Walking the Divide: A Public Health Journey from Manhattan to Harlem.

This paper examines the striking contrasts and inequalities observation by walking from Manhattan to Harlem in New York City, highlighting the significant social and economic differences that have profound implications for public health and social policy. Through this journey, we explore various aspects including racial segregation, the composition of shops, smoking habits, street cleanliness, police presence, unemployment, real estate disparities, and the pervasive sense of insecurity. The transition from a predominantly White Manhattan to a predominantly Black and Hispanic Harlem underscores the historical and systemic inequalities that continue to shape the city's demographic and economic landscape. These disparities, rooted in discriminatory housing policies, economic disparities, and social exclusion, manifest in poorer health outcomes, higher rates of substance use, and limited economic opportunities for minority populations. By addressing these structural issues through targeted policies and sustained interventions, policymakers may work towards reducing health disparities and promoting racial equity. This paper also highlights the concept of Minorities' Diminished Returns (MDRs), where the benefits of education and income are less pronounced for minority individuals compared to their White counterparts, further perpetuating cycles of disadvantage. Comprehensive efforts to dismantle systemic inequities are essential for fostering a more equitable and healthy society.

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

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.

Latinos' diminished returns of educational attainment on reducing food insecurity: the role of ethnic disparities in family structure and employment.

Background: Higher education is widely recognized as a strategy to mitigate food insecurity. However, marginalized and racialized groups, especially Latinos, often do not experience the same economic and health benefits from their educational achievements as non-Latino Whites, highlighting a pattern of diminished returns within these communities. Aims: This study aims to explore the disparities in how educational attainment influences marital status and employment, and subsequently, food insecurity among Latino and non-Latino adults. Methods: Utilizing data from the 2022 National Health Interview Survey (NHIS), which encompassed 27,648 adults from both Latino and non-Latino backgrounds, this research applied a structural equation model to examine the relationship between educational attainment, ethnicity, and food insecurity. The study specifically focused on the mediating roles of marital status and employment. Results: Findings reveal significant interactions between education and ethnicity affecting marital status and employment, both of which serve as protective factors against food insecurity. These results indicate that higher levels of unemployment and lower marriage rates may disproportionately escalate food insecurity among Latinos, irrespective of educational attainment. Conclusion: The study highlights profound societal and environmental obstacles that prevent Latinos from leveraging educational achievements to improve their marital and employment statuses, and thereby, their food security. Addressing these disparities demands targeted interventions directed at Latino communities to bridge gaps in employment and marriage rates stemming from educational disparities. A holistic strategy that transcends mere access to education is essential to dismantle the societal barriers that undermine the educational dividends for Latino communities.

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

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.

Race, College Graduation, and Time of Retirement in the United States: A Thirty-Year Longitudinal Cohort of Middle-Aged and Older Adults.

Introduction: College education is typically associated with the ability to work in less physically demanding occupations, allowing for a later retirement age. However, research indicates that highly educated Black individuals often work in more demanding occupations, which affects their retirement age. Aim: Building on the Minorities' Diminished Returns (MDRs) literature, we tested whether the benefit of college education on delaying the time of retirement is weaker for Black compared to White middle-aged and older adults. Methods: We utilized data from the Health and Retirement Study (HRS), which includes a 30-year longitudinal follow-up of a nationally representative sample of middle-aged and older adults in the United States. Education levels at baseline were categorized as less than college graduate (some high school, GED, high school diploma, or some college) and college graduate. The outcome was the time to retirement, measured from wave 2 to wave 15 (baseline to 30 years later). We graphed survival curves and used independent samples t-tests to assess associations between college graduation and time of retirement, overall and by race. Results: Our analysis included 6,803 White and Black participants who were employed at baseline and followed for up to 30 years. Overall, there was a positive association between college graduation and retirement timing, with individuals with higher education retiring later. However, we found significant racial differences in the retirement age of college graduates, indicating notable racial disparities in the effects of college graduation on retirement timing, disadvantaging Black college-educated individuals. Specifically, among Whites, but not Blacks, college education was associated with later retirement. Conclusion: Consistent with Minorities' Diminished Returns theory, the positive effect of college education on retirement timing are weaker for Black than for White middle-aged and older Americans. To address racial disparities, it is insufficient to focus solely on economic disparities. While closing the educational gap is important, we must also work to equalize labor market experiences for Black and White individuals with similar educational credentials. Structural factors contributing to the diminished returns of college education for Black populations must be addressed to effectively close racial disparities.

