was the focal moderator. To analyze the data, we used linear regression models without and with interactions and SES as covariates. RESULTS We included 5,066 9-10 years old children. Age and race did not show direct effects on PFC response to threatening relative to neutral faces. While ethnicity, sex, and socioeconomic status were controlled, age and race showed a systematic interaction on PFC response to threatening relative to neutral faces. CONCLUSIONS For American children, race and age do not have direct effects but multiplicative effects on PFC response to threat. The results may be reflective of social inequalities in how Black and White children are socialized and developed. The results are important given the role of the PFC in regulating the limbic system response to threat. Coordinated work of the limbic system and PFC is a core element of children's behavioral and emotional development. Future research is needed on how social stratification and racism shape emotion processing and regulation of American children in response to threat.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Mohammed Saqib
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
38
|
The Impact of Educational Attainment on Black Women's Obesity Rate in the United States. J Racial Ethn Health Disparities 2019; 7:345-354. [PMID: 31728932 PMCID: PMC7064624 DOI: 10.1007/s40615-019-00663-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 11/04/2022]
Abstract
Over the last two decades, Black women have been disproportionately impacted by the obesity epidemic in the USA. According to the Centers for Disease Control and Prevention (CDC), 56.6% of Black women are overweight or obese compared with 44.4% Hispanic and 32.8% of white women. Social scientists and public health researchers have argued that increasing educational attainment would lead to overall improvements in health outcomes. Using the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey, Cycles 1999–2010, I examined how educational attainment impacts Black women’s rate of obesity and C-reactive protein levels (N = 2685). Multiple linear regression was used to analyze the association between body mass index (BMI) and educational attainment. C-reactive protein, inflammation response, was used to measure the body’s reaction to being exposed to stress. The results demonstrated that educational attainment among Black women does not decrease their risk of being obese or levels of C-reactive protein. This article provides evidence to support a need to increase awareness of health disparities that disproportionately impact Black women.
Collapse
|
39
|
Educational Attainment and Self-Rated Oral Health among American Older Adults: Hispanics' Diminished Returns. Dent J (Basel) 2019; 7:dj7040097. [PMID: 31581515 PMCID: PMC6960509 DOI: 10.3390/dj7040097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/08/2019] [Accepted: 09/12/2019] [Indexed: 12/30/2022] Open
Abstract
Background: Minorities’ diminished returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES), particularly educational attainment, on the health of non-Whites compared to Whites. Aim: Using a nationally representative sample, we aimed to investigate ethnic differences in the effect of SES (educational attainment) on the self-rated oral health of Hispanic older adults in the US. Methods: This study analyzed the University of Michigan National Poll on Healthy Aging (UM-NPHA) 2017 data, which included 2131 older adults who were 50 to 80 years old (202 Hispanics and 1929 non-Hispanics). Ethnicity, race, educational attainment (SES), age, gender, employment, retirement, and self-rated oral health (single item) were measured. Logistic regressions were applied for data analysis. Results: High educational attainment was associated with lower odds of poor oral health in the pooled sample, net of all covariates. The effect of educational attainment on poor self-rated oral health was found to be weaker for Hispanics than for non-Hispanics. Conclusion: We observed MDRs of educational attainment (SES) on oral health for Hispanic older adults. In other words, compared to non-Hispanics, Hispanics gain less oral health from their educational attainment (SES).
Collapse
|
40
|
Assari S, Boyce S, Bazargan M, Mincy R, Caldwell CH. Unequal Protective Effects of Parental Educational Attainment on the Body Mass Index of Black and White Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3641. [PMID: 31569829 PMCID: PMC6801712 DOI: 10.3390/ijerph16193641] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Parental educational attainment is shown to be protective against health problems; the Minorities' Diminished Returns theory, however, posits that these protective effects tend to be smaller for socially marginalized groups particularly blacks than whites. AIMS To explore racial differences in the effect of parental educational attainment on body mass index (BMI) in a national sample of US adolescents. METHODS In this cross-sectional study, we used baseline data of 10,701 (8678 white and 2023 black) 12-17 years old adolescents in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the predictor. Youth BMI (based on self-reported weight and height) was the dependent variable. Age, gender, ethnicity, and family structure were covariates. Race was the focal moderator. RESULTS Overall, higher parental educational attainment was associated with lower youth BMI. Race, however, moderated the effect of parental educational attainment on BMI, suggesting that the protective effect of parental educational attainment on BMI is significantly smaller for black than white youth. CONCLUSIONS In the United States, race alters the health gains that are expected to follow parental educational attainment. While white youth who are from highly educated families are fit, black youth have high BMI at all levels of parental educational attainment. This means, while the most socially privileged group, whites, gain the most health from their parental education, blacks, the least privileged group, gain the least. Economic, social, public, and health policymakers should be aware that health disparities are not all due to lower socioeconomic status (SES) of the disadvantaged group but also diminished returns of SES resources for them. Black-white health disparities exist across all high socioeconomic status (SES) levels.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Ron Mincy
- Center for Research on Fathers, Children, and Family Well-Being, Columbia University, New York, NY 10027-5927, USA.
