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Assari S, Zare H. Unequal Effect of Educational Attainment on Reducing Poverty and Welfare; Diminished Returns of American Indian/Alaska Native Populations. JOURNAL OF REHABILITATION THERAPY 2024; 6:1-11. [PMID: 39100915 PMCID: PMC11296615 DOI: 10.29245/2767-5122/2024/2.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Background American Indian and Alaska Native (AIAN) communities face pronounced economic and health disparities compared to White Americans, a situation rooted in long-standing historical injustices and segregation. The theory of Minorities' Diminished Returns (MDR) provides insight beyond the traditional focus on socioeconomic status (SES) disparities, such as educational attainment. It suggests that the beneficial outcomes of educational achievements on health and economic status are less substantial for marginalized and racially non-White groups compared to White Americans. Aims This study investigates the applicability of the MDR theory to AIAN populations by examining whether the positive effects of education on poverty reduction and the decreased risk of disability benefit dependency are weaker for AIAN adults relative to their White counterparts. Methods Utilizing data from the 2022 National Health Interview Survey (NHIS), this cross-sectional study analyzed a cohort of 20,743 adults, comprising 20,474 White and 269 AIAN individuals. We assessed the relationships between educational attainment, poverty level, and the likelihood of receiving disability benefits. A structural equation model was employed, with receipt of disability benefits as a latent factor influenced by racial background (AIAN) as a potential moderator, education as the main predictor, and poverty level and self-rated health as mediators. Gender, age, employment status, marital status, and Hispanic ethnicity served as additional covariates. Results Findings indicate that higher educational levels are generally associated with a lower likelihood of receiving disability benefits, mediated by improved health and economic status. Nonetheless, the interaction between race (AIAN) and education significantly influenced economic outcomes, subsequently affecting the risk of receiving disability benefits. This suggests that Whites benefit more economically from education than AIAN individuals do. Conclusion The study underscores the MDR theory's relevance to the disparities in educational outcomes related to poverty risk and receiving disability benefits among AIAN populations. The challenges AIAN individuals face in leveraging their educational achievements for economic gain relative to Whites may be attributed to pervasive racism and discrimination within various sectors, including employment and education. Addressing these disparities necessitates policy interventions that ensure educational returns are equitable across racial groups, with a focus on equal access to resources and opportunities.
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Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R Drew University of Medicine and Science, USA
- Department of Family Medicine, Charles R Drew University of Medicine and Science, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, USA
- Marginalization-Related Diminished Returns (MDRs) Research Center, Charles R Drew University of Medicine and Science, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, USA
- University of Maryland Global Campus, Health Services Management, USA
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Assari S. Black Americans' Diminished Health Returns of Professional Occupations: A Thirty-Year Follow-Up Study of Middle-Aged and Older Adults. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02034-9. [PMID: 38807025 DOI: 10.1007/s40615-024-02034-9] [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: 02/13/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
INTRODUCTION Occupational classes exert substantial effects on both subjective and objective health outcomes. However, it remains unclear whether the health impact of similar occupational classes varies across racial groups among middle-aged and older adults in the United States. AIM Grounded in the theory of Minorities' Diminished Returns (MDRs), which posits that health benefits from resources such as employment are systematically weaker for racial minority populations, particularly Non-Latino Black individuals, this study tested Black-White disparities in the effects of similar occupational classes on health outcomes in middle-aged and older adults. METHODS Utilizing data from the Health and Retirement Study (HRS), we employed a 30-year longitudinal design with a nationally representative sample of middle-aged and older adults in the United States. Six occupational classes-operator, managerial, professional specialty, sales, clerical/admin, and service-served as the key predictor variables (independent variables), with race as the moderator. Various health outcomes, including self-rated health, chronic disease, body mass index (BMI), activities of daily living (ADL), and cognitive function, were measured longitudinally from wave 1 to wave 15 (from baseline to 30 years later). Statistical analyses, incorporating logistic regression models, were conducted to assess associations between occupational class and health outcomes overall and based on race. RESULTS Our analysis included 7538 Non-Latino White or Non-Latino Black participants followed for up to 30 years. Initial findings revealed positive health effects of professional occupations on cognitive function and self-rated health over 30 years of follow-uWe also identified significant interactions between race and professional occupational class on all health outcomes, indicating notable racial differences in the effects of professional occupations on health outcomes across domains. The effects of professional occupational class were weaker for Non-Latino Black individuals than for Non-Latino White individuals. CONCLUSION Consistent with the Minorities' Diminished Returns theory, our findings indicated less pronounced positive effects of professional occupations on a wide range of health outcomes for Non-Latino Black individuals compared to Non-Latino Whites. These disparities emphasize the critical need to address structural factors that contribute to the diminished returns of prestigious occupations for Non-Latino Black populations.
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Affiliation(s)
- Shervin Assari
- Department of Internal 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.
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.
- Marginalization-Related Diminished Returns Center, Los Angeles, CA, USA.
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Assari S, Zare H, Sonnega A. Racial Disparities in Occupational Distribution Among Black and White Adults with Similar Educational Levels: Analysis of Middle-Aged and Older Individuals in the Health and Retirement Study. JOURNAL OF REHABILITATION THERAPY 2024; 6:1-11. [PMID: 38774764 PMCID: PMC11108055 DOI: 10.29245/2767-5122/2024/1.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Background Occupational classes play a significant role in influencing both individual and population health, serving as a vital conduit through which higher education can lead to better health outcomes. However, the pathway from education to corresponding occupational classes does not apply uniformly across different racial and ethnic groups, hindered by factors such as social stratification, labor market discrimination, and job segregation. Aims This study seeks to investigate the relationship between educational attainment and occupational classes among Black, Latino, and White middle-aged and older adults, with a focus on their transition into retirement. Methods Using cross-sectional data from the Health and Retirement Study (HRS), this research examines the impact of race/ethnicity, educational attainment, occupational classes, and timing of retirement among middle-aged and older adults. The analysis includes a sample of 7,096 individuals identified as White, Black, or Latino. Through logistic regression, we assess the additive and multiplicative effects of race/ethnicity and education on six defined occupational classes: 1. Managerial and specialty operations, 2. Professional Specialty, 3. Sales, 4. Clerical/administrative support, 5. Services, and 6. Manual labor. Results Participants were Black (n = 1,143) or White (n =5,953). This included Latino (N =459) or non-Latino (n = 6,634). Our analysis reveals a skewed distribution of Black and Latino adults in manual and service occupations, in stark contrast to White adults who were more commonly found in clerical/administrative and managerial positions. Educational attainment did not equate to similar occupational outcomes across racial groups. Key findings include: Firstly, Black individuals with a college degree or higher were less likely to occupy clerical and administrative positions compared to their White counterparts. Secondly, holding a General Educational Development (GED) credential or some college education was generally linked to reduced likelihood of being in managerial roles; however, this inverse relationship was less evident among Black middle-aged and older adults than White ones. Thirdly, having a GED reduced the chances of working in sales roles, while having a college degree increased such chances. An interaction between race and some college education revealed that the impact of some college education on sales roles was more significant for Black adults than for White ones. We did not observe any interaction between ethnicity (Latino) and educational attainment on occupational classes. Given the stability of occupational classes, these findings could also apply to the last occupation held prior to retirement. Conclusion This study highlights significant racial disparities in occupational classes among individuals with comparable levels of education, underscoring the profound implications for health and wellbeing disparities. Future research should explore strategies to alleviate labor market discrimination and job segregation as ways to close these occupational gaps. Additionally, the influence of social stratification, job segregation, and historical legacies, such as the repercussions of the Jim Crow era, on these disparities merits further investigation. Addressing these issues is crucial for enhancing the health and wellbeing of all populations.
