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Open Access November 06, 2025

Ventral Attention Network Resting State Functional Connectivity: Psychosocial Correlates among US Adolescents

Abstract Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN [...] Read more.
Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN resting state functional connectivity varies by demographic, socioeconomic, psychosocial, and behavioral factors during early adolescence. Objective: To examine associations between VAN rsfMRI connectivity and multiple demographic, socioeconomic, psychosocial, and behavioral characteristics. Methods: Data came from the baseline and early follow-up waves of the Adolescent Brain Cognitive Development (ABCD) Study. The analytic sample included youth with high-quality baseline rsfMRI data and complete socioeconomic and psychosocial measures. The primary outcome was mean resting-state functional connectivity within the VAN across subcortical and cortical regions of interest (ROIs). Bivariate correlations were computed between VAN connectivity and demographic (age, sex, puberty, race/ethnicity), socioeconomic (income, parental education, marital status, neighborhood income), psychosocial (trauma, discrimination, financial difficulty), trait (impulsivity), and behavioral variables (body mass index, depression, suicide, prodromal symptoms, and substance use). Unadjusted bivariate correlations and adjusted logistic regressions were used for data analysis. Results: VAN connectivity showed small but significant correlations with multiple contextual factors. Higher household income, parental education, and neighborhood affluence were associated with greater connectivity, whereas Black race and Hispanic ethnicity were related to lower connectivity. Youth reporting higher discrimination and financial difficulty exhibited weaker VAN connectivity. Greater VAN connectivity was negatively associated with impulsive reward-driven trait (drive), prodromal symptoms, BMI, and marijuana and alcohol use. Associations between VAN connectivity and suicide, depression, marijuana use, and alcohol use remained significant in age and sex adjusted models. Conclusions: VAN connectivity reflects subtle neural correlates of socioeconomic and psychosocial context in early adolescence. Our results underscore the importance of integrating structural and contextual factors in interpreting brain-behavior associations across diverse populations. These findings are suggestive of stable socioeconomic and psychosocial correlates of network efficiency.
Article
Open Access October 29, 2025

Mean Diffusivity of the Left Caudal Anterior Cingulate Cortex and Past Major Depressive Disorder in Adolescents: Evidence from the ABCD Study

Abstract Background: Adolescence is a critical developmental stage for the emergence of major depressive disorder (MDD). Structural and diffusion neuroimaging studies have highlighted the anterior cingulate cortex (ACC) as a key region implicated in emotion regulation, stress reactivity, and mood processing. However, few studies have examined whether microstructural characteristics of the ACC, [...] Read more.
Background: Adolescence is a critical developmental stage for the emergence of major depressive disorder (MDD). Structural and diffusion neuroimaging studies have highlighted the anterior cingulate cortex (ACC) as a key region implicated in emotion regulation, stress reactivity, and mood processing. However, few studies have examined whether microstructural characteristics of the ACC, reflected by mean diffusivity (MD) within gray matter–white matter (GM–WM) contrast regions, are associated with depression in early adolescence. Objective: To examine whether mean diffusivity (MD) within the GM–WM contrast of the left caudal anterior cingulate cortex (ACC) is associated with a past diagnosis of MDD among adolescents in the Adolescent Brain Cognitive Development (ABCD) Study, after accounting for demographic, socioeconomic, and adversity-related factors. Methods: Data were drawn from adolescents with diffusion MRI–derived mean diffusivity measures and diagnostics. The independent variable was mean diffusivity (MD) of the GM–WM contrast in the left caudal ACC. The primary outcome was past MDD diagnosis based on structured psychiatric assessments. Covariates included age, sex, socioeconomic status (SES), and exposure to adverse childhood experiences (ACEs). Logistic regression models tested the association between ACC MD and past MDD. A secondary model evaluated the relationship between ACC MD and past suicide attempt. Results: Mean diffusivity of the left caudal ACC was associated with the odds of past MDD, independent of age, sex, SES, and adversity exposure. In contrast, ACC mean diffusivity was not associated with a history of suicide attempt. Conclusions: Increased mean diffusivity in the caudal ACC may indicate microstructural alterations associated with depressive vulnerability in adolescence. ACC tissue integrity may serve as a sensitive neural correlate of early-onset depression.
Article
Open Access October 01, 2025

Place-Based Diminished Returns of Economic Resources in Rural America: A Framework for Understanding Geography-Conditioned Inequality

Abstract Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from [...] Read more.
Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.
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Perspective Article
Open Access May 05, 2025

To Be Twice as Good to Get Half

Abstract “To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits [...] Read more.
“To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”
Article
Open Access March 25, 2025

Resting-State Sensory-Motor Connectivity between Hand and Mouth as a Neural Marker of Socioeconomic Disadvantage, Psychosocial Stress, Cognitive Difficulties, Impulsivity, Depression, and Substance Use in Children

Abstract Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor [...] Read more.
Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor connectivity, early-life adversity, and later health behaviors remains understudied. Objective: This study examines the associations between rsFC within the sensory-motor network (mouth and hand regions) and key social, psychological, and behavioral factors, including baseline and past socioeconomic status (SES), trauma exposure, family conflict, impulsivity, major depressive disorder (MDD), and future substance use. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, a national sample of U.S. children. Resting-state fMRI data were used to assess functional connectivity within the sensory-motor network. Bivariate analyses examined associations between rsFC in the sensory-motor mouth and hand regions and baseline SES, past SES, childhood trauma exposure, family conflict, impulsivity, and MDD. Longitudinal analyses assessed whether baseline rsFC predicted future substance use. Results: Greater rsFC between the sensory-motor mouth and hand regions was significantly associated with lower SES, higher trauma exposure, and greater family conflict. Increased connectivity was also correlated with older age and more advanced puberty status. Higher rsFC between the sensory-motor mouth and hand regions was linked to greater impulsivity, lower cognitive function, an increased likelihood of MDD, and future marijuana use. Conclusion: These findings suggest that sensory-motor connectivity is sensitive to socioeconomic and psychosocial stressors, with potential long-term implications for mental health and substance use risk. The results highlight the importance of early-life environmental factors in shaping neurodevelopmental trajectories and emphasize the need for targeted interventions to mitigate the effects of adversity on brain function and behavior. Future research should further explore the role of sensory-motor network alterations in behavioral health outcomes as a function of environmental stressors.
Original Article
Open Access March 12, 2025

Academic Aspirations of 12th Grade Students in the United States: Place-Based Diminished Returns of Parental Education in Rural Areas