- Columbia Population Research Center (CPRC), Columbia University, New York, NY 10027-5927, USA.
- Columbia University School of Social Work, Columbia University, New York, NY 10027-5927, USA.
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| |
Collapse
|
41
|
Assari S, Bazargan M. Minorities' Diminished Returns of Educational Attainment on Hospitalization Risk: National Health Interview Survey (NHIS). HOSPITAL PRACTICES AND RESEARCH 2019; 4:86-91. [PMID: 31650101 PMCID: PMC6812545 DOI: 10.15171/hpr.2019.17] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND As suggested by the Minorities' Diminished Returns (MDRs) theory, educational attainment shows a weaker protective effect for racial and ethnic minority groups compared to non-Hispanic Whites. This pattern, however, is never shown for hospitalization risk. OBJECTIVES This cross-sectional explored racial and ethnic variation in the association between educational attainment and hospitalization in the US. METHODS Data came from the National Health Interview Survey (NHIS 2015). The total sample was 28,959 American adults. Independent variables were educational attainment and hospitalization. The main outcome was hospitalization during the last 12 months. Age, gender, employment, marital status, region, obesity, and the number of cardiovascular conditions were covariates. Race and ethnicity were the effect modifiers. Logistic regression models were utilized to analyze the data. RESULTS From all participants, 16.2% were Black and 11.6 were Hispanic, with a mean age of 51 years old. Overall, higher education levels were associated with lower odds of hospitalization, independent of all confounders. Educational attainment showed significant interactions with race (OR =1.04, 95% CI = 1.01 - 1.08) and ethnicity (OR = 1.04, 95% CI =1.01 -1.07) on hospitalization, indicating smaller protective effects of educational attainment on hospitalization of Hispanics and Blacks than non-Hispanic Whites. CONCLUSION The protective effect of educational attainment on population health is smaller for Blacks and Hispanics compared to non-Hispanic Whites. To prevent health disparities, there is a need to minimize diminished returns of educational attainment for racial and ethnic minorities. To do so, there is a need for innovative and bold economic, public, and social policies that do not limit themselves to equalizing socioeconomic status but also help minorities leverage their available resources and gain tangible outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
- Department of Family Medicine, UCLA, Los Angeles, CA
| |
Collapse
|
42
|
Assari S, Mistry R, Bazargan M. Race, Educational Attainment, and E-Cigarette Use. JOURNAL OF MEDICAL RESEARCH AND INNOVATION 2019; 4:10.32892/jmri.185. [PMID: 32090188 PMCID: PMC7034862 DOI: 10.32892/jmri.185] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although higher educational attainment lowers high-risk behaviors such as substance use, according to the Minorities' Diminished Returns theory, the effect of educational attainment may be smaller for Blacks than Whites. AIMS To explore the racial differences in the link between educational attainment and electronic cigarettes (e-cigarettes). METHODS We used the Health Information National Trends Survey (HINTS) data. This national survey was conducted in 2017 and included 2,277 American adults composed of 1,868 White and 409 Black individuals. Educational attainment was the independent variable. E-cigarette use (lifetime) was the dependent variables. Age and gender were the covariates. Race was the effect modifier. RESULTS In the overall sample, a higher level of education attainment was linked to lower odds of e-cigarette use (OR = 0.76, 95% CI =0.61-0.95). Race showed a significant interaction with educational attainment on the outcome (OR = 1.63, 95% CI =1.04-2.56), suggesting a weaker negative association between high educational attainment and e-cigarette use for Blacks than Whites. In race-stratified logistic regression models, high educational attainment was inversely associated with risk of e-cigarette use for Whites but not Blacks. CONCLUSIONS Educational attainment shows a stronger effect on e-cigarette use in White than Black Americans.