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Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Marginalization-Related-Diminished Returns (MDRs) Center, Los Angeles, CA, 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, 20774, USA
| | - Amanda Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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León-Pérez G, Bakhtiari E. How Education Shapes Indigenous Health Inequalities in the USA and Mexico. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01922-4. [PMID: 38411797 DOI: 10.1007/s40615-024-01922-4] [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: 09/21/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/28/2024]
Abstract
Indigenous peoples around the world face significant health disparities relative to the dominant groups in their countries, yet the magnitude and patterns of health disparities vary across countries. We use data from the National Health Interview Survey and Mexican Family Life Survey to examine the health of Indigenous peoples in Mexico and American Indians and Alaska Natives in the USA and to evaluate how they fare relative to the majority populations in their countries (non-Indigenous Mexicans and non-Hispanic Whites, respectively). We assess disparities in self-rated health and activity limitations, with a focus on how Indigenous health disparities intersect with educational gradients in health. Regression analyses reveal three primary findings. First, Indigenous health disparities are larger in the USA than in Mexico. Second, differences in educational attainment account for most of the differences between Indigenous and non-Indigenous populations in Mexico, but less than half in the USA. Third, in both countries, health is moderated by educational attainment such that between-group disparities are largest at the highest levels of education. However, for Indigenous Mexicans there is a "cross-over" in which Indigenous Mexicans report better health at the lowest level of education. Overall, this study finds a weak relationship between education and Indigenous health, and raises the question about the validity of using traditional measures of SES in Indigenous contexts.
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Affiliation(s)
- Gabriela León-Pérez
- Department of Sociology, Virginia Commonwealth University, Richmond, VA, USA
| | - Elyas Bakhtiari
- Department of Sociology, William and Mary, Williamsburg, VA, USA.
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Adinkrah E, Najand B, Young-Brinn A. Race and Ethnic Differences in the Protective Effect of Parental Educational Attainment on Subsequent Perceived Tobacco Norms among US Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2517. [PMID: 36767881 PMCID: PMC9916299 DOI: 10.3390/ijerph20032517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/10/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Although parental educational attainment is known to be associated with a lower prevalence of behaviors such as tobacco use, these effects are shown to be weaker for Black than White youth. It is important to study whether this difference is due to higher perceived tobacco use norms for Black youth. AIM To study the association between parental educational attainment and perceived tobacco use norms overall and by race/ethnicity among youth in the US. METHODS The current study used four years of follow-up data from the Population Assessment of Tobacco and Health (PATH-Youth) study conducted between 2013 and 2017. All participants were 12- to 17-year-old non-smokers at baseline and were successfully followed for four years (n = 4329). The outcome of interest was perceived tobacco use norms risk at year four. The predictor of interest was baseline parental educational attainment, the moderator was race/ethnicity, and the covariates were age, sex, and parental marital status at baseline. RESULTS Our linear regressions in the pooled sample showed that higher parental educational attainment at baseline was predictive of perceived disapproval of tobacco use at year four; however, this association was weaker for Latino than non-Latino youth. Our stratified models also showed that higher parental educational attainment was associated with perceived tobacco use norms for non-Latino but not for Latino youth. CONCLUSION The effect of high parental educational attainment on anti-tobacco norms differs between Latino and non-Latino youth. Latino youth with highly educated parents remain at risk of tobacco use, while non-Latino youth with highly educated parents show low susceptibility to tobacco use.
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Affiliation(s)
- Edward Adinkrah
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
| | - Angela Young-Brinn
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns, Los Angeles, CA 90059, USA
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Dunn EC, Busso DS, Davis KA, Smith AD, Mitchell C, Tiemeier H, Susser ES. Sensitive Periods for the Effect of Child Maltreatment on Psychopathology Symptoms in Adolescence. Complex Psychiatry 2023; 9:145-153. [PMID: 37900909 PMCID: PMC10601948 DOI: 10.1159/000530120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/20/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Child maltreatment is among the strongest risk factors for mental disorders. However, little is known about whether there are ages when children may be especially vulnerable to its effects. We sought to identify potential sensitive periods when exposure to the 2 most common types of maltreatment (neglect and harsh physical discipline) had a particularly detrimental effect on youth mental health. Methods Data came from the Future of Families and Child Wellbeing Study (FFCWS), a birth cohort oversampled from "fragile families" (n = 3,474). Maltreatment was assessed at 3, 5, and 9 years of age using an adapted version of the Parent-Child Conflict Tactics Scales (CTS-PC). Using least angle regression, we examined the relationship between repeated measures of exposure to maltreatment on psychopathology symptoms at age 15 years (Child Behavior Checklist; CBCL/6-18). For comparison, we evaluated the strength of evidence to support the existence of sensitive periods in relation to an accumulation of risk model. Results We identified sensitive periods for harsh physical discipline, whereby psychopathology symptom scores were highest among girls exposed at age 9 years (r2 = 0.67 internalizing symptoms; r2 = 1% externalizing symptoms) and among boys exposed at age 5 years (r2 = 0.41%). However, for neglect, the accumulation of risk model explained more variability in psychopathology symptoms for both boys and girls. Conclusion Child maltreatment may have differential effects based on the child's sex, type of exposure, and the age at which it occurs. These findings provide additional evidence for clinicians assessing the benefits and drawbacks of screening efforts and point toward possible mechanisms driving increased vulnerability to psychopathology.
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Affiliation(s)
- Erin C. Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Daniel S. Busso
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Kathryn A. Davis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew D.A.C. Smith
- Applied Statistics Group, University of the West of England at Bristol, Bristol, UK
| | - Colter Mitchell
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Henning Tiemeier
- Department of Child Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ezra S. Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York City, NY, USA
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Cobb S, Najand B, Gravidez T, Navarro B, Herreraramos A, Bazargan M. Number of Chronic Medical Conditions and Quality of Life of Ethnic Minority Older Adults. Geriatrics (Basel) 2022; 7:geriatrics7050106. [PMID: 36286209 PMCID: PMC9602015 DOI: 10.3390/geriatrics7050106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The Blacks’ mental health paradox is defined as disproportionately better mental health among Black individuals compared to White individuals, despite their higher exposure to a wide range of adversities. However, the existing literature on this phenomenon is mainly limited to studies that have compared Black and White individuals. There has been little research on this phenomenon among ethnic groups other than Whites. Objectives: This study tested the Blacks’ mental health paradox with consideration of Latinx individuals as the control group. Methods: This cross-sectional study collected demographic data, socioeconomic status, chronic medical conditions, and mental and physical quality of life of 724 older Black and Latinx adults residing in low socioeconomic areas of south Los Angeles. Linear regressions were used for data analysis with mental and physical health-related quality of life (HRQoL) as dependent variables and the number of chronic medical conditions as the independent variable. Results: Overall, a higher number of chronic medical conditions was associated with lower mental and physical quality of life. A statistically significant interaction was found between race/ethnicity and the effect of the number of chronic medical conditions on mental HRQoL, which was indicative of Blacks’ mental health paradox. Conclusion: Older Black adults with a higher number of chronic medical conditions report better mental health compared to their Latinx peers with the same number of chronic medical conditions. Thus, Blacks’ mental health paradox can be seen when Black and Latinx populations are compared. Replication of such a paradox provides additional support for the relative mental health advantage of Black people compared to other ethnic groups.
