Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ Diminished Returns (MDRs) posits that structural racism, segregation, and labor market discrimination limit the benefits of socioeconomic resources, such as education, for Black and Latino individuals. This suggests that the effects of education on maternity leave may not be uniform across racial and ethnic groups. Objective: This study aimed to examine the MDRs of education on access to unpaid and paid maternity leave among Black and Latino mothers compared to White mothers giving birth while living in poverty. Methods: We utilized baseline data from the Baby’s First Years Study (BFY), a longitudinal investigation of the effects of poverty on child development. The sample consisted of 1,050 mothers living in poverty who had recently given birth. Maternity leave (paid and unpaid) was assessed via self-report, and educational attainment was measured in years of schooling. Structural equation modeling (SEM) and interaction terms were employed to analyze racial and ethnic differences in the relationship between education and access to maternity leave. Results: Educational attainment was positively associated with access to unpaid maternity leave for the overall sample of mothers giving birth in poverty, but this association was weaker for Black and Latino mothers compared to non-Latino White mothers. Education did not significantly increase the likelihood of paid maternity leave, and there were no group differences for this association. Conclusion: This study highlights the urgent needs to address structural racism, labor market discrimination, and residential segregation that diminish the impact of education on living conditions for Black and Latino mothers, compared to non-Latino White mothers, even for those living under poverty. Policymakers and practitioners should develop targeted interventions to reduce racial and ethnic disparities in access to paid and unpaid maternity leave and other critical resources, particularly for new mothers living in poverty. Addressing these inequities is essential for improving maternal and newborn health outcomes and promoting social justice.

Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.

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.

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.

Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. Results: Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. Conclusion: Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.

Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.

Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs.

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.

Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. Methods: Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. Results: No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. Conclusion: Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.