Collapse
Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, 118th St, Los Angeles, CA, 90059, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | - Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, 118th St, Los Angeles, CA, 90059, United States
- Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| |
Collapse
|
43
|
Assari S, Bazargan M. Being Married Increases Life Expectancy of White but Not Black Americans. J Family Reprod Health 2019; 13:132-140. [PMID: 32201487 PMCID: PMC7072027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: The positive effect of high socioeconomic position (SEP) on health is well established. According Minorities' Diminished Returns (MDRs) theory, however, the SEP-health link is smaller for Blacks compared to Whites. Using a 25-year follow up data of a national sample, this study tested racial differences in the effects of marital status on life expectancy among American adults. Materials and methods: The data of Americans' Changing Lives (ACL, 1986 - 2011) were used. The ACL is a nationally representative longitudinal cohort study followed 3,361 White or Blacks adults from 1986 to 2011. The predictor of interest was marital status in 1986. Confounders included demographic factors (age and gender), SEP (education and employment), health behaviors (drinking, smoking, and physical activity), and health status (depressive symptoms, chronic disease, and self-rated health) all measured at baseline. Race was the moderator variable. All-cause mortality was the main dependent variable (outcome). Cox proportional hazard modeling was applied for data analysis. Results: In the overall sample, individuals who were married at baseline had a lower risk of mortality during the 25 years of follow up. Race altered the effect of marital status on life expectancy, indicating smaller protective effect for Blacks relative to Whites. Race -specific Cox regression models showed an association between marital status and life expectancy for White but not Black Americans. Conclusion: In line with the MDRs theory, the health gain that follows marital status is diminished for Black Americans compared to White Americans. Only equalizing SEP across racial groups may not be adequate for eliminating racial/ethnic health inequalities. Policies should go beyond SEP and reduce societal and structural barriers that disproportionately hinder Blacks from translating their SEP indicators to desirable health outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States
| | - Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States,Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| |
Collapse
|
44
|
Assari S, Bazargan M, Caldwell C. Parental Educational Attainment and Chronic Medical Conditions among American Youth; Minorities' Diminished Returns. CHILDREN-BASEL 2019; 6:children6090096. [PMID: 31454956 PMCID: PMC6770143 DOI: 10.3390/children6090096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Background: Parental educational attainment is protective against chronic medical conditions (CMCs). According to the minorities’ diminished returns (MDRs) theory, however, the health effects of socioeconomic status (SES) indicators are smaller for socially marginalized groups such as racial and ethnic minorities rather than Whites. Aims: To explore racial and ethnic differences in the effect of parental educational attainment on CMCs in a nationally representative sample of American youth. Methods: In this cross-sectional study, we used baseline data of 10,701 12–17 years old youth in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the independent variable. The dependent variable was the number of CMCs in youth. Age, gender, and family structure were covariates. Race and ethnicity were the focal moderators. Linear and multinomial regression were applied to analyze the data. Results: Overall, higher parental educational attainment was associated with a lower number of CMCs. Race and ethnicity, however, showed significant interactions with parental educational attainment on a number of CMCs as well as 2+ CMCs, suggesting that the effect of parenting educational attainment on CMCs is significantly smaller for Black and Hispanic than White youth. Conclusions: In the United States, race and ethnicity alter the health gains that are expected to follow parental educational attainment. While White youth who are from highly educated families are most healthy, Black and Hispanic youth from highly educated families remain at higher risk for CMCs. That means, while the most socially privileged group, Whites, gain the most health from their parental education, Blacks and Hispanics, the least privileged groups, gain the least. The result is a disproportionately high number of CMCs in middle-class Blacks and Hispanics. Economic, social, public, and health policy makers should be aware that health disparities are not all due to lower SES of the disadvantaged group but also diminished returns of SES resources for them. Youth physical health disparities due to race and ethnicity exist across all SES levels.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra Caldwell
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| |
Collapse
|
45
|
Assari S. Association between General Sense of Mastery and Income in White- and African-American Adults. Nurs Midwifery Stud 2019; 8:162-167. [PMID: 31396545 PMCID: PMC6686666 DOI: 10.4103/nms.nms_47_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Some research has shown that general sense of mastery (i.e., sense of control over the forces that impact one's life) does not have universal causes and consequences in racial groups. For instance, sense of mastery better predicts depression and mortality for non-Hispanic Whites (NHWs) than that of African-Americans (AAs). OBJECTIVES The objective of this study was to test the heterogeneity in the association between the sense of mastery and income by race in a nationally representative sample of NHW and AA adults. METHODS This study included a total of 3570 AA and 891 NHW adults who were enrolled to the National Survey of American Life. Variables included race/ethnicity, age, gender, socioeconomic status (SES and household income), and sense of mastery. Linear regression models were applied in the overall sample and also by race. RESULTS Overall, high sense of mastery was associated with high household income. In race-specific models, higher levels of sense of mastery were associated with high household income in AAs but not NHWs. CONCLUSIONS Racial differences exist in how sense of mastery and income are correlated. It is not clear whether high income generates more sense of mastery for AAs or high sense of mastery is more essential for generating high income for AAs. Policy-makers and clinicians should be aware that SES and sense of mastery are differently linked in AAs and NHWs.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, California, USA
| |
Collapse
|
46
|
Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101826. [PMID: 31126049 PMCID: PMC6572418 DOI: 10.3390/ijerph16101826] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/11/2019] [Accepted: 05/17/2019] [Indexed: 12/17/2022]
Abstract
Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities' diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors.