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Affiliation(s)
- Sharon Cobb
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Correspondence:
| | - Babak Najand
- Marginalization-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA 90059, USA
| | - Tara Gravidez
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Berlin Navarro
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Alondra Herreraramos
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Marginalization-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA 90059, USA
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
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System-Cluster Technology of e-Learning Improvement under the Conditions of COVID-19. SUSTAINABILITY 2021. [DOI: 10.3390/su132414024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper defines the scientific provisions on the feasibility and effectiveness of using e-learning under conditions of quarantine restrictions related to the COVID-19 pandemic. It was proved that within the use of e-learning there has been a convergence between the scientific and methodological bases and the learning process itself, and new approaches to the general didactic and information content of e-learning courses within the education process have been formed. Modern platforms of e-learning are examined and a scheme involving the synchronous technology of e-learning was formed. Within the framework of the suggested learning platform, effective learning tools under conditions of quarantine restrictions were identified, the use of which allows the most successful solution of didactic tasks facing e-learning to be ensured on the basis of the everyday use of digital media and electronic devices for learning purposes. The fractal-cluster technology of an e-learning organization was suggested for an introduction. The functional dependencies on the forms and technologies of the educational process for the efficiency of higher education were obtained. The expediency of introducing fractal-cluster structures into the organizational component of the educational process was determined. Based on the tools of the fractal-cluster approach, a model of organization of the educational process in the information-entropy format was formulated.
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Amezcua L, Rivera VM, Vazquez TC, Baezconde-Garbanati L, Langer-Gould A. Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis and Related Disorders in the US: A Review. JAMA Neurol 2021; 78:1515-1524. [PMID: 34605866 DOI: 10.1001/jamaneurol.2021.3416] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance There is empirical evidence that social determinants of health (SDOH) impact health outcomes in Black and Hispanic and Latinx individuals in the US. Recently, SDOH have risen to the top as essential intervention targets that could help alleviate racial and ethnic disparities. Neuromyelitis optica spectrum disorder (NMOSD) disproportionately affects Black individuals, and multiple sclerosis (MS) has seen a recent shift in select racial groups. It is unclear to what degree SDOH have been investigated and contribute to racial and ethnic health disparities and inequities. Observations This narrative review provides a contemporary synthesis of SDOH associated with racial and ethnic health disparities and inequities in MS, NMOSD, and other autoimmune disorders, such as myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. These immune-mediated neurological diseases were chosen for their capacity to be a high burden to society and because of complementary SDOH-associated challenges among minority populations. A paucity of research addressing inequities and the role of SDOH in MS and NMOSD was noted despite findings that Black individuals have a higher risk of developing MS or NMOSD and associated mortality compared with White individuals. Greater health disparities were also found for those with lower income and education, lower health literacy, and negative illness perceptions in MS. No studies in MOG-Ab disorders were found. Conclusions and Relevance Increased efforts are needed to better understand the role of SDOH in racial and ethnic health disparities and inequities in MS, NMOSD, and emerging autoimmune disorders. This includes developing research frameworks aimed at understanding the magnitude and interrelationships of SDOH to better develop system-based multilevel interventions across the spectrum of care for these neurological conditions.
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Affiliation(s)
- Lilyana Amezcua
- Keck School of Medicine, Department of Neurology, University of Southern California, Los Angeles
| | - Victor M Rivera
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | | | - Lourdes Baezconde-Garbanati
- Keck School of Medicine, Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles
| | - Annette Langer-Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
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Fenelon A, Boudreaux M, Slopen N, Newman SJ. The Benefits of Rental Assistance for Children's Health and School Attendance in the United States. Demography 2021; 58:1171-1195. [PMID: 33970240 PMCID: PMC8561436 DOI: 10.1215/00703370-9305166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Programs that provide affordable and stable housing may contribute to better child health and thus to fewer missed days of school. Drawing on a unique linkage of survey and administrative data, we use a quasi-experimental approach to examine the impact of rental assistance programs on missed days of school due to illness. We compare missed school days due to illness among children receiving rental assistance with those who will enter assistance within two years of their interview, the average length of waitlists for federal rental assistance. Overall, we find that children who receive rental assistance miss fewer days of school due to illness relative to those in the pseudo-waitlist group. We demonstrate that rental assistance leads to a reduction in the number of health problems among children and thus to fewer days of school missed due to illness. We find that the effect of rental assistance on missed school days is stronger for adolescents than for younger children. Additionally, race-stratified analyses reveal that rental assistance leads to fewer missed days due to illness among non-Hispanic White and Hispanic/Latino children; this effect, however, is not evident for non-Hispanic Black children, the largest racial/ethnic group receiving assistance. These findings suggest that underinvestment in affordable housing may impede socioeconomic mobility among disadvantaged non-Hispanic White and Hispanic/Latino children. In contrast, increases in rental assistance may widen racial/ethnic disparities in health among disadvantaged children, and future research should examine why this benefit is not evident for Black children.