Unequal Effect of Educational Attainment on Reducing Poverty and Welfare; Diminished Returns of American Indian/Alaska Native Populations.

Background: American Indian and Alaska Native (AIAN) communities face pronounced economic and health disparities compared to White Americans, a situation rooted in long-standing historical injustices and segregation. The theory of Minorities' Diminished Returns (MDR) provides insight beyond the traditional focus on socioeconomic status (SES) disparities, such as educational attainment. It suggests that the beneficial outcomes of educational achievements on health and economic status are less substantial for marginalized and racially non-White groups compared to White Americans. Aims: This study investigates the applicability of the MDR theory to AIAN populations by examining whether the positive effects of education on poverty reduction and the decreased risk of disability benefit dependency are weaker for AIAN adults relative to their White counterparts. Methods: Utilizing data from the 2022 National Health Interview Survey (NHIS), this cross-sectional study analyzed a cohort of 20,743 adults, comprising 20,474 White and 269 AIAN individuals. We assessed the relationships between educational attainment, poverty level, and the likelihood of receiving disability benefits. A structural equation model was employed, with receipt of disability benefits as a latent factor influenced by racial background (AIAN) as a potential moderator, education as the main predictor, and poverty level and self-rated health as mediators. Gender, age, employment status, marital status, and Hispanic ethnicity served as additional covariates. Results: Findings indicate that higher educational levels are generally associated with a lower likelihood of receiving disability benefits, mediated by improved health and economic status. Nonetheless, the interaction between race (AIAN) and education significantly influenced economic outcomes, subsequently affecting the risk of receiving disability benefits. This suggests that Whites benefit more economically from education than AIAN individuals do. Conclusion: The study underscores the MDR theory's relevance to the disparities in educational outcomes related to poverty risk and receiving disability benefits among AIAN populations. The challenges AIAN individuals face in leveraging their educational achievements for economic gain relative to Whites may be attributed to pervasive racism and discrimination within various sectors, including employment and education. Addressing these disparities necessitates policy interventions that ensure educational returns are equitable across racial groups, with a focus on equal access to resources and opportunities.

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

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 intervention point for preventing or reducing depression, particularly 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.

Paradoxical Effects of Income and Income Inequality on Racial Health Disparities.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

Household Income and Offspring Education Explain Blacks' Diminished Returns of Parental Education.

Background: High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities' diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. Methods: Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. Results: The study confirmed the role of our proposed serial mediators for Blacks' weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. Conclusions: The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

Black-White Differences in The Effects of Parental Education on College Students' Beliefs about Racial Discrimination.

Background: Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. Objectives: This study aims to examine the multiplicative effects of race and parental education on beliefs about the persistence of racial discrimination among Black and White college students. We hypothesize that Black students, particularly those with highly educated parents, will exhibit stronger beliefs in the persistence of racial discrimination as a significant issue compared to their White peers. Methods: Data were drawn from the Higher Education Research Institute (HERI) study, which includes a national sample of Black and White young adults on college campuses across the United States. We conducted statistical analyses to explore the influence of race and parental education on students' beliefs about racial discrimination. Results: Black students demonstrated stronger beliefs in the persistence of racial discrimination compared to White students. Additionally, students with higher parental education levels were more likely to recognize racial discrimination as a significant issue than those with lower parental education. The impact of parental education on these beliefs was more pronounced for Black students compared to White students. Discussion: Black college students, especially those from higher SES backgrounds, exhibit a heightened awareness of racial discrimination due to their lived experiences and educational exposure. High SES Black individuals often face increased visibility and prejudice in predominantly White environments, further reinforcing their beliefs about the persistence of discrimination. These findings highlight the need for targeted interventions to support Black students in higher education and promote awareness of racial discrimination. Policy solutions should include comprehensive anti-discrimination policies, increased diversity and inclusion efforts, and educational curricula that address systemic racism and social justice. The cross-sectional nature of the data limits causality inference, and self-reported measures may be subject to bias. Despite these limitations, the study's large and diverse sample enhances the generalizability of the findings. Race and parental education have multiplicative effects on college students' beliefs about the persistence of racial discrimination. Black students, particularly those from high SES backgrounds, are more likely to perceive racial discrimination as a continuing problem. Addressing these disparities through targeted policies and interventions is essential for creating equitable and inclusive educational environments.