Abstract Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This [...] Read more.
Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This study examines the association between parental education and aspirations for graduate or professional education among non-Latino White adolescents, with a specific focus on urban-suburban versus rural differences. Methods: Using data from the 12th-grade cohort of the Monitoring the Future (MTF) 2024 survey, we conducted multivariate analyses to assess the relationship between parental education and aspirations for graduate or professional education. We further examined whether this association was moderated by geographic location (urban-suburban vs. rural) to identify place-based MDRs. Results: Higher parental education was associated with greater aspirations for advanced education; however, this effect was weaker in rural areas compared to urban and suburban settings. These findings highlight that even among non-Latino White adolescents, rural residence diminishes the benefits of socioeconomic resources, providing evidence of place-based MDRs. Conclusion: Rural residents face a dual disadvantage—both lower socioeconomic status and weaker returns on those resources—necessitating targeted interventions beyond resource allocation. To address disparities in educational aspirations in rural areas, policymakers should focus on improving equitable access to educational opportunities and ensuring that these resources translate into comparable outcomes across different social and geographic contexts.
Article
Open Access March 11, 2025

Why High Income Fails to Reduce E-Cigarette Use: The Knowledge-Attitude Paradox in the SMOKES Study

Abstract Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and [...] Read more.
Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. Objectives: This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. Methods: The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. Results: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. Conclusions: Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.
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Original Article
Open Access March 09, 2025

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms

Abstract Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical [...] Read more.
Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.
Article
Open Access March 09, 2025

Place-Based Diminished Returns of Parental Education on Adolescents’ Inhalant Use in Rural Areas

Abstract Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer [...] Read more.
Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.
Article
Open Access February 27, 2025

Hopelessness and Smoking among Black Adults

Abstract Background: While the link between depression and smoking is known, less is known about the relationship between hopelessness and smoking in large national community-based sample of Black people. Aims: This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically [...] Read more.
Background: While the link between depression and smoking is known, less is known about the relationship between hopelessness and smoking in large national community-based sample of Black people. Aims: This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically diverse nationally representative sample of Black adults. Methods: Data from the NSAL were analyzed. Hopelessness and smoking status were assessed using structured interviews. Logistic regression was employed to assess the link between hopelessness and smoking status, controlling for potential confounders such as demographic factors and socioeconomic indicators as well as depression. Results: 4,939 participants entered our analysis. Hopelessness was significantly associated with higher odds of smoking status. This association remained robust after adjusting for confounders such as demographic factors, socioeconomic status, and depression. Conclusions: Hopelessness may be a critical risk factor for smoking in Black adults. Promoting hope as a component of targeted tobacco cessation programs may help reduce tobacco use of Black populations.
Article
Open Access February 25, 2025

Nucleus Accumbens Resting State Functional Connectivity is Linked to Family Income, Reward Salience, and Substance Use

Abstract Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural [...] Read more.
Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural mechanisms underlying reward processing and the propensity for self-reported reward salience and substance use, research exploring the association between NAcc rsFC and brain networks beyond the default mode network (DMN) and prefrontal cortex (PFC) is limited. Objective: To investigate the role of the resting-state functional connectivity of the NAcc with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network in the association between socioeconomic status, self-reported reward salience, and future substance use. Methods: Data were obtained from the Adolescent Brain Cognitive Development (ABCD) study. NAcc rsFC with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network was assessed at baseline. Socioeconomic status was measured using family income. Self-reported reward salience was assessed using validated psychometric scales. Substance use outcomes were tracked longitudinally over the study period. Structural Equation Modeling was employed to examine the covariances between family income, NAcc rsFC, reward salience, and subsequent substance use. Results: Higher baseline family income was positively associated with baseline NAcc rsFC (B = 0.092, p < 0.001) and negatively associated with baseline reward salience (B = -0.040, p = 0.036) and future substance use (B = -0.081, p < 0.001). Baseline NAcc rsFC was strongly and positively associated with reward salience (B = 0.734, p < 0.001) and future substance use up to age 13 (B = 0.124, p < 0.001). Additionally, baseline reward salience was positively associated with future substance use (Covariance = 0.176, p < 0.001). Conclusion: The findings suggest that NAcc rsFC with brain networks beyond the DMN or PFC may contribute to the links between low parental socioeconomic status, reward salience, and substance use risk. Expanding the understanding of NAcc rsFC provides new insights into the neural mechanisms underlying these associations. These results have important implications for developing targeted interventions aimed at preventing substance use, particularly among low-income youth with heightened reward salience. Further research is needed to explore causal pathways and moderating factors influencing these relationships.
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Article
Open Access February 24, 2025

Socioeconomic Status, Trauma, Cognitive Function, Impulsivity, Reward Salience, and Future Substance Use: Role of Left Caudate Connectivity with the Cingulo-Opercular Network

Abstract Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state [...] Read more.
Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state functional connectivity (rsFC) with the cingulo-opercular network as a proxy of corticostriatal connectivity in social, cognitive, and behavioral processes. Objective: This study investigates the associations between left caudate-cingulo-opercular connectivity and multiple biopsychosocial domains, including low SES, high trauma exposure (financial and life events), cognitive function, reward salience, impulsivity, depression, and future substance use (tobacco and marijuana use). Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were analyzed to assess connectivity between the left caudate and the cingulo-opercular network. Data on socioeconomic status, trauma exposure, cognitive performance, and mental health were collected from participants. Future substance use behaviors were evaluated through longitudinal follow-ups. Correlation and regression analyses were conducted to examine relationships between corticostriatal connectivity and the targeted domains. Results: Corticostriatal hypoconnectivity was associated with lower SES, higher trauma exposure, poorer cognitive function, heightened reward salience, higher impulsivity, and history of depression. Additionally, corticostriatal hypoconnectivity at baseline predicted future tobacco and marijuana use during follow-up years. Conclusion: Corticostriatal hypoconnectivity, particularly the rsFC between the left caudate and the cingulo-opercular network, may represent a potential mechanism linking a wide range of social, emotional, and behavioral problems in youth. These findings suggest that corticostriatal hypoconnectivity could serve as a neurobiological marker for identifying individuals at risk for depression, low cognitive function, high reward salience, impulsivity, and substance use, emphasizing the interplay between socioeconomic and neurocognitive factors in shaping behavioral health trajectories.
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Article
Open Access February 19, 2025

The CEASE Tobacco Cessation Controlled Trial for Low-Income Racial and Ethnic Minority Participants: Key Predictors of Success