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Affiliation(s)
- Andrew Fenelon
- School of Public Policy and Department of Sociology and Criminology, Penn State University, University Park, PA, USA
| | - Michel Boudreaux
- Department of Health Policy and Management, University of Maryland, College Park, MD, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sandra J Newman
- Department of Health Policy & Management, Johns Hopkins University, Baltimore, MD, USA
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Assari S, Boyce S, Bazargan M, Thomas A, Cobb RJ, Hudson D, Curry TJ, Nicholson HL, Cuevas AG, Mistry R, Chavous TM, Caldwell CH, Zimmerman MA. Parental Educational Attainment, the Superior Temporal Cortical Surface Area, and Reading Ability among American Children: A Test of Marginalization-Related Diminished Returns. CHILDREN-BASEL 2021; 8:children8050412. [PMID: 34070118 PMCID: PMC8158386 DOI: 10.3390/children8050412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent studies have shown that parental educational attainment is associated with a larger superior temporal cortical surface area associated with higher reading ability in children. Simultaneously, the marginalization-related diminished returns (MDRs) framework suggests that, due to structural racism and social stratification, returns of parental education are smaller for black and other racial/ethnic minority children compared to their white counterparts. PURPOSE This study used a large national sample of 9-10-year-old American children to investigate associations between parental educational attainment, the right and left superior temporal cortical surface area, and reading ability across diverse racial/ethnic groups. METHODS This was a cross-sectional analysis that included 10,817 9-10-year-old children from the Adolescent Brain Cognitive Development (ABCD) study. Parental educational attainment was treated as a five-level categorical variable. Children's right and left superior temporal cortical surface area and reading ability were continuous variables. Race/ethnicity was the moderator. To adjust for the nested nature of the ABCD data, mixed-effects regression models were used to test the associations between parental education, superior temporal cortical surface area, and reading ability overall and by race/ethnicity. RESULTS Overall, high parental educational attainment was associated with greater superior temporal cortical surface area and reading ability in children. In the pooled sample, we found statistically significant interactions between race/ethnicity and parental educational attainment on children's right and left superior temporal cortical surface area, suggesting that high parental educational attainment has a smaller boosting effect on children's superior temporal cortical surface area for black than white children. We also found a significant interaction between race and the left superior temporal surface area on reading ability, indicating weaker associations for Alaskan Natives, Native Hawaiians, and Pacific Islanders (AIAN/NHPI) than white children. We also found interactions between race and parental educational attainment on reading ability, indicating more potent effects for black children than white children. CONCLUSION While parental educational attainment may improve children's superior temporal cortical surface area, promoting reading ability, this effect may be unequal across racial/ethnic groups. To minimize the racial/ethnic gap in children's brain development and school achievement, we need to address societal barriers that diminish parental educational attainment's marginal returns for middle-class minority families. Social and public policies need to go beyond equal access and address structural and societal barriers that hinder middle-class families of color and their children. Future research should test how racism, social stratification, segregation, and discrimination, which shape the daily lives of non-white individuals, take a toll on children's brains and academic development.
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Affiliation(s)
- Shervin Assari
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Correspondence:
| | - Shanika Boyce
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Minorities’ Diminished Returns (MDRs) Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA; (S.B.); (M.B.)
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California-Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Alvin Thomas
- Human Development and Family Studies Department, School of Human Ecology, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Ryon J. Cobb
- Department of Sociology, University of Georgia, Athens, GA 30602, USA;
| | - Darrell Hudson
- Brown School, Washington University, St. Louis, MO 63130, USA;
| | - Tommy J. Curry
- Department of Philosophy, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh EH8 9JS, UK;
| | - Harvey L. Nicholson
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL 32611-7330, USA;
| | - Adolfo G. Cuevas
- Psychosocial Determinants of Health (PSDH) Lab, Tufts University, Boston, MA 02155, USA;
- Department of Community Health, Tufts University, Boston, MA 02155, USA
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
| | - Tabbye M. Chavous
- School of Education, University of Michigan, Ann Arbor, MI 48109-2029, USA;
- National Center for Institutional Diversity, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109-2029, USA
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA; (R.M.); (C.H.C.); (M.A.Z.)
- Prevention Research Center, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
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12
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Silberberg M, Muhlbaier LH, Hart-Brothers E, Weaver SM, James SA, King SB. The Role of Socioeconomic Status in a Community-Based Study of Diabetes Secondary Prevention Among African Americans. INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 2020; 60:262-272. [PMID: 36568915 PMCID: PMC9782674 DOI: 10.1080/14635240.2020.1866999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 12/17/2020] [Indexed: 06/17/2023]
Affiliation(s)
- Mina Silberberg
- Division of Community Health, Department of Family Medicine and Community Health, Duke Health, DUMC 105652, Durham, NC 27710
| | | | | | - Sarah M Weaver
- Division of Community Health, Department of Family Medicine and Community Health, Duke Health, DUMC 105652, Durham, NC 27710
| | - Sherman A James
- Sanford School of Public Policy, Duke University, Box 90245,Duke University, Durham, NC 27708
| | - Susan B King
- Sanford School of Public Policy, Duke University, Box 90245,Duke University, Durham, NC 27708
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13
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The Association between Family Structure Changes and High School Completion in South Africa. SOCIAL SCIENCES-BASEL 2020. [DOI: 10.3390/socsci9080133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the past few years, family structures have been dramatically transformed, yet limited research from South Africa has assessed the effect on children’s developmental outcomes. Using data from the National Income Dynamics Study, we aim to contribute to the literature by examining the relationship between family structure disruption and high school completion in South Africa. Our sample consisted of 1649 young people who were aged 12, 13 and 14 in 2008 and their educational attainment was tracked through to 2017. The results from the logistic regression analysis demonstrate that family structure disruption is negatively associated with high school completion. After controlling for variation in household income change, the child’s educational factors and socio-demographic controls, young people who experienced a change from a co-resident family or were in stable non-resident parent family structures were up to 50% less likely to complete high school relative to those from undisrupted co-resident parent family structures. Given that family structure disruption is a widespread phenomenon in South Africa, research should consider it as a key determinant of educational attainment and policymakers should come up with holistic interventions to support families as well as allocate public resources in ways that can help reduce educational inequalities.
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14
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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.
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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
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15
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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.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA
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16
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Chen R, Kessler RC, Sadikova E, NeMoyer A, Sampson NA, Alvarez K, Vilsaint CL, Green JG, McLaughlin KA, Jackson JS, Alegría M, Williams DR. Racial and ethnic differences in individual-level and area-based socioeconomic status and 12-month DSM-IV mental disorders. J Psychiatr Res 2019; 119:48-59. [PMID: 31563857 PMCID: PMC7255491 DOI: 10.1016/j.jpsychires.2019.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to: (1) examine the associations of individual-level objective socioeconomic status (OSS), subjective socioeconomic status (SSS), and area-based indicators of socioeconomic status, with 12-month DSM-IV mood, anxiety, alcohol use, and drug use disorders; and, (2) determine the extent of racial/ethnic differences in these associations across non-Latino White, non-Latino Black, Latino, and Asian participants. Data are from the Collaborative Psychiatric Epidemiology Studies dataset, a collection of three population-based surveys of mental disorders among U.S. residents aged 18 and older (n = 13,775). Among all indicators of socioeconomic status, SSS was most consistently associated with 12-month mental disorders. Income was negatively associated with mood and anxiety disorders; education was negatively associated with alcohol use and drug use disorders. Significant interactions with race/ethnicity were found for the associations of socioeconomic indicators with anxiety, alcohol use, and drug use disorders but not with mood disorders. SSS was not associated with any of the 12-month mental disorders among Blacks. Education had stronger associations with 12-month anxiety and alcohol use disorders among Whites than among other racial/ethnic groups. Among Asians, low income compared to high income was associated with a lower risk of anxiety disorders and less than high school completion compared to college or more was associated with a lower risk of alcohol use disorders. Finally, tract-level income inequality was associated with a greater risk of drug use disorders only among Blacks. The patterns and magnitudes of the associations of individual-level and area-based socioeconomic indicators differed by type of disorder and race/ethnicity.
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Affiliation(s)
- Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Amanda NeMoyer
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States.
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States.
| | - Corrie L Vilsaint
- Recovery Research Institute, Massachusetts General Hospital Center for Addiction Medicine, 151 Merrimac Street, Boston, MA, 02114, United States.
| | - Jennifer Greif Green
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, United States.
