16
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Association Between Parental Educational Attainment and Youth Outcomes and Role of Race/Ethnicity

      research-article
      , MD, MPH 1 , , , PhD 2 , 3 , , PhD 1 , 4
      JAMA Network Open
      American Medical Association

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Key Points

          Question

          Is parental educational attainment associated with the same amount of health benefits for various ethnic groups?

          Findings

          In this cross-sectional study of 10 619 youth aged 12 to 17 years, parental educational attainment was associated with fewer health benefits for Hispanic youth compared with their non-Hispanic counterparts.

          Meaning

          These findings suggest that elimination of ethnic health disparities requires more than equalizing socioeconomic resources across ethnic groups.

          Abstract

          This cross-sectional study uses data from the Population Assessment of Tobacco and Health survey to explore racial and ethnic differences in the associations between parental educational attainment and youth outcomes among US adolescents.

          Abstract

          Importance

          The concept of minorities’ diminished returns refers to the smaller protective effects of educational attainment for racial and ethnic minority groups compared with those for majority groups.

          Objective

          To explore racial and ethnic differences in the associations between parental educational attainment and youth outcomes among US adolescents.

          Design, Setting, and Participants

          A cross-sectional study was performed of 10 619 youth aged 12 to 17 years who were participants at wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative survey, in 2013. Data analysis was performed from August to October 2019.

          Main Outcomes and Measures

          The dependent variables were youth tobacco dependence, aggression, school performance, psychological distress, and chronic medical conditions. The independent variable was parental educational attainment. Age and sex of the adolescents and marital status of the parents were the covariates. Race and ethnicity were the moderating variables. Logistic regression was used for data analysis.

          Results

          Among the participants, 5412 (51.0%) were aged 12 to 15 years, and 5207 (49.0%) were aged 16 to 17 years; 5480 (51.7%) were male. For non-Hispanic white youth, as parental educational attainment increased, there were stepwise reductions in the prevalence of tobacco dependence (13.2% vs 6.9% vs 2.7%), aggression (37.9% vs 34.8% vs 26.1%), low grade point average (84.2% vs 75.6% vs 53.3%), and chronic medical conditions (51.7% vs 50.8% vs 43.9%), but there was not such a trend for psychological distress (43.7% vs 48.6% vs 41.0%). Interactions were significant between Hispanic ethnicity and parental education on tobacco dependence (OR, 3.37 [95% CI, 2.00-5.69] for high school graduation; OR, 5.40 [95% CI, 2.52-11.56] for college graduation; P < .001 for both), aggression (OR, 1.41 [95% CI, 1.09-1.81]; P = .008 for high school graduation; OR, 1.59 [95% CI, 1.14-2.21]; P = .006 for college graduation), and psychological distress (OR, 1.50 [95% CI, 1.05-2.13]; P = .03). Black race showed an interaction with college graduation on poor school performance (OR, 2.00 [95% CI, 1.26-3.17]; P = .003) and chronic medical conditions (OR, 1.56 [95% CI, 1.14-2.14]; P = .005). All these findings suggest that the protective associations between high parental educational attainment and youth development might be systemically smaller for Hispanic and black youth than for non-Hispanic youth.

          Conclusions and Relevance

          Although high parental educational attainment is associated with better outcomes for youth, this association is systemically less significant for Hispanic and black than non-Hispanic white youth. The result is an increased health risk in youth from middle class black and Hispanic families. Given the systemic pattern for outcomes across domains, the diminishing returns of parental educational attainment may be due to upstream social processes that hinder ethnic minority families from translating their capital and human resources into health outcomes.

          Related collections

          Most cited references67

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Unequal Gain of Equal Resources across Racial Groups

          The health effects of economic resources (eg, education, employment, and living place) and psychological assets (eg, self-efficacy, perceived control over life, anger control, and emotions) are well-known. This article summarizes the results of a growing body of evidence documenting Blacks’ diminished return, defined as a systematically smaller health gain from economic resources and psychological assets for Blacks in comparison to Whites. Due to structural barriers that Blacks face in their daily lives, the very same resources and assets generate smaller health gain for Blacks compared to Whites. Even in the presence of equal access to resources and assets, such unequal health gain constantly generates a racial health gap between Blacks and Whites in the United States. In this paper, a number of public policies are recommended based on these findings. First and foremost, public policies should not merely focus on equalizing access to resources and assets, but also reduce the societal and structural barriers that hinder Blacks. Policy solutions should aim to reduce various manifestations of structural racism including but not limited to differential pay, residential segregation, lower quality of education, and crime in Black and urban communities. As income was not found to follow the same pattern demonstrated for other resources and assets (ie, income generated similar decline in risk of mortality for Whites and Blacks), policies that enforce equal income and increase minimum wage for marginalized populations are essential. Improving quality of education of youth and employability of young adults will enable Blacks to compete for high paying jobs. Policies that reduce racism and discrimination in the labor market are also needed. Without such policies, it will be very difficult, if not impossible, to eliminate the sustained racial health gap in the United States.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Health Disparities due to Diminished Return among Black Americans: Public Policy Solutions

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Blacks' Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth.

              The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks' diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.
                Bookmark

                Author and article information

                Journal
                JAMA Netw Open
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2574-3805
                22 November 2019
                November 2019
                22 November 2019
                : 2
                : 11
                : e1916018
                Affiliations
                [1 ]College of Medicine, Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California
                [2 ]Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
                [3 ]Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health, Ann Arbor
                [4 ]Department of Family Medicine, University of California, Los Angeles, Los Angeles
                Author notes
                Article Information
                Accepted for Publication: September 23, 2019.
                Published: November 22, 2019. doi:10.1001/jamanetworkopen.2019.16018
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2019 Assari S et al. JAMA Network Open.
                Corresponding Author: Shervin Assari, MD, MPH, College of Medicine, Department of Family Medicine, Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA 90059 ( shervinassari@ 123456cdrewu.edu ).
                Author Contributions: Dr Assari had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Assari, Bazargan.
                Acquisition, analysis, or interpretation of data: Assari, Caldwell.
                Drafting of the manuscript: Assari, Bazargan.
                Critical revision of the manuscript for important intellectual content: Caldwell.
                Statistical analysis: Assari.
                Obtained funding: Assari.
                Administrative, technical, or material support: Caldwell.
                Supervision: Bazargan.
                Conflict of Interest Disclosures: None reported.
                Funding/Support: This study was supported by the National Cancer Institute of the National Institutes of Health (NIH) and the US Food and Drug Administration Center for Tobacco Products under award U54CA229974. Dr Assari is also funded by the NIH under awards U54MD008149 and R25MD007610 (principal investigator [PI]: M. Bazargan), U54MD007598 (PI: J. Vadgama), U54TR001627 (PIs: S. Dubinett and R. Jenders), and 5S21MD000103.
                Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.
                Additional Contributions: Mohammed Saqib, undergraduate student (University of Michigan), helped edit the manuscript and received no financial compensation for this work.
                Article
                zoi190610
                10.1001/jamanetworkopen.2019.16018
                6902825
                31755951
                5946ff89-3517-4120-ad1d-8fede3d4b742
                Copyright 2019 Assari S et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                History
                : 15 July 2019
                : 23 September 2019
                Categories
                Research
                Original Investigation
                Online Only
                Public Health

                Comments

                Comment on this article