Abstract Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p [...] Read more.
Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. Conclusion: Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.
Article
Open Access February 17, 2025

Gender Differences in the Association Between Socioeconomic Status and Cardiometabolic Health: National Health and Nutrition Examination Survey

Abstract Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the [...] Read more.
Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. Results: Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. Conclusion: The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.
Article
Open Access February 13, 2025

Psychosocial Correlates of Childhood Body Mass Index: Racial and Ethnic Differences

Abstract Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing [...] Read more.
Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing non-Latino White, Black, Latino, Asian, and Other racial/ethnic groups. BMI was the primary outcome. Key predictors were family SES, neighborhood SES, and inhibitory control. Multivariable regression models were stratified by race/ethnicity to identify group-specific associations. Results: Race/ethnic groups differed in psychosocial correlates of childhood BMI at age 9 and 10. Among non-Latino White children, higher family income (B = -0.086, p < 0.001), higher parental education (B = -0.069, p < 0.001), and living in a married household (B = -0.079, p < 0.001) were associated with lower BMI. Additionally, the presence of healthy food options in the zip code (B = -0.030, p = 0.032) was linked to lower BMI, while lack of planning (B = 0.032, p = 0.030) was associated with higher BMI. For non-Latino Black children, positive urgency (B = -0.068, p = 0.022) was negatively associated with BMI, while other factors such as family SES and neighborhood SES did not show significant associations. For Latino children, higher family income (B = -0.093, p = 0.001) and parental education (B = -0.099, p < 0.001) were associated with lower BMI. In this group, male gender (B = 0.043, p = 0.033) was associated with higher BMI. Among Asian children, higher family income (B = -0.199, p = 0.006) and parental education (B = -0.144, p = 0.037) were significantly associated with lower BMI. For children in the "Other" racial/ethnic category, higher family income (B = -0.101, p = 0.023), living in a married household (B = -0.076, p = 0.026), and higher median income in the zip code (B = -0.083, p = 0.013) were associated with lower BMI. In this group, male children had lower BMI compared to females (B = -0.089, p = 0.001). Conclusion: The findings highlight substantial racial/ethnic differences in the psychosocial and socioeconomic correlates of BMI in children. There is a need for tailored interventions that target social determinants of childhood high BMI. One size does not fit all.
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Open Access February 11, 2025

Childhood Depression, Hopelessness, and Suicidal Attempt Predict Earlier Tobacco and Marijuana Use Initiation During Adolescence

Abstract Background: Emotional problems have been associated with substance use, yet longitudinal research examining this relationship during childhood and adolescence in large, diverse, community-based samples remains limited. Aims: This study investigates the prospective associations between three emotional problems—hopelessness, depression, and suicide attempts—before ages 9–10 and [...] Read more.
Background: Emotional problems have been associated with substance use, yet longitudinal research examining this relationship during childhood and adolescence in large, diverse, community-based samples remains limited. Aims: This study investigates the prospective associations between three emotional problems—hopelessness, depression, and suicide attempts—before ages 9–10 and the subsequent initiation of tobacco and marijuana use before ages 14–15, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: Data from the ABCD study were analyzed. Baseline emotional problems, including hopelessness, depression, and suicide attempts, were assessed at ages 9–10 through structured parent interviews. Substance use outcomes (tobacco and marijuana initiation) were tracked from baseline to follow-up at ages 14–15 using structured self-report measures. Structural Equation Modeling (SEM) was employed to assess the predictive roles of these early-life emotional problems, controlling for potential confounders such as demographic factors and family and neighborhood socioeconomic status. Results: Baseline hopelessness, depression, and suicide attempts at ages 9–10 were significant predictors of tobacco and marijuana use initiation at ages 14–15. These associations remained robust after adjusting for confounders, indicating the independent effects of early emotional problems on adolescent substance use initiation. Conclusions: Emotional problems in early childhood, including hopelessness, depression, and suicidal behavior, are critical predictors of substance use initiation during adolescence. These findings underscore the importance of early identification and targeted mental health interventions to reduce the risk of substance use among vulnerable youth.
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Open Access January 10, 2025

Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children

Abstract Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the [...] Read more.
Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.
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Open Access January 24, 2025

High Socioeconomic Status Black Adolescents Attend Worse Schools than Whites

Abstract Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, [...] Read more.
Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, Minorities’ Diminished Returns (MDRs) theory suggests that Black families may not experience the same benefits of high family SES due to structural barriers. This study examines the association between family SES and school characteristics, focusing on racial disparities in access to high-quality educational environments. Objective: To investigate the relationship between family SES (parental education and household income) and multiple school characteristics (poverty, teacher experience, graduation rates, and college enrollment), and to assess racial differences in these associations. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, a national sample of US adolescents, was analyzed. We used multivariate regression models to examine associations between family SES and school characteristics and to test for interactions by race, specifically comparing Black and White adolescents. Results: Higher family SES was associated with positive school characteristics overall, including lower school poverty, greater teacher experience, and increased graduation and college enrollment rates. However, these positive effects of high family SES on school characteristics were significantly weaker for Black adolescents than for White adolescents. Black adolescents from high-income families were more likely than White adolescents from similar backgrounds to attend schools with higher poverty rates, less experienced teachers, and reduced graduation and college enrollment rates. Conclusion: Our findings highlight persistent racial inequities in access to educational opportunities, even among families with comparable socioeconomic resources. The diminished returns of family SES for Black adolescents underscore the role of structural barriers in limiting access to high-quality schools. These findings emphasize the need for policy interventions to address systemic inequalities that hinder Black families from fully leveraging their SES to access favorable educational environments.
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Open Access January 24, 2025

Neurocognitive, Emotional, and Behavioral Costs for Adolescents Due to Diminished Returns of Parental Employment on Trauma