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, United States.
| | - James S Jackson
- Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI, 48104, United States.
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, United States.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
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17
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Assari S, Schatten HT, Arias SA, Miller IW, Camargo CA, Boudreaux ED. Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks. J Racial Ethn Health Disparities 2019; 6:1001-1010. [PMID: 31278625 PMCID: PMC6739140 DOI: 10.1007/s40615-019-00601-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/16/2019] [Accepted: 05/19/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE In a sample of patients presenting to the emergency department (ED), the current study was conducted with two aims: (1) to investigate the protective effects of educational attainment (i.e., completing college) on subsequent risk of suicide attempt/death among patients presenting to the ED and (2) to compare this effect between non-Hispanic Black and non-Hispanic White ED patients. METHODS The current study analyzed data from the Emergency Department Safety Assessment and Follow-Up Evaluation (ED-SAFE) study, a quasi-experimental, eight-center study of universal suicide screening and follow-up of ED patients presenting for suicidal ideation and behavior. Our sample included 937 non-Hispanic White and 211 non-Hispanic Blacks. The dependent variable was suicide attempt/death during the 52-week follow-up. The independent variable was completing college. Age, gender, lesbian/gay/bisexual status, psychiatric history, and previous suicide attempts at baseline were covariates. Race/ethnicity was the focal effect modifier. Logistic regression models were used to test the protective effects of educational attainment on suicide risk in the overall sample and by race/ethnicity. RESULTS In the overall sample, educational attainment was not associated with suicide risk over the follow-up period. A significant interaction was found between race/ethnicity and educational attainment on suicide risk, suggesting a larger protective effect for non-Hispanic Whites compared with non-Hispanic Blacks. In race/ethnicity-specific models, completing college was associated with decreased future suicide risk for non-Hispanic Whites but not Blacks. CONCLUSIONS Consistent with the Minorities' Diminished Return theory, educational attainment better protected non-Hispanic White than non-Hispanic Blacks against future suicide attempt/death. While Whites who have not completed college may be at an increased risk of suicide, risk of suicide seems to be independent of educational attainment for non-Hispanic Blacks.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA.
| | - Heather T Schatten
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Sarah A Arias
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Edwin D Boudreaux
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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18
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Assari S. Ethnicity, educational attainment, and physical health of older adults in the United States. Aging Med (Milton) 2019; 2:104-111. [PMID: 31608316 PMCID: PMC6788632 DOI: 10.1002/agm2.12050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 12/29/2018] [Accepted: 01/01/2019] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Minorities' diminished returns theory suggests that socioeconomic status (SES) resources generate fewer health benefits for racial and ethnic minority groups, compared to the majority group. The current study aimed to compare Hispanic and non-Hispanic white older adults for the association between educational attainment and poor physical self-rated health (SRH). METHODS The first wave of the University of Michigan National Poll on Healthy Aging (UM-NPHA) included 1820 older adults who were 50-80 years old and were either non-Hispanic white (n = 1618) or Hispanic white (n = 202). The main independent variable of interest was educational attainment. The main dependent variable of interest was poor physical SRH. Gender, age, marital status, and employment status were covariates. Ethnicity was the focal effect modifier. RESULTS Overall, higher level of educational attainment was associated with better physical SRH. A significant interaction was found between ethnicity and level of educational attainment, which was indicative of a smaller physical SRH gain due to high educational attainment for Hispanic white compared to non-Hispanic white older adults. In ethnic-specific models, we found evidence suggesting that high educational attainment reduced the odds of poor physical SRH for non-Hispanic whites but not for Hispanic whites. CONCLUSION Compared to non-Hispanic whites, Hispanic whites gain less physical SRH benefits from their educational attainment.
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Affiliation(s)
- Shervin Assari
- Department of PsychologyUniversity of California Los Angeles (UCLA)Los AngelesCalifornia
- Center for Research on Ethnicity, Culture, and Health (CRECH)School of Public HealthUniversity of MichiganAnn ArborMichigan
- Department of PsychiatryUniversity of MichiganAnn ArborMichigan
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19
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Chalian H, Khoshpouri P, Assari S. Patients' age and discussion with doctors about lung cancer screening; Diminished returns of Blacks. Aging Med (Milton) 2019; 2:35-41. [PMID: 31179418 PMCID: PMC6553649 DOI: 10.1002/agm2.12053] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND As age is one of the main risk factors for lung cancer, older adults are expected to receive more messages for lung cancer screening (LCS). It is, however, unclear whether age similarly increases patient's chance of discussing LCS across various racial groups. OBJECTIVE To determine racial differences in the effect of patients' age on patient-physician discussion about LCS. METHODS This cross-sectional study borrowed data from the Health Information National Trends Survey (HINTS 2017) which included 2,277 adults. Patients' demographic factors, socioeconomic characteristics, smoking status, possible LCS indication, and patient-physician discussion about LCS were measured. We ran logistic regression models for data analysis. RESULTS Independent of possible LCS indication, older patients were more likely to have patient-physician discussion about LCS. However, there is a significant interaction between race and age, suggesting a larger effect of age on the likelihood of discussing LCS with doctors for Whites than Blacks. In race-stratified models that controlled for possible LCS indication, higher age increased lung cancer discussion for Whites but not for Blacks. CONCLUSIONS Whether age increases the chance of discussing LCS or not depends on the patient's race, with Blacks receiving fewer messages regarding LCS as a result of their aging.
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Affiliation(s)
- Hamid Chalian
- Department of RadiologyDuke University Medical CenterDurhamNorth Carolina
| | - Pegah Khoshpouri
- Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineBaltimoreMaryland
| | - Shervin Assari
- Department of Family MedicineCharles R. Drew University of Medicine and ScienceLos AngelesCalifornia
- Department of PsychiatryUniversity of MichiganAnn ArborMichigan
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20
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Assari S, Khoshpouri P, Chalian H. Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions. Healthcare (Basel) 2019; 7:E17. [PMID: 30682822 PMCID: PMC6473681 DOI: 10.3390/healthcare7010017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 12/24/2022] Open
Abstract
AIM To determine whether socioeconomic status (SES; educational attainment and income) explains the racial gap in cancer beliefs, cognitions, and emotions in a national sample of American adults. METHODS For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a nationally representative sample of American adults. The study enrolled 2277 adults who were either non-Hispanic Black (n = 409) or non-Hispanic White (n = 1868). Race, demographic factors (age and gender), SES (i.e., educational attainment and income), health access (insurance status, usual source of care), family history of cancer, fatalistic cancer beliefs, perceived risk of cancer, and cancer worries were measured. We ran structural equation models (SEMs) for data analysis. RESULTS Race and SES were associated with perceived risk of cancer, cancer worries, and fatalistic cancer beliefs, suggesting that non-Hispanic Blacks, low educational attainment and low income were associated with higher fatalistic cancer beliefs, lower perceived risk of cancer, and less cancer worries. Educational attainment and income only partially mediated the effects of race on cancer beliefs, emotions, and cognitions. Race was directly associated with fatalistic cancer beliefs, perceived risk of cancer, and cancer worries, net of SES. CONCLUSIONS Racial gap in SES is not the only reason behind racial gap in cancer beliefs, cognitions, and emotions. Racial gap in cancer related beliefs, emotions, and cognitions is the result of race and SES rather than race or SES. Elimination of racial gap in socioeconomic status will not be enough for elimination of racial disparities in cancer beliefs, cognitions, and emotions in the United States.
