Black Americans' Diminished Return of Educational Attainment on Tobacco Use in Baltimore City.
Educational attainment
Flavored tobacco
Marginalized groups
Smoking
Social determinants
Journal
Journal of racial and ethnic health disparities
ISSN: 2196-8837
Titre abrégé: J Racial Ethn Health Disparities
Pays: Switzerland
ID NLM: 101628476
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
23
06
2023
accepted:
14
09
2023
revised:
10
09
2023
medline:
15
11
2023
pubmed:
27
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
Socioeconomic status (SES) indicators such as educational attainment are fundamental factors affecting health. One mechanism through which education affects health is by reducing the likelihood of engaging in high-risk behaviors such as smoking. However, according to the marginalization-related diminished returns (MDRs) theory, the association between education and health may be weaker for marginalized populations such as Black than White, primarily due to racism and discrimination. However, little is known about the racial variations in the differential associations between educational attainment and tobacco use in a local setting. This study aimed to investigate the differential association between educational attainment and tobacco use among racial groups in a community sample in Baltimore City. This cross-sectional study used data from a community survey conducted in 2012-2013 in Baltimore City among adults aged 18 years or older. The participants were 3501 adults. Univariate, bivariate, and logistic regression analyses were performed using Stata to investigate the racial difference in the association between education and two outcomes: current smoking status and menthol tobacco product use. The study found that adults with a graduate degree were less likely to be current smokers (adjusted odds ratio [AOR]: 0.10, 95% confidence interval [CI]: 0.08-0.13) and menthol tobacco users (AOR: 0.10, 95% CI: 0.07-0.14) compared to those with less than high school diploma. The inverse associations between educational attainment and current smoking (AOR: 1.83, 95% CI: 1.05-3.21) and menthol tobacco product use (AOR: 4.73, 95% CI: 2.07-10.80) were weaker for Back individuals than those who were White. Due to MDRs of educational attainment, while highly educated White adults show a low risk of tobacco use, educated Black adults remain at a disproportionately increased risk. The study emphasizes the need for better policies and programs that address minorities' diminished return of education for tobacco use.
Sections du résumé
BACKGROUND
Socioeconomic status (SES) indicators such as educational attainment are fundamental factors affecting health. One mechanism through which education affects health is by reducing the likelihood of engaging in high-risk behaviors such as smoking. However, according to the marginalization-related diminished returns (MDRs) theory, the association between education and health may be weaker for marginalized populations such as Black than White, primarily due to racism and discrimination. However, little is known about the racial variations in the differential associations between educational attainment and tobacco use in a local setting.
AIM
This study aimed to investigate the differential association between educational attainment and tobacco use among racial groups in a community sample in Baltimore City.
METHODS
This cross-sectional study used data from a community survey conducted in 2012-2013 in Baltimore City among adults aged 18 years or older. The participants were 3501 adults. Univariate, bivariate, and logistic regression analyses were performed using Stata to investigate the racial difference in the association between education and two outcomes: current smoking status and menthol tobacco product use.
RESULTS
The study found that adults with a graduate degree were less likely to be current smokers (adjusted odds ratio [AOR]: 0.10, 95% confidence interval [CI]: 0.08-0.13) and menthol tobacco users (AOR: 0.10, 95% CI: 0.07-0.14) compared to those with less than high school diploma. The inverse associations between educational attainment and current smoking (AOR: 1.83, 95% CI: 1.05-3.21) and menthol tobacco product use (AOR: 4.73, 95% CI: 2.07-10.80) were weaker for Back individuals than those who were White.
CONCLUSION
Due to MDRs of educational attainment, while highly educated White adults show a low risk of tobacco use, educated Black adults remain at a disproportionately increased risk. The study emphasizes the need for better policies and programs that address minorities' diminished return of education for tobacco use.
Identifiants
pubmed: 37755685
doi: 10.1007/s40615-023-01805-0
pii: 10.1007/s40615-023-01805-0
pmc: PMC10645619
doi:
Substances chimiques
Menthol
1490-04-6
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
3178-3187Subventions
Organisme : NIMHD NIH HHS
ID : R24 MD002803
Pays : United States
Organisme : NIDA NIH HHS
ID : U24 DA012390
Pays : United States
Organisme : NIDA NIH HHS
ID : R24 DA019805
Pays : United States
Informations de copyright
© 2023. The Author(s).