Abstract Background: Parental employment is a significant social determinant of children's developmental outcomes, shaping their cognitive and behavioral trajectories. However, the effects of parental employment may not be equally protective across racial groups. The Minority Diminished Returns (MDRs) framework suggests that socioeconomic status (SES) factors, such as employment, yield fewer [...] Read more.
Background: Parental employment is a significant social determinant of children's developmental outcomes, shaping their cognitive and behavioral trajectories. However, the effects of parental employment may not be equally protective across racial groups. The Minority Diminished Returns (MDRs) framework suggests that socioeconomic status (SES) factors, such as employment, yield fewer protective benefits for Black families compared to White families. Objective: This study investigates the diminished returns of parental employment on trauma and associated neurocognitive and behavioral outcomes in children, with a focus on racial variation in these effects. Methods: Using data from the Adolescent Brain Cognitive Development (ABCD) study, a large and diverse sample of children was analyzed. We applied MDRs theory and social determinants of health frameworks to examine the association between parental employment, trauma, and children's cognitive and behavioral outcomes. The analysis controlled for family SES, neighborhood factors, and racial group differences. Results: Preliminary findings suggest that while parental employment is generally protective against trauma, the strength of this association is diminished for Black children. Black families with employed parents experience higher levels of trauma and stress compared to their White counterparts, which may contribute to racial disparities in cognitive and behavioral outcomes. Conclusion: Parental employment may not equally buffer against trauma-related risks for Black children, reflecting the broader pattern of diminished returns for racially disadvantaged groups. These findings highlight the need for policies addressing the unequal benefits of SES across racial groups.
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Open Access January 24, 2025

Pallidum Functional Hypoconnectivity and Inhibitory Control as Partial Mediators of Environmental Influences on Tobacco and Marijuana Initiation

Abstract Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased [...] Read more.
Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased tobacco and marijuana use initiation among adolescents. Objectives: To examine the mediating roles of PM2.5 exposure, resting-state functional connectivity between the right pallidum and the ventral attention network (P-VAN rsFC), and inhibitory control in the relationship between low SES and tobacco and marijuana use initiation. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study to assess associations between baseline SES, baseline PM2.5 exposure (based on zip code), baseline P-VAN rsFC, baseline inhibitory control, and subsequent tobacco and marijuana use initiation. Mediation models were used to determine whether PM2.5 exposure and changes in P-VAN rsFC act as pathways linking low SES to diminished inhibitory control and subsequent substance use initiation. Results: Low SES was associated with higher PM2.5 exposure, which, in turn, was linked to alterations in P-VAN rsFC. These alterations were correlated with lower inhibitory control, which significantly predicted tobacco and marijuana use initiation over time. Inhibitory control partially mediated the relationship between low SES and substance use initiation, indicating a complex pathway influenced by environmental and neurocognitive factors. Conclusions: This study identifies a potential mechanism linking low SES to tobacco and marijuana use initiation through environmental and neurobiological pathways. Understanding how PM2.5 exposure and neurofunctional connectivity impact inhibitory control can provide valuable insights for developing targeted interventions to reduce substance use among adolescents in low SES environments.
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Open Access January 24, 2025

Cingulate Gyrus Volume as a Mediator of the Social Gradient in Cognitive Function

Abstract Background: Socioeconomic status (SES) is a well-established predictor of cognitive function in children, but the neurobiological pathways through which SES influences cognitive outcomes remain underexplored. This study examines the role of the cingulate gyrus (region of the brain that is involved in emotion regulation, decision-making, error detection, and cognitive control) in mediating [...] Read more.
Background: Socioeconomic status (SES) is a well-established predictor of cognitive function in children, but the neurobiological pathways through which SES influences cognitive outcomes remain underexplored. This study examines the role of the cingulate gyrus (region of the brain that is involved in emotion regulation, decision-making, error detection, and cognitive control) in mediating the relationship between SES and cognitive performance, with a focus on whether these effects vary by sex. Objective: To investigate the role of the cingulate gyrus in mediating the association between social gradients (family SES) and cognitive function in children and assess potential sex differences in these pathways. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Cognitive function was assessed using a composite measure of executive function and general cognitive ability. Structural MRI data were used to measure the volume of the cingulate gyrus. Path analysis was conducted to examine the mediating role of the cingulate gyrus in the association between SES and cognitive function. Interaction terms were included to test for sex differences. Results: Higher SES was significantly associated with a larger cingulate gyrus volume and better cognitive function. The volume of the left cingulate gyrus partially mediated the relationship between family and neighborhood SES and cognitive function, explaining a portion of the social gradient in cognitive outcomes. No significant sex differences were found in these mediating effects. Conclusions: The cingulate gyrus partially mediates the link between SES and cognitive function in children. These findings suggest that social disparities in cognitive function may operate, in part, through neurobiological changes such as those in the cingulate gyrus, without significant variation by sex.
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Open Access January 23, 2025

Population Diversity Matters: Heterogeneity of Biopsychosocial Pathways from Socioeconomic Status to Tobacco Use via Cerebral Cortical Volume in the ABCD Study

Abstract Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting [...] Read more.
Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting long-term health outcomes. The Adolescent Brain Cognitive Development (ABCD) study provides a unique opportunity to examine racial disparities in the pathways from SES to brain development and behavior, especially through the lens of Marginalization-Related Diminished Returns (MDRs), where the effects of SES are attenuated for minority groups. Objective: This study investigates racial variation in the associations between SES, cerebral cortical volume, and tobacco use initiation, comparing Black and White youth over 4-6 years of follow-up. Methods: Data from the ABCD study were analyzed to assess pathways from family income to adolescents’ cortical volume via the needs-to-income ratio, and from cortical volume to tobacco use initiation. Structural equation modeling was used to evaluate these pathways, stratified by race, with a focus on comparing Black and White participants. Covariates included family and neighborhood SES, demographic factors, and baseline behavioral measures. Results: We found that the positive association between income (via the needs-to-income ratio) and total cortical volume was significantly weaker for Black youth compared to White youth. Additionally, the link between larger total cortical volume and reduced risk of tobacco initiation was also weaker in Black adolescents. These findings were consistent over 4-6 years of follow-up, suggesting that Black youth experience diminished returns from higher SES in terms of brain development and behavioral outcomes. Conclusions: Our findings highlight significant racial disparities in the pathways from SES to brain development and tobacco use initiation, supporting the Marginalization-Related Diminished Returns (MDRs) framework. While higher SES is associated with larger cortical volumes and lower tobacco use risk in White youth, these associations are attenuated in Black adolescents.
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Open Access January 23, 2025

Weaker Effects of Educational Attainment on Chronic Medical Conditions in American Indian Alaska Native, Black, and Latino Adults: National Health Interview Survey 2023