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Affiliation(s)
- Shervin Assari
- 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.
| | - Pegah Khoshpouri
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
| | - Hamid Chalian
- Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
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21
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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.
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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.
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22
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Assari S. Subjective financial status and suicidal ideation among American college students: Racial differences. ARCHIVES OF GENERAL INTERNAL MEDICINE 2019; 3:16-21. [PMID: 34308338 PMCID: PMC8297587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The current study aimed to compare American Black and White college students for the protective effect of subjective socioeconomic status (SES) on suicidal ideation. METHODS This study used data from the Healthy Mind Study (HMS 2015-2017). This study included 2,983 undergraduate college students who were at least 18 years of old. These participants were either White (n=2,704) or Black (n=279). The dependent variable was suicidal ideation. The independent variable was subjective SES. Age, gender, transition status, first generation status, and social isolation were covariates. Race/ethnicity was the moderator. Logistic regressions were applied to test the effect of subjective SES on suicidal ideation in the overall sample and by race/ ethnicity. RESULTS In the overall sample, high subjective SES was associated with less suicidal ideation in the pooled sample of college students. A significant interaction was found between race and subjective SES on suicide risk, suggesting a larger protective effect of high subjective SES for Whites than Blacks. In race-stratified models, high subjective SES was associated with less suicidal ideation for White college students but not for Black college students. CONCLUSIONS Consistent with the Minorities' Diminished Returns theory and in line with previous research that has documented worse mental health of high SES Blacks particularly Black men, this study showed that high SES protects White college students but not Black college students against suicidal ideation. While Whites with low SES are protected against risk of suicide, risk of suicidal ideation seems to be constant regardless of SES among Black college students.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Assari S. Race, Education Attainment, and Happiness in the United States. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019; 6:76-82. [PMID: 31363495 PMCID: PMC6666429 DOI: 10.15171/ijer.2019.14] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As suggests by the Minorities' Diminished Returns (MDR) theory, education attainment and other socioeconomic status (SES) indicators have a smaller impact on the health and well-being of non-White than White Americans. To test whether MDR also applies to happiness, in the present study, Blacks and Whites were compared in terms of the effect of education attainment on the level of happiness among American adults. METHODS General Social Survey (1972-2016) is a series of national surveys that are performed in the United States. The current analysis included 54,785 adults (46,724 Whites and 8,061 Blacks). The years of schooling (i.e., education attainment) and happiness were the main independent variable and the main dependent variable of interest, respectively. In addition, other parameters such as gender, age, employment status, marital status, and the year of the survey were the covariates and race was the focal effect modifier. Finally, the logistic regression model was used to analyze the data. RESULTS Based on the results, high education attainment was associated with higher odds of happiness in the pooled sample. Further, a significant interaction was found between race and education attainment on the odds of happiness, showing a larger gain for Whites compared to Blacks. Race-specific models also confirmed this finding (i.e., a larger magnitude of the effect of education for Whites compared to Blacks). CONCLUSION Overall, the MDR theory also applies to the effect of education attainment on happiness. Blacks' disadvantage in comparison to the Whites in gaining happiness from their education may be due to the structural, institutional, and interpersonal racism and discrimination in the US. Therefore, there is a need for economic and public policies that can minimize the Blacks' diminished returns of education attainment and other SES resources.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Research on Ethnicity, Culture, and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
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Assari S. Parental Education Attainment and Educational Upward Mobility; Role of Race and Gender. Behav Sci (Basel) 2018; 8:E107. [PMID: 30469353 PMCID: PMC6262323 DOI: 10.3390/bs8110107] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 11/16/2022] Open
Abstract
Background. The Minorities' Diminished Return theory suggests that education attainment and other socioeconomic resources have smaller effects on the health and well-being of African Americans and other racial and ethnic minorities compared to Whites. Racial and ethnic differences in the processes involved with educational upward mobility may contribute to the diminished returns of education attainment for African Americans compared to Whites. Aim: This study compared African Americans and non-Hispanic Whites for the effect of parental education attainment on educational upward mobility and explored gender differences in these effects. Methods. The National Survey of American Life (NSAL 2003) is a nationally representative survey of American adults. Participants included 891 non-Hispanic White and 3570 African American adults. Gender, race/ethnicity, age, highest parental education attainment, and respondents' educational attainment were measured. Data were analyzed using linear regression models. Results. Overall, higher parental education attainment was associated with higher educational upward mobility (b = 0.34, p < 0.001), however, this boosting effect was significantly smaller for African Americans compared to Whites (b = -0.13, p = 0.003). Our further analysis showed that race by parental education attainment can be found for females (b = -0.14, p = 0.013) but not males (p > 0.05). Conclusion. African American females are at a disadvantage compared to White females regarding the effect of parental education attainment on their educational upward mobility, a phenomenon which could not be observed when comparing African American and White males. These results advocate for taking intersectionality frameworks to study the effects of race, gender, and class in the US.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., 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), Franz Hall, 502 Portola Plaza, Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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Assari S. Race, Intergenerational Social Mobility and Stressful Life Events. Behav Sci (Basel) 2018; 8:E86. [PMID: 30241335 PMCID: PMC6211020 DOI: 10.3390/bs8100086] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
Background. Socioeconomic status (SES) has smaller protective effects on the health of African Americans, and the differential association between social mobility and stress may explain the diminished returns of SES for African Americans. Aim. This study tested the race/ethnic differences in the association between upward and downward social mobility and stress in a nationally representative sample of African American and White American adults. Methods. This study included 3570 African Americans and 891 non-Hispanic White Americans from the National Survey of American Life (NSAL), 2003. Race/ethnicity, gender, age, upward and downward social mobility (independent variable, defined as difference between parent and respondent education), and stressful life events (SLE, dependent variable) were measured. Linear regression models were used for data analysis. Results. In the pooled sample that included both races, upward and downward social mobility were both associated with SLE, the net of all covariates. Significant interactions were found between race/ethnicity and social mobility, suggesting a stronger association between social mobility and stress for White Americans than for African Americans. According to race-stratified models, upward and downward social mobility were associated with higher SLE for White Americans but not African Americans. Conclusion. Although upwardly and downwardly mobile White Americans experience more stress than the socially stable White Americans, African Americans do not experience a change in SLE related to their intergenerational social mobility.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Assari S. Blacks' Diminished Return of Education Attainment on Subjective Health; Mediating Effect of Income. Brain Sci 2018; 8:E176. [PMID: 30213135 PMCID: PMC6162786 DOI: 10.3390/brainsci8090176] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/05/2018] [Accepted: 08/10/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Minorities' Diminished Return (MDR) can be defined as smaller health gains from socioeconomic status (SES) indicators, such as education attainment among ethnic minorities compared to the majority group. The current study tested whether income explains why Black and White adults differ in the association between education attainment and self-rated health (SRH). Methods: With a cross-sectional design, this study used data from Cycle 5 of the Health Information National Trends Survey (HINTS), 2017. With a nationally representative sample, the HINTS study generates results that are generalizable to US adults. This study included 2277 adults who were either non-Hispanic White (n = 1868; 82%) or non-Hispanic Black (n = 409; 18%). The independent variable was education attainment. The dependent variable was SRH, measured using a standard single item. Age, gender, and health insurance status were covariates. Ethnicity was the focal moderator. Income was the mediator. A structural equation model (SEM) was applied for data analysis. Results: Overall, higher education attainment was associated with better SRH, net of covariates. However, a significant interaction between ethnicity and education attainment suggested a smaller SRH gain from education for Blacks compared to Whites. This interaction could be explained by Black⁻White differences in income. Conclusion: Our study results suggests that labor market preferences may explain smaller effects of education attainment on SRH for Blacks relative to Whites. Given this finding and other studies documenting MDR, policies should reduce labor market discrimination, increasing job opportunities and reducing the racial pay gap for Blacks. Programs should help Blacks compete for prestigious and high-paying jobs.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd.; Ann Arbor, MI 48109-2700, USA.