Poverty Status at Birth Predicts Epigenetic Changes at Age 15.

Epigenetic studies have provided new opportunities to better understand the biological effects of poverty and racial/ethnic minority status. However, little is known about sex differences in these processes. Methods: 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.

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

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.

Incarceration's lingering health effects on Black men: impacts persist into retirement.

Background: The unique challenges Black men face within the criminal justice system underscore structural and systemic factors driving widespread inequalities. The long-term effects of these challenges on economic, health, and social outcomes as individuals transition to retirement remain poorly understood, highlighting a critical gap in our knowledge of life trajectories long after justice system involvement. Objectives: This study investigated the enduring health impacts of incarceration on Black men, particularly focusing on the transition into retirement. It aimed to explore the influence of race and gender on experiences of incarceration before age 50, and how such experiences affected self-rated health during the retirement transition. Methods: Utilizing data from the Health and Retirement Study, which followed individuals aged 50-59 for up to thirty years, this research examined the interplay of race, gender, incarceration history, and self-rated health during the retirement transition. Logistic regression and path modeling were employed for data analysis. Results: Logistic regression results indicated that being Black, male, and having lower educational attainment significantly increased the likelihood of experiencing incarceration before the age of 50 (p < 0.05). This suggests that Black men with lower levels of education are at the greatest risk of incarceration. The path model revealed a correlation between incarceration experiences before age 50 and poorer self-rated health at the time of retirement. Conclusion: The findings highlighted the disproportionately high risk of incarceration among Black men, especially those with lower educational attainment, and its persistent negative impacts on health decades later, including during the transition into retirement. Addressing structural racism and the mass incarceration of Black men is crucial for achieving racial health equity as individuals retire.

Sex Differences in the Relationship Between Nucleus Accumbens Volume and Youth Tobacco or Marijuana Use Following Stressful Life Events.

Background: Exposure to stressful life events (SLEs) can upset balance and affect the healthy brain development of children and youths. These events may influence substance use by altering brain reward systems, especially the nucleus accumbens (NAc), which plays a key role in motivated behaviors and reward processing. The interaction between sensitization to SLEs, depression, and substance use might vary between male and female youths, potentially due to differences in how each sex responds to SLEs. Aims: This study aims to examine the effect of sex on the relationship between SLEs, Nucleus Accumbens activity, and substance use in a nationwide sample of young individuals. Methods: We utilized data from the Adolescent Brain Cognitive Development study (ABCD), a longitudinal study of pre-adolescents aged 9-10 years, comprising 11,795 participants tracked over 36 months. Structured interviews measuring SLEs were conducted using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Initial linear regression analyses explored if SLEs could predict volumes of the right and left NAc. Subsequently, Cox regression models were used to investigate how SLEs and NAc volume might predict the initiation of tobacco and marijuana use, with the analysis stratified by sex to address potential sex differences. Results: Our findings reveal that SLEs significantly predicted marijuana use in males but not in females, and tobacco use was influenced by SLEs in both sexes. A higher number of SLEs was linked with decreased left NAc volume in males, a trend not seen in females. The right NAc volume did not predict substance use in either sex. However, volumes of both the right and left NAc were significant predictors of future tobacco use, with varying relationships across sexes. In females, an inverse relationship was observed between both NAc volumes and the risk of tobacco use. In contrast, a positive correlation existed between the left NAc volume and tobacco and marijuana use in males, with no such relationship for females. Conclusion: This study underscores that the associations between SLEs, NAc volume, and subsequent substance use are influenced by a nuanced interplay of sex, brain hemisphere, and substance type.