Abstract Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors [...] Read more.
Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors contributing to these disparities. While higher socioeconomic status is generally associated with better health outcomes, this benefit may be diminished for racialized and minoritized populations. Objective: This study investigates the protective effects of educational attainment and income-to-poverty ratio on the prevalence of chronic medical conditions and examines whether these effects vary across racial and ethnic groups, specifically among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino White adults. Methods: Using data from the 2023 National Health Interview Survey (NHIS), this cross-sectional study analyzed the association between educational attainment and chronic medical conditions across racial and ethnic groups. Logistic regression models were employed to assess whether the strength of the relationship between education and chronic medical conditions differed by racial/ethnic group, controlling for key demographic and socioeconomic covariates. Sample size was 29,373 which was reflective of 256,566,689 US population. Results: Consistent with the theory of Minorities' Diminished Returns, findings showed that the protective effects of higher educational attainment on chronic medical conditions were significantly weaker for Black, Latino, and American Indian and Alaska Native adults than for their non-Latino White counterparts. Even among individuals with higher education, Black, Latino, and American Indian and Alaska Native adults faced elevated risks of chronic medical conditions. Conclusion: While educational attainment generally reduces the prevalence of chronic medical conditions, this protective effect is moderated by racial and ethnic background. Structural barriers limit the health benefits of educational attainment. This underscores the need for policies that address structural inequities—such as low-quality education and occupational segregation—that constrain the protective health effects of educational attainment for minoritized groups.
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Open Access January 23, 2025

Trauma and Early Puberty May Be Stronger Predictors of Early Tobacco Initiation in Girls Compared to Boys

Abstract Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines [...] Read more.
Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines potential mediating effects of trauma and early puberty on the association between SES and tobacco use, while comparing these pathways for males and females. Methods: Data were drawn from the ABCD study, and structural equation modeling (SEM) was employed to test direct and indirect pathways between SES, trauma, early puberty, and tobacco use. The sample was stratified by sex to assess differences in these relationships for males and females. Key predictors included SES, race, and age, while outcomes were trauma, early puberty, and tobacco use. The model assessed mediating effects of trauma and early puberty on tobacco use. Results: Trauma was a significant predictor of early puberty for females (B = 0.032, SE = 0.015, p = 0.039) but not males. Early puberty was significantly linked to tobacco use for females (B = 0.048, SE = 0.015, p = 0.001) but not for males. Additionally, trauma had an effect on tobacco use among females (B = 0.048, SE = 0.014, p < 0.001) but not males. Lower SES was significantly associated with higher trauma exposure for both males (B = -0.109, SE = 0.014, p < 0.001) and females (B = -0.110, SE = 0.015, p < 0.001). Conclusions: The findings suggest that trauma and early puberty play more significant roles in the pathways from SES to tobacco use for females than for males. While trauma and early puberty are crucial mediators for females, these factors are less predictive for males. These results highlight the importance of sex-specific interventions targeting trauma and early puberty as pathways to early tobacco use.
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Open Access January 23, 2025

Brain-Wide Resting-State Functional Connectivity Partially Mediates Socioeconomic Disparities in Children's Cardiometabolic Health

Abstract Background: Although some neural mechanisms underlying socioeconomic status (SES) disparities are known, the role of brain-wide resting-state functional connectivity in these effects remains less understood. Aim: This study aims to identify brain-wide resting-state functional connectivity signatures that may mediate the effects of SES on body mass index (BMI) and blood pressure in [...] Read more.
Background: Although some neural mechanisms underlying socioeconomic status (SES) disparities are known, the role of brain-wide resting-state functional connectivity in these effects remains less understood. Aim: This study aims to identify brain-wide resting-state functional connectivity signatures that may mediate the effects of SES on body mass index (BMI) and blood pressure in children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: Data were drawn from the ABCD study, a large, diverse cohort of children aged 9-10. Pre-processed resting-state functional MRI data were used, and factor analysis was conducted to extract a whole-brain connectivity factor. The first factor, capturing the greatest variance in brain-wide resting-state connectivity, was selected for further analysis in a structural equation model (SEM). This connectivity factor was tested as a potential mediator of the relationship between SES (measured by parental education, family income, and neighborhood characteristics) and two indicators of cardiometabolic health: BMI and systolic blood pressure. Results: Factor analysis revealed a robust first factor that accounted for a significant proportion of variance in brain-wide resting-state functional connectivity. This factor was significantly associated with SES, indicating that children from lower SES backgrounds exhibited distinct connectivity patterns. Additionally, the factor was linked to both BMI and systolic blood pressure, suggesting its relevance to cardiometabolic health. Mediation analysis showed that this connectivity factor partially mediated the relationship between SES and both BMI and systolic blood pressure. Conclusions: Brain-wide functional connectivity may be a mediator of SES effects on BMI and blood pressure in children. The first connectivity factor provides a promising neural signature linking SES with cardiometabolic risk. Comprehensive brain-wide approaches to functional connectivity may offer valuable insights into how social determinants of health shape neural and physical development in childhood.
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Open Access January 16, 2025

Extreme Heat Exposure and Adolescent Cognitive Function

Abstract Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. [...] Read more.
Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Methods: Data were drawn from the ABCD study, comprising over 10,000 children aged 9–10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Results: Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Conclusions: Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children’s cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.
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Open Access January 16, 2025

Heat Exposure Predicts Earlier Childhood Pubertal Initiation, Behavioral Problems, and Tobacco Use

Abstract Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association [...] Read more.
Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association between extreme heat exposure and early puberty initiation (ages 9-10), using data from the Adolescent Brain Cognitive Development (ABCD) study. It further explores how early puberty correlates with behavioral problems and tobacco use initiation. Methods: Data from 11,878 participants in the ABCD study were analyzed to examine the relationship between extreme heat exposure (independent variable) and puberty initiation (outcome). Behavioral problems and tobacco use initiation were evaluated as downstream outcomes of early puberty. Covariates included age, sex, and race/ethnicity, and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Structural equation modeling (SEM) was employed for analysis. Results: Extreme heat exposure was significantly associated with earlier puberty initiation at ages 9-10. Early puberty, in turn, correlated with higher levels of behavioral problems and an increased likelihood of tobacco use initiation. Conclusions: These findings underscore the importance of addressing environmental factors such as extreme heat to reduce risks associated with early maturation, including behavioral and substance use challenges. Targeted interventions and policies are needed to mitigate the impact of extreme heat on child development, and longitudinal studies are essential to confirm these results and inform effective prevention strategies.
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Open Access January 16, 2025

Puberty Onset and Positive Urgency Explain Diminished Returns of Family Income on Tobacco and Marijuana Use

Abstract Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral [...] Read more.
Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents. Objective: This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers. Methods: Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race. Results: Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. Conclusions: This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.
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Open Access January 15, 2025