Références
Am J Public Health. 2015 Sep;105(9):e8-18
pubmed: 26180986
BMC Public Health. 2017 Dec 29;17(1):983
pubmed: 29284458
Milbank Q. 1993;71(2):279-322
pubmed: 8510603
J Med Res Innov. 2020;4(1):
pubmed: 32090188
Cent Eur J Public Health. 2015 Dec;23(4):299-305
pubmed: 26841142
Acta Cardiol. 2008 Apr;63(2):135-40
pubmed: 18468190
Brain Sci. 2017 Nov 24;7(12):
pubmed: 29186800
J Ment Health Clin Psychol. 2020;4(1):21-27
pubmed: 32285045
Inquiry. 2023 Jan-Dec;60:469580221135953
pubmed: 37178129
Prev Med. 2020 Oct;139:106220
pubmed: 32693179
Womens Health Bull. 2019 Jul;6(3):
pubmed: 31552286
Front Public Health. 2016 Apr 21;4:67
pubmed: 27148514
BMC Public Health. 2019 Apr 11;19(1):390
pubmed: 30971249
Prev Med. 2019 Aug;125:32-39
pubmed: 31004620
Int J Epidemiol. 2018 Aug 1;47(4):1131-1140
pubmed: 29961807
J Racial Ethn Health Disparities. 2018 Aug;5(4):808-819
pubmed: 28842841
Soc Sci Med. 2008 Aug;67(3):420-30
pubmed: 18486291
Nicotine Tob Res. 2023 Mar 22;25(4):718-728
pubmed: 36239224
Brain Sci. 2018 Sep 12;8(9):
pubmed: 30213135
Nicotine Tob Res. 2010 Dec;12 Suppl 2:S102-9
pubmed: 21177366
Health Equity. 2019 Apr 11;3(1):138-144
pubmed: 31289772
Behav Sci (Basel). 2017 Oct 16;7(4):
pubmed: 29035330
J Res Adolesc. 2022 Mar;32(1):170-190
pubmed: 35040213
BMJ Open. 2015 Oct 09;5(10):e007485
pubmed: 26453588
Nicotine Tob Res. 2016 Apr;18 Suppl 1:S91-101
pubmed: 26980870
Nicotine Tob Res. 2022 Mar 1;24(4):484-492
pubmed: 34687204
Subst Use Misuse. 2016 Oct 14;51(12):1593-1599
pubmed: 27484877
Tob Control. 2020 May;29(3):269-276
pubmed: 31147473
Int J Environ Res Public Health. 2018 Apr 16;15(4):
pubmed: 29659482
Am Fam Physician. 2000 Aug 1;62(3):579-84, 591-2
pubmed: 10950214
Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1825-8
pubmed: 17035388
Circulation. 2018 May 15;137(20):2166-2178
pubmed: 29760227
Health Rep. 2012 Mar;23(1):47-53
pubmed: 22590805
Addict Behav. 2018 Apr;79:203-212
pubmed: 29173942
Am J Public Health. 2011 Apr;101(4):699-706
pubmed: 21330593
Am J Prev Med. 2008 May;34(5):404-12
pubmed: 18407007
J Health Care Poor Underserved. 2016;27(1):35-50
pubmed: 27763459
Int J Epidemiol. 2017 Aug 1;46(4):1312-1318
pubmed: 28938756
J Health Soc Behav. 2010;51 Suppl:S28-40
pubmed: 20943581
Health Psychol. 2011 Nov;30(6):693-701
pubmed: 21574709
Tob Control. 2015 Jan;24(1):28-37
pubmed: 23997070
Nicotine Tob Res. 2010 Dec;12 Suppl 2:S147-53
pubmed: 21177371
Exp Clin Psychopharmacol. 2022 Jun;30(3):365-370
pubmed: 33630647
Nicotine Tob Res. 2023 Mar 22;25(4):692-698
pubmed: 36223889
Am J Public Health. 1994 Jul;84(7):1086-93
pubmed: 8017530