Collapse
|
47
|
Assari S, Caldwell CH. Parental Educational Attainment Differentially Boosts School Performance of American Adolescents: Minorities' Diminished Returns. J Family Reprod Health 2019; 13:7-13. [PMID: 31850092 PMCID: PMC6911144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: To explore racial and ethnic variation in the effects of parental educational attainment on students' grade point average (GPA) in the US. As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment. For example, the differential impacts of parental educational attainment on school performance of youth from various racial and ethnic backgrounds are still unknown. Materials and methods: The Population Assessment of Tobacco and Health (PATH 2013 - 2014) is a nationally representative survey in the US. The total sample was 10,701 youth (12-17 years old) were enrolled. The independent variable was parental educational attainment. The main outcome was GPA measured using self-report. Age, gender, and parental marital status were the covariates. Race and ethnicity were the effect modifiers. Linear regression models were used to analyze the data. Results: Overall, higher parental educational attainment was associated with a higher GPA, independent of all possible confounders. Race and ethnicity, however, both showed significant interaction with parental educational attainment on students' GPA, indicating smaller positive effects of parental educational attainment on students' GPA for Hispanic and Black compared to non-Hispanic White youth. Conclusion: The boosting effect of parental educational attainment on GPA is smaller for Black and Hispanic compared to White youth. To minimize diminished returns of parental educational attainment for Black and Hispanic families, there is a need for innovative public and social policies and programs that are not limited to equalizing SES but also address the structural barriers that disproportionately limit upward social mobility of racial and ethnic minority students and their families. The US society should reduce extra costs of upward social mobility for racial and ethnic minority families. As the underlying mechanisms are multifaceted, multi-level approach is needed to undo minorities' diminished returns, so every individual can gain the same tangible outcome from their SES resources.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Cleopatra H. Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
48
|
Assari S. Education Attainment and Obesity:Differential Returns Based on Sexual Orientation. Behav Sci (Basel) 2019; 9:E16. [PMID: 30699932 PMCID: PMC6406256 DOI: 10.3390/bs9020016] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Although high educational attainment is linked to better health and lower health risk behaviors, this effect may be systemically smaller for racial and ethnic minority groups compared to Whites. However, it is still unknown whether these diminished returns also apply to marginalization based on sexual orientation. Aims: In a national sample of adults which was composed of people of color, we compared straight and homosexual people for the association between education attainment and obesity. Methods: The Social Justice Sexuality Project (SJS-2010) is a cross-sectional national survey of health and wellbeing of predominantly people of color who identify as homosexual. The current analysis included 2884 adults (age 24 or more) who were either heterosexual (n = 260) or homosexual (n = 2624). The predictor variable was education attainment, and the outcome variable was obesity status (body mass index larger than 30 kg/m² [kilograms per meter squared]). Demographic factors (age and gender), household income, nativity (US born vs. immigrant), and health (self-rated health and current smoking) were the covariates. Sexual orientation was the moderator. Results: In the pooled sample, high education attainment was protective against obesity status. Sexual orientation interacted with education attainment on odds of obesity, which was suggestive of stronger protective effects of high education attainment against obesity for heterosexual than homosexual individuals. Conclusion: High education attainment better protects heterosexual than homosexual people against obesity, a pattern similar to what has been observed for comparison of Whites and non-Whites. Smaller protective effects of education attainment on health behaviors of marginalized people are possibly, due to prejudice and discrimination that they experience. Discrimination may minimize stigmatized individuals' abilities to mobilize their economic and human resources and translate them to tangible outcomes. This finding extends the Minorities' Diminished Returns theory, suggesting that it is not just race/ethnicity but possibly any marginalizing and stigmatizing social identity that results in diminished returns of socioeconomic status resources.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2700, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| |