Too Much Heat May Make You Smoke

Abstract Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. [...] Read more.
Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. Objectives: This study examines the relationship between extreme heat exposure and the initiation of tobacco use in adolescents, using data from the Adolescent Brain Cognitive Development (ABCD) study. It also evaluates the mediating roles of major depressive disorder (MDD) and childhood behavioral problems. Methods: Data from 11,878 participants in the ABCD study were analyzed to explore the link between extreme heat exposure (independent variable) and tobacco use initiation (dependent variable). Covariates included age, sex, and race/ethnicity, while MDD and behavioral problems (measured using the Child Behavior Checklist, CBCL) were assessed as potential mediators. Structural equation modeling (SEM) was applied for analysis. Results: The findings indicated a significant association between extreme heat exposure and an increased likelihood of tobacco use initiation in adolescents aged 9 to 15. MDD and behavioral problems partially mediated this relationship. Conclusions: These results underscore the importance of targeted interventions aimed at mitigating the impact of extreme heat on adolescent health, including its influence on tobacco use initiation. Addressing mental health and behavioral challenges could help reduce these risks. Future longitudinal research is needed to confirm these findings and evaluate the efficacy of strategies to protect vulnerable youth populations.
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Open Access November 21, 2024

Financial Strain Partially Explains Diminished Returns of Parental Education in the ABCD Study

Abstract Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, [...] Read more.
Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, this study examines whether high financial strain contributes to the diminished returns of parental education for Black children, using data from the Adolescent Brain Cognitive Development (ABCD) Study. We hypothesized that: (1) there would be a positive effect of parental education on total cortical volume, (2) this effect would be weaker for Black than White children, and (3) higher household financial strain in Black families would mediate the diminished returns of parental education on total cortical volume for Black children. Methods: Data were drawn from the baseline ABCD Study, focusing on 7,936 9- and 10-year-old children identified as either Black (n = 1,775) or White (n = 6,161). Parental education was the key independent variable, covariates included age, sex, household income, and marital status, race was the moderator, financial strain was the mediator, and total cortical volume was the outcome. Structural Equation Models (SEMs) were employed to examine the associations between parental education and cortical volume, with financial strain as a mediator and race as a moderator. Results: Higher parental education was associated with greater cortical volume in the pooled sample. However, this effect was significantly weaker for Black children. Financial strain partially mediated the observed diminished returns of parental education. Conclusion: High financial strain experienced by middle-class Black families partially explains why the association between parental education and child development is weaker in Black than White families. Interventions aimed at enhancing educational quality, increasing employability, expanding access to higher-paying jobs, and reducing labor market discrimination against Black individuals may help address racial inequities in child development in the U.S. Efforts to reduce financial strain should extend beyond low-income populations to also support higher-educated minority families.
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Open Access November 19, 2024

The Cost of Opportunity: Anti-Black Discrimination in High Resource Settings

Abstract Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental [...] Read more.
Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental education, and their interaction are associated with perceived school discrimination, which in turn reduces their cognitive, academic, and emotional wellbeing. We also hypothesize that Black children with high socioeconomic status (SES) report high perceived school discrimination in high-COI settings. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which measures a wide range of educational, cognitive, and emotional outcomes. At the same time, the ABCD children are sampled across areas with vast differences in COI rankings, that can be classified into these five categories: very high, high, average, low, and very low educational COIs. Our structural equation models (SEM) tested the additive and interactive effects of race and educational attainment on perceived school discrimination, and the effects of school discrimination on various cognitive abilities (reading proficiency, picture vocabulary, and list sorting working memory), school suspension, as well as depressed mood. Our multi-group SEM assessed how these relationships vary across educational COI levels. Results: Our findings showed that high SES Black children report highest school discrimination in residential areas with highest COIs. This is based on the observation that the interaction between race and parental education on experiences of school discrimination were only significant in areas with highest COI. Across residential areas with different COI levels, students who experienced higher school discrimination had higher suspension, worse depression, and worse cognitive performance. Conclusion: While higher COIs are associated with better academic outcomes, Black-White gaps exist in the role of increased COI through increased racial bias that children perceive. These findings underscore the complexity of educational equity, suggesting that improving COI alone is insufficient for eliminating racial disparities in school experiences. Policies should be in place to reduce school-based discrimination against Black students in high COI settings.
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Open Access November 03, 2024

School Poverty Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Abstract Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. [...] Read more.
Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. Objective. This study investigates whether school poverty and associated peer deviance and delinquent behaviors explain the disproportionately higher tobacco use among Black youth from high-income backgrounds, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods. We conducted a longitudinal analysis of Black youth from high-income families within the Adolescent Brain Cognitive Development (ABCD) study. A total of 8,777 youth was included in our analysis. We examined the associations between household income and tobacco use, with school poverty and associated peer deviance and delinquent behaviors as mediators. Race was considered as a moderator. Results. Compared to their high-income White counterparts, Black youth from high-income backgrounds were more likely to live in areas with higher school poverty, which exposed them to increased levels of peer deviance and delinquent behaviors compared to their White counterparts. These exposures, in turn, were associated with higher rates of tobacco use among Black youth. Thus, higher school poverty, along with the related peer deviance and delinquent behaviors, contributed to the elevated tobacco use observed among Black adolescents from high-income backgrounds. Conclusion. The study suggests that residing in areas with school poverty, peer deviance, and youth delinquency may explain Minorities' Diminished Returns, which are defined as the weaker protective effects of socioeconomic status on tobacco use among Black youth. Interventions aiming to prevent tobacco use need to include structural components addressing these broader social determinants of health.
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Open Access October 30, 2024

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data

Abstract Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers [...] Read more.
Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Methods: Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. Results: The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. Conclusions: This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.
Article
Open Access October 30, 2024

Smokers with Multiple Chronic Disease Are More Likely to Quit Cigarette

Abstract Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population [...] Read more.
Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, using data from Waves 1 to 6. Only current daily smokers were included in our analysis. The independent variable was the number of chronic medical conditions, defined as zero, one, or two or more. The outcome was becoming a former smoker (quitting smoking). Using multivariate regression analyses, we assessed the association between the number of chronic conditions and tobacco cessation over the six waves. We controlled for potential confounding variables, including demographic factors and socioeconomic status. Results: Our analysis revealed a significant association between the number of chronic medical conditions and the likelihood of quitting smoking. Specifically, individuals with two or more chronic conditions exhibited a greater probability of quitting smoking compared to those with no chronic conditions. The results remained significant after adjusting for potential confounders. Conclusions: Multiple chronic medical conditions may act as a catalyst for smoking cessation among U.S. adults. This suggests that the presence of multimorbidity, defined as multiple chronic disease diagnoses, may serve as “teachable moments,” prompting significant health behavior changes. These findings highlight the potential for leveraging chronic disease management and healthcare interventions to promote tobacco cessation, particularly among individuals with multiple chronic conditions.
Article
Open Access September 12, 2024

