Race, Educational Attainment, and E-Cigarette Use

Assari, Shervin; Mistry, Ritesh; Bazargan, Mohsen

doi:10.32892/jmri.185

Cited by 58 publications

(60 citation statements)

References 64 publications

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“…The observation that as income increases, the psychological well-being of middle-aged and older adults improves, but less for immigrants than non-immigrants, is an extension of previous literature on MDRs 21,22 of income, [23][24][25][26][27] educational attainment, 36 occupation, 29,30 and marital status 46 on a wide range of mental health outcomes, including psychological distress, 54 depression, 24,55 suicide, 31 and anxiety. 46 These MDRs go beyond physical health outcomes and extend to behavioral outcomes such as vaping, 33 smoking, 35,42,44,56,57 drinking, 34,58 diet, 59 and exercise. 11 Finally, MDRs are seen for physical health outcomes such as obesity, 36,37 self-rated health, 23,32,54 CMCs, 25,26,38 disability, 60 and mortality.…”

Section: Discussionmentioning

confidence: 99%

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Assari

2020

Int J Travel Med Glob Health

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Introduction: Although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (SES) resources compared to socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). Most of the existing knowledge on MDRs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. As a result, very limited information exists on whether similar MDRs can be observed for middle-aged and older immigrants or not. Building on the MDRs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the United States. Methods: This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12166; 86.0%). The independent variable (IV) was income that was treated as a continuous variable. The dependent variable was mental well-being, also treated as a continuous variable. Age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. Immigration (nativity status) was the moderator. Logistic regression was applied for data analysis. Results: High income was associated with higher odds of good mental well-being in middle-aged and older adults. However, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults. Conclusion: In line with MDRs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. There is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. Such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.

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Section: Discussionmentioning

confidence: 99%

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Assari

2020

Int J Travel Med Glob Health

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“…Previous research has shown disproportionately high risk of tobacco use in highly educated and high-socioeconomic status Hispanic and African American individuals, across tobacco products. 16,17,21,67 Highly educated Hispanic and African American individuals are also exposed to higher levels of secondhand tobacco smoke inside their homes 68 and at work 26 compared with white individuals. Thus, highly educated racial/ethnic minority groups remain at high risk of chronic medical conditions, such as chronic obstructive pulmonary disease, 69 asthma, 70 and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults

Assari

2020

JAMA Netw Open

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IMPORTANCE Associations of educational attainment with improved health outcomes have been found to be weaker among racial/ethnic minority groups compared with those among the racial/ ethnic majority group. Recent research has also documented higher than expected prevalence of smoking in highly educated African American and Hispanic adults. OBJECTIVE To compare the association of educational attainment with exposure to tobacco advertisements among racial/ethnic groups of US young adults. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included data from 6700 young adults who participated in wave 1 of the Population Assessment of Tobacco and Health Study, a nationally representative survey of US adults in 2013. Educational attainment was classified as less than high school diploma, high school graduate, or college graduate. Analysis was conducted between September 20 and October 4, 2019. MAIN OUTCOMES AND MEASURES The independent variable was educational attainment (less than high school diploma, high school graduate, and college graduate). The dependent variable was any exposure to tobacco advertisements in the past 12 months. Race/ethnicity, age, sex, poverty status, unemployment, and region were the covariates. Binary logistic and Poisson regression were used to analyze the data. RESULTS The study included 6700 participants (3366 [50.2%] men) between ages 18 and 24 years. Most participants were non-Hispanic (5257 participants [78.9%]) and white (5394 participants [80.5%]), while 1443 participants (21.5%) were Hispanic. Educational levels included 1167 participants (17.4%) with less than a high school diploma, 4812 participants (71.8%) who were high school graduates, and 4812 participants (10.8%) who were college graduates. A total of 4728 participants (70.6%) reported exposure to tobacco advertisements in the past 12 months. Exposure to tobacco advertising was reported by 383 participants (53.1%) who were college graduates, 3453 participants (71.8%) who were high school graduates, and 892 participants (76.4%) with less than high school educational attainment. In regression analysis, high school graduation (odds ratio, 0.79; 95% CI, 0.68-0.92) and college graduation (odds ratio, 0.46; 95% CI, 0.39-0.54) were associated with lower odds of exposure to tobacco advertisements compared with young adults with lower educational attainment. Compared with non-Hispanic participants, high school education had a weaker protective association for tobacco advertisement exposure among Hispanic participants (odds ratio, 1.44; 95% CI, 1.03-2.01; P = .03), suggesting that the association of high school graduation with lower exposure to tobacco advertisement is weaker among Hispanic young adults than non-Hispanic young adults. CONCLUSIONS AND RELEVANCE This study found that high school graduation had a weaker inverse association with tobacco advertisement exposure among Hispanic than non-Hispanic young (continued)