Collapse
|
49
|
Assari S, Caldwell CH. Family Income at Birth and Risk of Attention Deficit Hyperactivity Disorder at Age 15: Racial Differences. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E10. [PMID: 30646634 PMCID: PMC6352113 DOI: 10.3390/children6010010] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Socioeconomic status (SES) resources protect children and adults against the risk of medical and psychiatric conditions. According to the Minorities' Diminished Returns theory, however, such protective effects are systemically weaker for the members of racial and ethnic minority groups compared to Whites. AIMS Using a national data set with 15 years of follow up, we compared Black and White youth for the effects of family SES at birth on the risk of Attention Deficit Hyperactivity Disorder (ADHD) at age 15. Methods: The Fragile Families and Child Wellbeing Study (FFCWS, 1998⁻2016) is a longitudinal prospective study of urban youth from birth to age 15. This analysis included 2006 youth who were either White (n = 360) or Black (n = 1646). The independent variable was family income, the dependent variable was ADHD at age 15. Child gender, maternal age, and family type at birth were covariates, and race was the focal moderator. We ran logistic regressions in the overall sample and specific to race. RESULTS In the overall sample, high family income at birth was not associated with the risk of ADHD at age 15, independent of all covariates. Despite this relationship, we found a significant interaction between race and family income at birth on subsequent risk of ADHD, indicating a stronger effect for Whites compared to Blacks. In stratified models, we found a marginally significant protective effect of family SES against the risk of ADHD for White youths. For African American youth, on the other hand, family SES was shown to have a marginally significant risk for ADHD. CONCLUSIONS The health gain that follows family income is smaller for Black than White families, which is in line with the Minorities' Diminished Returns. The solution to health disparities is not simply policies that aim to reduce the racial gap in SES, because various racial health disparities in the United States are not due to differential access to resources but rather the impact of these resources on health outcomes. Public policies, therefore, should go beyond equalizing access to resources and also address the structural racism and discrimination that impact Blacks' lives. Policies should fight racism and should help Black families to overcome barriers in their lives so they can gain health from their SES and social mobility. As racism is multi-level, multi-level interventions are needed to tackle diminished returns of SES.
Collapse
Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| |
Collapse
|
50
|
Assari S. Parental Educational Attainment and Academic Performance of American College Students; Blacks' Diminished Returns. JOURNAL OF HEALTH ECONOMICS AND DEVELOPMENT 2019; 1:21-31. [PMID: 31372601 PMCID: PMC6673665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment (PEA). PURPOSE This cross-sectional study explored racial variation in the effect of PEA on the college students' grade point average (GPA) in the US. METHODS The Healthy Mind Study (HMS, 2016-2017) is a national telephone of college students in the US. The total sample was 18,072 domestic undergraduate college students who were either non-Hispanic Whites (n = 16,718; %92.50) or non-Hispanic Blacks (n = 1,354; %7.50). The independent variable was PEA. The main outcome was GPA measured using self-reported data. Age, gender, sexual orientation, transgender status, and financial difficulty were covariates. Race/ethnicity was the effect modifier. Linear regression models were used to analyze the data. RESULTS Overall, higher PEA was associated with a higher GPA, independent of all possible confounders. Race/ethnicity, however, showed a significant interaction with PEA on students' GPA, indicating a smaller positive effect of PEA on non-Hispanic Blacks compared to non-Hispanic Whites college students' GPA. Race/ethnicity stratified models also showed a larger effect for White than Black students. CONCLUSIONS The boosting effect of PEA in GPA is smaller for Black compared to White college students. US should systematically reduce extra costs of upward social mobility for racial and ethnic minority families.
Collapse
Affiliation(s)
- Shervin Assari
- Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|