Assessment of Coping Strategies Among Nursing Students: Basis for Psychological First Aid

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.
Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for non-Latino White women poverty at certain level, and childbirth weight, and for non-Latino Black maternal age were predictors of telomere lengths nine years later. Conclusion: Poverty at a specific level, maternal age and childbirth weight serve as predictors of telomere lengths nine years later in some women. These findings underscore the importance of socioeconomic factors and early-life influences in understanding telomere dynamics and aging processes among women from varied racial and ethnic backgrounds.
Article
Open Access September 10, 2024

Does Adulthood Socioeconomic Status Predict Subsequent Telomere Length in Racially and Ethnically Diverse Women?

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.
Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for women in our study, no adulthood SES indicators such as poverty status, education, or marital status at baseline were predictive of telomere lengths nine years later. Conclusion: Our observations challenge that expected longitudinal association between adulthood SES indicators and subsequent telomere length almost a decade later in racially and ethnically diverse group of women. These findings underscore the need for additional research on the validity of TL as a mediator of the effects of adulthood SES on future rate of biological aging.
Article
Open Access September 05, 2024

Caste-based Diminished Returns of Educational Attainment on Wealth Accumulation in India

Abstract Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education [...] Read more.
Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education compared to their White counterparts, a phenomenon explained by the theory of Minorities' Diminished Returns (MDRs). Although MDRs have been documented in various countries, their relevance to caste-based disparities in India remains unexplored. Objective: This study aims to investigate the caste-based diminished returns of education on wealth in India. We hypothesize that the returns on educational attainment, in terms of wealth generation, will be weaker for individuals from Scheduled Castes (SCs) compared to those from higher castes, using data from the India Demographic and Health Surveys (DHS). Methods: This study was a cross-sectional analysis of DHS -2019/2021 data from India, examining the relationship between educational attainment and wealth across different caste groups (scheduled castes and non-scheduled castes). Multivariate regression models will be employed to assess the interaction between caste and education in predicting wealth outcomes, controlling for relevant covariates such as age, gender, and region. Results: The study is expected to find that the returns on education, in terms of wealth, are significantly weaker for individuals from Scheduled Castes compared to those from higher castes. This would indicate that caste-based discrimination continues to hinder the economic progress of Scheduled Castes, even when they achieve similar levels of education as their upper-caste counterparts. Conclusion: The findings of this study will extend the MDR framework to the Indian context, demonstrating that caste-based disparities result in diminished returns on education for wealth generation. This study underscores the need for targeted policies that address the specific barriers faced by Scheduled Castes in translating educational attainment into economic success and highlights the ongoing impact of caste-based discrimination in India.
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Open Access September 04, 2024

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study

Abstract Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the [...] Read more.
Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Results: Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. Conclusion: This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.
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Original Research
Open Access August 27, 2024

Role of Impulsivity in Explaining Social Gradient in Youth Tobacco Use Initiation: Does Race Matter?

Abstract Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and [...] Read more.
Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and the phenomenon of Minorities' Diminished Returns (MDRs), where the protective effects of SES, such as educational attainment, tend to be weaker or even reversed for Black youth compared to their White counterparts. Objectives: This study aims to examine the racial heterogeneity in the pathway from childhood SES to impulsivity and subsequent tobacco use initiation during adolescence, focusing on differences between Black and White youth. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, which includes a diverse sample of youth aged 9 to 16 years. The analysis examined the relationship between baseline family SES (age 9), impulsivity (age 9), and subsequent tobacco use (ages 9 to 16). Impulsivity was measured using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency Impulsive Behavior Scale (UPPS-P). Structural equation modeling (SEM) was employed, with analyses stratified by race to explore potential differences in these associations. Results: Overall, 6,161 non-Latino White and 1,775 non-Latino Black adolescents entered our analysis. In the full sample, higher family SES was linked to lower childhood impulsivity and, consequently, less tobacco uses in adolescence. However, racial differences emerged upon stratification. Among White youth, higher SES was associated with lower impulsivity, leading to reduced tobacco use, consistent with the expected model. In contrast, among Black youth, higher SES was not associated with lower impulsivity, thereby disrupting the protective effect of SES on tobacco use through this pathway. These findings suggest that racial heterogeneity exists in the SES-impulsivity-tobacco use pathway, aligning with the MDRs framework, which highlights how structural factors may weaken the protective effects of high SES among Black youth. Conclusions: These findings underscore the importance of considering racial heterogeneity in the relationships between SES, impulsivity, and tobacco use. The observed disparities suggest a need for targeted interventions that address the unique challenges faced by Black youth, who may not experience the same protective benefits of high SES as their White peers. These results carry significant implications for public health strategies aimed at reducing tobacco use in racially diverse populations.
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Open Access August 18, 2024

Extreme Heat Exposure Is Associated with Higher Socioeconomic Disadvantage and Elevated Youth Delinquency

Abstract Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as [...] Read more.
Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as delinquency. Objectives: This study investigates the association between extreme heat exposure and delinquency among children, utilizing data from the Adolescent Brain Cognitive Development (ABCD) study. It also explores the potential mediating roles of neighborhood socioeconomic status (SES; measured by median home value), puberty, peer deviance, and financial difficulties. Methods: Data from the national ABCD study were analyzed to assess the relationship between extreme heat exposure (exposure) and delinquency (outcome). Covariates included race/ethnicity, sex, and age. Mediators examined were neighborhood SES, puberty, peer deviance, and financial difficulties. Structural equation modeling (SEM) was employed for data analysis. Results: Overall, 11,878 children entered our analysis. The analysis revealed a significant association between extreme heat exposure and higher levels of delinquency among children. Children more exposed to extreme heat were more likely to be Black, reside in lower SES neighborhoods, experience greater financial difficulties, and have more advanced puberty status. The group facing the highest heat exposure was also economically disadvantaged. Conclusions: The findings suggest that children already disadvantaged by socio-economic factors are disproportionately affected by extreme heat, leading to increased delinquency. This highlights the need for targeted interventions to protect these vulnerable populations and address the mediators of extreme heat exposure. Future research should focus on longitudinal studies and evaluate the effectiveness of various mitigation strategies to address these disparities.
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Open Access August 17, 2024