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“…The results may be due to the fact that highly educated and high-income Blacks and Hispanics smoke cigarette (Assari & Mistry, 2018; and vape e-cigarette (Assari, Mistry, & Bazargan, 2020) more than what is expected based on their SES. Such more than expected behavioral risk profile of high-SES…”

Section: Ses) Declinesmentioning

confidence: 86%

“…In a study, highly educated Blacks and Hispanics were found to be exposed to high levels of second-hand smoke exposure . In another study, highly educated and high-income Blacks and Hispanics were more likely to drink alcohol (Assari, Farokhnia, & Mistry, 2019;, smoke cigarette (Assari & Mistry, 2018;Shervin & Ritesh, 2019), and vape e-cigarette (Assari, Mistry, & Bazargan, 2020). This is probably why highly educated and high-income Blacks and Hispanics may be at higher risk of chronic obstructive pulmonary disease (COPD) (Assari, Caldwell, & Bazargan, 2019) and asthma (Assari & Moghani Lankarani, 2018), compared to highly educated non-Hispanic…”

Section: Introductionmentioning

confidence: 99%

“…Thus, diverse race/ethnic groups not only vary in their SES (Navarro, 1991(Navarro, , 1990(Navarro, , 1989) but also how their SES turns to health outcomes Assari, Preiser, & Kelly, 2018). As a result, it is "race/ethnicity and SES" not "race/ethnicity or SES" that generates racial and ethnic health disparities (Navarro, 1991(Navarro, , 1990(Navarro, , 1989 Although high education and income reduces exposure to risk factors overall (Lunau, Siegrist, Dragano, & Wahrendorf, 2015;Hackman, Gallop, Evans, & Farah, 2015), Blacks and Hispanics with high education and income report high level of environmental risk factors such as stress , discrimination , and active and passive exposure to tobacco smoke (Assari & Mistry, 2018;Assari & Bazargan, 2009;Assari, Mistry, & Bazargan, 2020). That is, the very same SES indicators, such as educational attainment and income, show stronger impact on lowering Whites' than Blacks' and Hispanics' environmental risk exposures, highly educated Blacks and…”

Section: Introductionmentioning

confidence: 99%

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Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S.

Assari¹,

Chalian²,

Bazargan³

2020

RHS

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Background: Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive PulmonaryDisease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs.Purpose: Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults.Methods: In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health(PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate = 3) and income (living out of poverty = 1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data.Results: Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with 49 Published by SCHOLINK INC. educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. Conclusions: Education and income better reduce the risk of CLDs among Whites than Hispanics andBlacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems. 58 Published by SCHOLINK INC.Hispanic people, a rate which is disproportionate to their SES. Researchers should know that health disparities are not merely due to the additive but also multiplicative effects of race, ethnicity and SES.Real solution to racial and health disparities in CLDs is not only increasing SES of Blacks and Hispanic but also empowering them to translate their available SES resources to health outcomes. Public policies that are needed should go beyond equalizing SES and specifically address societal barriers, environmental risk factors, and structural factors that endanger the health and well-...

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Race, Educational Attainment, and E-Cigarette Use

Cited by 58 publications

References 64 publications

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults

Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S.

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