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History of Non-Fatal Physical Assault Is Associated with Premature Mortality for Whites but Not Blacks. J 2018. [DOI: 10.3390/j1010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Exposure to trauma increases the long-term risk of mortality, and experiencing non-fatal physical assault is not an exception. To better understand population heterogeneity in this link, the current study explored Black–White differences in the association between history of non-fatal physical assault and risk of all-cause mortality over a 25-year period in the United States. Data came from the Americans’ Changing Lives (ACL) study that followed 3617 non-institutionalized respondents for up to 25 years. History of non-fatal physical assault at baseline was the predictor. Outcome was time to death due to all-cause mortality during follow-up from baseline (1986) to follow-up (2011). Confounders included gender, age, and baseline socio-economic status (education and income), health behaviors (smoking and drinking), and health status (chronic medical conditions, self-rated health, and body mass index). Race was the moderator. Cox regressions were used for multi-variable analysis. History of non-fatal physical assault at baseline was associated with an increased risk of mortality, above and beyond baseline socioeconomic status, health behaviors, and health status. Race interacted with history of non-fatal physical assault on mortality, suggesting a stronger effect for Whites compared to Blacks. In race-specific models, history of non-fatal physical assault was associated with risk of mortality for Whites but not Blacks. The current study showed that experiencing non-fatal physical assault increases the risk of premature death above and beyond demographics, socioeconomic status, health behaviors, and health status. Experiencing non-fatal physical assault may have a larger effect on premature mortality among Whites than Blacks. Future research is needed on how Blacks and Whites differ in the health consequences of social adversities.
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Assari S, Moghani Lankarani M. Workplace Racial Composition Explains High Perceived Discrimination of High Socioeconomic Status African American Men. Brain Sci 2018; 8:E139. [PMID: 30060492 PMCID: PMC6120025 DOI: 10.3390/brainsci8080139] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sociological and epidemiological literature have both shown that socioeconomic status (SES) protects populations and individuals against health problems. Recent research, however, has shown that African Americans gain less from their SES and African Americans of high SES, particularly males, may be vulnerable to perceived discrimination, as explained by the Minorities' Diminished Returns theory. One potential mechanism for this phenomenon is that high SES African Americans have a higher tendency to work in predominantly White workplaces, which increases their perceived discrimination. It is, however, unknown if the links between SES, working in predominantly White work groups and perceived discrimination differ for male and female African Americans. AIM To test the associations between SES, workplace racial composition and perceived discrimination in a nationally representative sample of male and female African American adults. METHODS This study included a total number of 1775 employed African American adults who were either male (n = 676) or female (n = 1099), all enrolled from the National Survey of American Life (NSAL). The study measured gender, age, SES (educational attainment and household income), workplace racial composition and perceived discrimination. Structural Equation Modeling (SEM) was applied in the overall sample and also by gender. RESULTS In the pooled sample that included both genders, high education and household income were associated with working in a predominantly White work group, which was in turn associated with more perceived discrimination. We did not find gender differences in the associations between SES, workplace racial composition and perceived discrimination. CONCLUSION Although racial composition of workplace may be a mechanism by which high SES increases discriminatory experiences for African Americans, males and females may not differ in this regard. Policies are needed to reduce discrimination in racially diverse workplaces. This is particularly the case for African Americans who work in predominantly White work environments.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Center for Research on Ethnicity, Culture and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Assari S, Preiser B, Kelly M. Education and Income Predict Future Emotional Well-Being of Whites but Not Blacks: A Ten-Year Cohort. Brain Sci 2018; 8:E122. [PMID: 29966278 PMCID: PMC6070982 DOI: 10.3390/brainsci8070122] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The Minorities’ Diminished Return (MDR) theory is defined as systematically smaller effects of socioeconomic status (SES) on the health and well-being of minority groups when compared to Whites. To extend the existing literature on the MDR theory as applied to the change of mental well-being over time, we investigated Black-White differences in the effects of baseline education and income on subsequent changes in positive and negative affect over a ten-year period. METHODS The Midlife in the United States (MIDUS) is a 10-year longitudinal study of American adults. This analysis followed 3731 adults who were either Whites (n = 3596) or Blacks (n = 135) for 10 years. Education and income, as measured at baseline and 10 years later, were the independent variables. Negative and positive affect, measured at baseline and over ten years of follow up, were the dependent variables. Covariates were age, gender, and physical health (body mass index, self-rated health, and chronic medical conditions), measured at baseline. Race was the focal moderator. We ran multi-group structural equation modeling in the overall sample, with race defining the groups. RESULTS High education at baseline was associated with an increase in income over the 10-year follow up period for Whites but not Blacks. An increase in income during the follow up period was associated with an increase in the positive affect over time for Whites but not Blacks. CONCLUSION The MDR theory is also relevant to the effects of baseline education attainment on subsequent changes in income and then in turn on positive affect over time. The relative disadvantage of Blacks in comparison to Whites in receiving mental health gains from SES may reflect structural racism and discrimination in the United States. There is a need for additional research on specific societal barriers that minimize Blacks’ mental health gains from their SES resources, such as education and income. There is also a need for policies and programs that help Blacks to leverage their SES resources.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Brianna Preiser
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Marisa Kelly
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
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Assari S, Gibbons FX, Simons R. Depression among Black Youth; Interaction of Class and Place. Brain Sci 2018; 8:E108. [PMID: 29895752 PMCID: PMC6025590 DOI: 10.3390/brainsci8060108] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/04/2018] [Accepted: 06/10/2018] [Indexed: 12/12/2022] Open
Abstract
Although high socioeconomic status (SES) is traditionally conceptualized as a health protective factor, recent literature has documented positive associations between SES (e.g., income) and depression among Blacks, including Black youth. To extend the results of this recent literature, the current study used the Family and Community Health Study (FACHS) data to examine the multiplicative effects of gender, place, and SES on average depressive symptoms of Black youth over a long period of time. FACHS, 1997⁻2017, followed 889 Black children aged 10⁻12 years old for up to 18 years. Depressive symptoms were measured in seven waves. The main predictors of interest were two SES indicators, parent education and family income measured at baseline (1997). Main outcome of interest was average depressive symptoms over the 18 year follow up period. Place of residence and gender were the focal moderators. Linear regression models were used for data analysis. In the pooled sample, living in a predominantly White area was associated with higher average depressive symptoms over time, however, this association was fully explained by higher perceived racial discrimination in the predominantly White areas. We found an interaction between income and place of residence on average depressive symptoms, suggesting that higher income is associated with more depressive symptoms in predominantly White compared to predominantly Black areas. Place did not interact with parent education on average depressive symptoms. Gender also did not interact with education or income on depressive symptoms. Findings suggest that place and SES may interact on depressive symptoms of Black youth, with high income becoming a risk factor for depressive symptoms in predominantly White areas. How SES indicators, such as income, protect or become a risk factor depend on other contextual factors, such as place of residence. There is a need to reduce discrimination experienced by Blacks, especially in predominantly White areas. Meanwhile, Black youth who live in predominantly White areas may require additional help that enhances their coping.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ronald Simons
- Department of Sociology, University of Georgia, Athens, GA 30602, USA.