Socioeconomic Status Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Abstract Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in [...] Read more.
Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in the United States. However, there has been limited exploration of the psychosocial mediators of this relationship, particularly in the context of youth aged 10-16 years. Objective: This study aimed to assess the roles of socioeconomic status (SES), tobacco susceptibility, and perceived discrimination as potential mediators in the relationship between state-level structural racism and youth tobacco initiation rates. Methods: We analyzed data from the ABCD study, a nationally representative longitudinal survey of 11,698 youth followed from ages 9/10 to 15/16. These data were combined with state-level indicators of structural racism. We employed structural equation modeling (SEM) to investigate the mediators of the association between structural racism and self-reported initiation of tobacco use, while controlling for individual and state-level covariates. Results: Our findings indicate that higher levels of structural racism were associated with increased rates of tobacco initiation among youth. This relationship was partially mediated by lower SES, but not by perceived discrimination or tobacco susceptibility. Conclusion: The association between structural racism and youth tobacco initiation appears to be influenced in part by the lower SES prevalent in states with higher levels of racism. These results highlight the need for addressing both racism and SES inequalities as key strategies for reducing tobacco disparities among youth.
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Open Access August 14, 2024

Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns

Abstract Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and [...] Read more.
Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.
Perspective
Open Access July 24, 2024

Race by Sex Intersectional Differences in the Association between Allostatic Load and Depression in US Adults: 2005-2018

Abstract Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated [...] Read more.
Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. Methods: This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. Results: Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. Conclusion: The study highlights the critical need to consider allostatic load as a key target for interventions that aim to reduce depression among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.
Article
Open Access July 16, 2024

Poverty Status at Birth Predicts Epigenetic Changes at Age 15

Abstract We used 15 years of follow up of 854 racially and ethnically diverse birth cohort who were followed from birth to age 15. Structural equation modeling (SEM) was used to examine the effects of race/ethnicity, maternal education, and family structure on poverty at birth, as well as the effects of poverty at birth on epigenetic changes at age 15. We also explored variations by sex. Results: [...] Read more.
We used 15 years of follow up of 854 racially and ethnically diverse birth cohort who were followed from birth to age 15. Structural equation modeling (SEM) was used to examine the effects of race/ethnicity, maternal education, and family structure on poverty at birth, as well as the effects of poverty at birth on epigenetic changes at age 15. We also explored variations by sex. Results: Our findings indicate that Black and Latino families had lower maternal education and married family structure which in turn predicted poverty at birth. Poverty at birth then was predictive of epigenetic changes 15 years later when the index child was 15. This suggested that poverty at birth partially mediates the effects of race/ethnicity, maternal education, and family structure on epigenetic changes of youth at age 15. There was an effect of poverty status at birth on DNA methylation of male but not female youth at age 15. Thus, poverty at birth may have a more salient effect on long term epigenetic changes of male than female youth. Conclusions: Further studies are needed to understand the mechanisms underlying the observed sex differences in the effects of poverty as a mechanism that connects race/ethnicity, maternal education, and family structure to epigenetic changes later in life.
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Open Access July 12, 2024

Race, Poverty Status at Birth, and DNA Methylation of Youth at Age 15

Abstract Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future [...] Read more.
Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future of Families and Child Wellbeing Study (FFCWS) cohort, with GrimAge used as a measure of DNAm levels and epigenetic aging. Our analysis included 854 racially and ethnically diverse participants followed from birth to age 15. Structural equation modeling (SEM) examined the relationships among race, SEP at birth, and epigenetic aging at age 15, controlling for sex, ethnicity, and family structure at birth. Findings indicate that race was associated with lower SEP at birth and faster epigenetic aging. Specifically, income to poverty ratio at birth partially mediated the effects of race on accelerated aging by age 15. The effect of income to poverty ratio at birth on DNAm was observed in male but not female youth at age 15. Thus, SEP partially mediated the effect of race on epigenetic aging in male but not female youth. These results suggest that income to poverty ratio at birth partially mediates the effects of race on biological aging into adolescence. These findings highlight the long-term biological impact of early-life poverty in explaining racial disparities in epigenetic aging and underscore the importance of addressing economic inequalities to mitigate these disparities. Policymakers should focus on poverty prevention in Black communities to prevent accelerated biological aging and associated health risks later in life. Interventions aimed at eliminating poverty and addressing racial inequities could have significant long-term benefits for public health. Future research should explore additional factors contributing to epigenetic aging and investigate potential interventions to slow down the aging process. Further studies are needed to understand the mechanisms underlying these associations and to identify effective strategies for mitigating the impact of SEP and racial disparities on biological aging.
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Open Access May 18, 2022

Parental Involvement in the Academic Performance of Students in Ghana: Socio-Economic Status

Abstract The purpose of the study was to assess the socioeconomic status and levels of parental involvement on the academic performance of Junior High School Students in the Upper West Akim District in Ghana. The study adopted the quantitative approach and specifically used the descriptive survey design. Simple random sampling and purposive sampling techniques were used for the selection of schools and [...] Read more.
The purpose of the study was to assess the socioeconomic status and levels of parental involvement on the academic performance of Junior High School Students in the Upper West Akim District in Ghana. The study adopted the quantitative approach and specifically used the descriptive survey design. Simple random sampling and purposive sampling techniques were used for the selection of schools and respondents for the study. The main instrument used for data collection was questionnaire. The Statistical Product and Service Solutions (SPSS) software version 22 was used for analysis of data gathered. The study concluded that, parents’ socioeconomic status specifically; education, occupation and income levels, is an important factor that determines the academic performance of students in the Upper West Akim District. The educational and income statuses have a positive relationship with the academic performance of students. The findings from the study also revealed that, parents who ensure that their children study at home, provide their educational needs, discuss their progress with their teachers and attend PTA meetings regularly have children who perform better academically as compared to children whose parents do not see to it that their children study at home, provide the educational needs of their children, discuss their children’s learning with teachers and attend PTA meeting regularly. It is recommended that, Considering the strong positive relationship between parental involvement and academic performance, it is recommended that government through the National Commission for Civic Education (NCCE) should educate parents, teachers and school managers on the relevance of parental involvement in the education of the child and the need for the school to create an atmosphere that would involve parents in the education of their wards. It is also recommended that, adult literacy should be enhanced by government to improve the level of education of parents in the Upper West Akim District which will go a long way to improve participation of parents in children’s education and hence improve their academic performance.
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