The link between residential stability and youth substance use: Role of stressful life events and behavioral problems.

Introduction: Residential stability is increasingly recognized as a significant factor influencing youth positive development. While the existing body of research provides valuable insights, gaps remain regarding the determinants of residential stability and how its outcomes may vary by gender and race. This study aims to investigate the relationship between residential stability, substance use, and behavioral issues among children aged 9-10 years, with a focus on the mediating role of trauma exposure. Methods: This research utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal project initiated in 2016 with a sample of 11,849 participants. It explores the links between residential stability, socioeconomic factors, stress, and emotional and behavioral outcomes using the Child Behavior Checklist (CBCL). Structural equation modeling was employed to analyze the data. Results: Findings indicate that higher household income, living in a household with married parents, and residing in areas with greater household incomes correlate with residential stability. In turn, residential stability is linked to lower levels of life stress and reduced substance use in the future. Furthermore, the impact of residential stability on substance uses and CBCL scores was entirely mediated by trauma exposure. Conclusions: The findings advocate for the implementation of economic, social, and public policies aimed at fostering stable living environments for children and families to mitigate the emotional and behavioral challenges future generations may face. Enhancing socioeconomic status and supporting structures that promote married family living arrangements emerge as effective strategies to improve residential stability and the well-being of young people in the United States.

Income Inequality, Gender Disparities, and Ethnic Differences: Investigating Allostatic Load in American Adults.

AIM: To estimate the association between income inequality and allostatic load score (AL) in adults ages 20 years and older, with a particular focus on the differential impacts across racial and gender groups. By examining this association, the study seeks to inform targeted policy interventions to mitigate health disparities exacerbated by economic inequality. METHODS: Utilizing data from the 1999-2016 National Health and Nutrition Examination Survey (NHANES), we assessed AL through eight biomarkers: systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg), pulse rate (beats/min), body mass index (kg/m2), glycohemoglobin (%), direct HDL cholesterol (mg/dL), total cholesterol (mg/dL), and serum albumin (g/dL). Employing negative binomial regression (NBRG), we estimated incidence rate ratios (IRR) for a sample comprising 7367 men and 7814 women, adjusting for age, race/ethnicity, marital status, education, health insurance, comorbidity, and mental health professional utilization. Gini coefficients (GC) were calculated to assess income inequality among men and women. RESULTS: Findings revealed that men exhibited a higher poverty-to-income ratio (PIR) compared to women (3.12 vs. 2.86, p < 0.01). Yet, women experienced higher rates of elevated AL (AL > 4) (31.8% vs. 29.0%) and were more adversely affected by income inequality (GC: 0.280 vs. 0.333). NBRG results indicated that high PIR individuals had a lower IRR (0.96; CI:0.92-0.95) compared to their low PIR counterparts, a trend observed in women but not men. High PIR was notably protective among White non-Hispanic (WNH) men and women. Additionally, vigorous and moderate physical activity engagement was associated with lower AL (IRR: 0.89, CI: 0.85-0.93). CONCLUSION: The study emphasizes the importance of implementing policies that target AL in low-income populations across all racial groups, with a specific focus on Black non-Hispanic (BNH) and Hispanic communities. By prioritizing these groups, policies can more effectively target the nexus of income inequality, health disparities, and allostatic load, contributing to the reduction of health inequities.

Racial Disparities in Occupational Distribution Among Black and White Adults with Similar Educational Levels: Analysis of Middle-Aged and Older Individuals in the Health and Retirement Study.