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Assari S, Moghani Lankarani M. Poverty Status and Childhood Asthma in White and Black Families: National Survey of Children's Health. Healthcare (Basel) 2018; 6:E62. [PMID: 29895767 PMCID: PMC6023379 DOI: 10.3390/healthcare6020062] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/10/2018] [Accepted: 06/11/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Living above the poverty line reduces the risk of physical illnesses, including childhood asthma (CA). Minorities’ Diminished Return theory, however, suggests that the protective effects of socioeconomic status (SES) on health are weaker for racial minorities than White families. It is unknown whether the association between SES and CA differs for White and Black families. Aims: Using a national sample, the current study compared Black and White families for the association between living above the poverty line and CA. Methods: Data came from the National Survey of Children’s Health (NSCH), 2003⁻2004, a national telephone survey. A total of 86,537 Black or White families with children (17 years old or younger) were included in the study. This sample was composed of 76,403 White (88.29%) and 10,134 Black (11.71%) families. Family SES (living above the poverty line) was the independent variable. The outcome was CA, reported by the parent. Age, gender, and childhood obesity were the covariates. Race was conceptualized as the moderator. A number of multivariable logistic regressions were used in the pooled sample and specific to each race for data analysis. Results: In the pooled sample, living above the poverty line was associated with lower odds of CA. An interaction was found between race and living above the poverty line on odds of CA, indicating a smaller association for Black compared to White families. Although race-stratified logistic regressions showed negative associations between living above the poverty line and CA in both White and Black families, the magnitude of this negative association was larger for White than Black families. Conclusions: The health gain from living above the poverty line may be smaller for Black than White families. Due to the existing Minorities’ Diminished Return, policies that merely reduce the racial gap in SES may not be sufficient in eliminating racial health disparities in the United States. Public policies must go beyond reducing poverty to address structural and environmental risk factors that disproportionately impact Blacks’ health. Policies should help Black families gain health as they gain upward social mobility. As they are more likely to face societal and structural barriers, multi-level interventions are needed for the health promotion of Blacks.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 90095, USA.
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Assari S, Moghani Lankarani M. Depressive Symptoms and Self-Esteem in White and Black Older Adults in the United States. Brain Sci 2018; 8:E105. [PMID: 29891800 PMCID: PMC6024986 DOI: 10.3390/brainsci8060105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 05/24/2018] [Accepted: 06/09/2018] [Indexed: 01/03/2023] Open
Abstract
Background. Poor self-esteem is a core element of depression. According to recent research, some racial groups may vary in the magnitude of the link between depression and poor self-esteem. Using a national sample, we compared Black and White older Americans for the effect of baseline depressive symptoms on decline in self-esteem over time. Methods. This longitudinal study used data from the Religion, Aging, and Health Survey, 2001⁻2004. The study followed 1493 older adults (734 Black and 759 White) 65 years or older for three years. Baseline depressive symptoms (CES-D), measured in 2001, was the independent variable. Self-esteem, measured at the end of the follow up, was the dependent variable. Covariates included baseline demographic characteristics (age and gender), socioeconomic factors (education, income, and marital status), health (self-rated health), and baseline self-esteem. Race/ethnicity was the moderator. Linear multi-variable regression models were used for data analyses. Results. In the pooled sample, higher depressive symptoms at baseline were predictive of a larger decline in self-esteem over time, net of covariates. We found a significant interaction between race/ethnicity and baseline depressive symptoms on self-esteem decline, suggesting a weaker effect for Blacks compared to Whites. In race/ethnicity-specific models, high depressive symptoms at baseline was predictive of a decline in self-esteem for Whites but not Blacks. Conclusion. Depressive symptoms may be a more salient contributor to self-esteem decline for White than Black older adults. This finding has implications for psychotherapy and cognitive behavioral therapy of depression of racially diverse populations.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2700, USA.
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Assari S, Lapeyrouse LM, Neighbors HW. Income and Self-Rated Mental Health: Diminished Returns for High Income Black Americans. Behav Sci (Basel) 2018; 8:E50. [PMID: 29772799 PMCID: PMC5981244 DOI: 10.3390/bs8050050] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/11/2018] [Accepted: 05/13/2018] [Indexed: 01/16/2023] Open
Abstract
Background: The minorities' diminished return theory suggests that socioeconomic position (SEP) generates smaller health gains for racial/ethnic minorities compared to Whites. The current study was a Black⁻White comparison of the association between household income and self-rated mental health (SRMH). Methods: This cross-sectional study used data from the 2017 State of the State Survey (SOSS). With representative sampling, the SOSS generates results that are generalizable to the state of Michigan. This study included 881 adults, (n = 92) Black and (n = 782) White. The independent variable was household income. The dependent variable was SRMH, measured using a single item. Age, gender, and participation in the labor force were covariates. Race/ethnicity was the focal moderator. Logistic regression models were used for data analysis. Results: Overall, higher household income was associated with better SRMH, net of covariates. An interaction was found between race/ethnicity and household income on SRMH, suggesting a smaller, or nonexistent, protective effect for Blacks compared to Whites. In race/ethnicity-stratified models, higher household income was associated with better SRMH for Whites but not Blacks. Conclusion: Supporting the minorities' diminished return theory, our study documents differential effects for income on SRHM for Blacks and Whites, where Whites but not Blacks appear to benefit from their income. Given this, researchers and policy makers are cautioned against making assumptions that racial groups benefit equally from similar economic resources.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd.; Ann Arbor, MI 48109-2700, USA.
| | - Lisa M Lapeyrouse
- Department of Public Health and Health Sciences, University of Michigan, Flint, MI 48502, USA.
| | - Harold W Neighbors
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI 48502, USA.
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