Household Income and Children’s Unmet Dental Care Need; Blacks’ Diminished Return

Assari, Shervin; Hani, Neda

doi:10.3390/dj6020017

Cited by 77 publications

(101 citation statements)

References 42 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.…”

Section: Discussionmentioning

confidence: 71%

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: 71%

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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“…According to the Barker hypothesis [78], pathological changes that mediate adversities may start in utero. Some behavioral mechanisms such as drinking [34], vaping [36], smoking [18,59], poor diet [25], poor health care use [79,80], and low exercise [16] that are all common in highly educated Blacks may mediate the additional cardiovascular risk of middle-class Blacks. Another mechanism is environmental exposures in highly educated Blacks [81 -83].…”

Section: Discussionmentioning

confidence: 99%

Diminished Returns of Educational Attainment on Heart Disease among Black Americans

Assari¹,

Cobb²,

Saqib³

et al. 2020

TOCMJ

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Background:Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose:Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods:We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health -Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results:Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion:Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.

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“…The effects of education and income on a wide range of health behaviors such as drinking [13], diet [30], impulse control [18], body mass index [17], poor sleep [31], oral health [28,29], and chronic disease [14,32] are shown to be smaller for Blacks than Whites. Education attainment [13] and employment [20] have smaller effects on life expectancy for Blacks than for Whites.…”

Section: Introductionmentioning

confidence: 99%

Does School Racial Composition Explain Why High Income Black Youth Perceive More Discrimination? A Gender Analysis

Assari

2018

Brain Sciences

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Recent research has documented poor mental health among high socioeconomic status (SES) Blacks, particularly African American males. The literature has also shown a positive link between SES and perceived discrimination, suggesting that perceived discrimination may explain why high SES Black males report poor mental health. To better understand the role of contextual factors in explaining this pattern, we aimed to test whether school racial composition explains why high income Black youth perceive more discrimination. We explored these associations by ethnicity and gender. Using data from the National Survey of American Life-Adolescent supplement (NSAL-A), the current study included 810 African American and 360 Caribbean Black youth, with a mean age of 15. Ethnicity, age, gender, income-to-needs ratio (SES), skin color, school racial composition, and perceived (daily) discrimination were measured. Using Stata 15.0 (Stata Corp., College Station, TX, USA), we fitted seven structural equation models (SEMs) for data analysis in the pooled sample based on the intersection of ethnicity and gender. Considerable gender by ethnicity variations were found in the associations between SES, school racial composition, and perceived discrimination. For African American males but not African American females or Caribbean Black males or females, school racial composition fully mediated the effect of SES on perceived discrimination. The role of inter-racial contact as a mechanism for high discrimination and poor mental health of Black American adolescents may depend on their intersection of ethnicity and gender. School racial composition may be a mechanism for increased perceived discrimination among high SES African American males.

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Household Income and Children’s Unmet Dental Care Need; Blacks’ Diminished Return

Cited by 77 publications

References 42 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

Diminished Returns of Educational Attainment on Heart Disease among Black Americans

Does School Racial Composition Explain Why High Income Black Youth Perceive More Discrimination? A Gender Analysis

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