Background: Occupational classes play a significant role in influencing both individual and population health, serving as a vital conduit through which higher education can lead to better health outcomes. However, the pathway from education to corresponding occupational classes does not apply uniformly across different racial and ethnic groups, hindered by factors such as social stratification, labor market discrimination, and job segregation. Aims: This study seeks to investigate the relationship between educational attainment and occupational classes among Black, Latino, and White middle-aged and older adults, with a focus on their transition into retirement. Methods: Using cross-sectional data from the Health and Retirement Study (HRS), this research examines the impact of race/ethnicity, educational attainment, occupational classes, and timing of retirement among middle-aged and older adults. The analysis includes a sample of 7,096 individuals identified as White, Black, or Latino. Through logistic regression, we assess the additive and multiplicative effects of race/ethnicity and education on six defined occupational classes: 1. Managerial and specialty operations, 2. Professional Specialty, 3. Sales, 4. Clerical/administrative support, 5. Services, and 6. Manual labor. Results: Participants were Black (n = 1,143) or White (n =5,953). This included Latino (N =459) or non-Latino (n = 6,634). Our analysis reveals a skewed distribution of Black and Latino adults in manual and service occupations, in stark contrast to White adults who were more commonly found in clerical/administrative and managerial positions. Educational attainment did not equate to similar occupational outcomes across racial groups. Key findings include: Firstly, Black individuals with a college degree or higher were less likely to occupy clerical and administrative positions compared to their White counterparts. Secondly, holding a General Educational Development (GED) credential or some college education was generally linked to reduced likelihood of being in managerial roles; however, this inverse relationship was less evident among Black middle-aged and older adults than White ones. Thirdly, having a GED reduced the chances of working in sales roles, while having a college degree increased such chances. An interaction between race and some college education revealed that the impact of some college education on sales roles was more significant for Black adults than for White ones. We did not observe any interaction between ethnicity (Latino) and educational attainment on occupational classes. Given the stability of occupational classes, these findings could also apply to the last occupation held prior to retirement. Conclusion: This study highlights significant racial disparities in occupational classes among individuals with comparable levels of education, underscoring the profound implications for health and wellbeing disparities. Future research should explore strategies to alleviate labor market discrimination and job segregation as ways to close these occupational gaps. Additionally, the influence of social stratification, job segregation, and historical legacies, such as the repercussions of the Jim Crow era, on these disparities merits further investigation. Addressing these issues is crucial for enhancing the health and wellbeing of all populations.

Black Americans' Diminished Health Returns of Professional Occupations: A Thirty-Year Follow-Up Study of Middle-Aged and Older Adults.

INTRODUCTION: Occupational classes exert substantial effects on both subjective and objective health outcomes. However, it remains unclear whether the health impact of similar occupational classes varies across racial groups among middle-aged and older adults in the United States. AIM: Grounded in the theory of Minorities' Diminished Returns (MDRs), which posits that health benefits from resources such as employment are systematically weaker for racial minority populations, particularly Non-Latino Black individuals, this study tested Black-White disparities in the effects of similar occupational classes on health outcomes in middle-aged and older adults. METHODS: Utilizing data from the Health and Retirement Study (HRS), we employed a 30-year longitudinal design with a nationally representative sample of middle-aged and older adults in the United States. Six occupational classes-operator, managerial, professional specialty, sales, clerical/admin, and service-served as the key predictor variables (independent variables), with race as the moderator. Various health outcomes, including self-rated health, chronic disease, body mass index (BMI), activities of daily living (ADL), and cognitive function, were measured longitudinally from wave 1 to wave 15 (from baseline to 30 years later). Statistical analyses, incorporating logistic regression models, were conducted to assess associations between occupational class and health outcomes overall and based on race. RESULTS: Our analysis included 7538 Non-Latino White or Non-Latino Black participants followed for up to 30 years. Initial findings revealed positive health effects of professional occupations on cognitive function and self-rated health over 30 years of follow-uWe also identified significant interactions between race and professional occupational class on all health outcomes, indicating notable racial differences in the effects of professional occupations on health outcomes across domains. The effects of professional occupational class were weaker for Non-Latino Black individuals than for Non-Latino White individuals. CONCLUSION: Consistent with the Minorities' Diminished Returns theory, our findings indicated less pronounced positive effects of professional occupations on a wide range of health outcomes for Non-Latino Black individuals compared to Non-Latino Whites. These disparities emphasize the critical need to address structural factors that contribute to the diminished returns of prestigious occupations for Non-Latino Black populations.

Racial Differences in Biopsychosocial Pathways to Tobacco and Marijuana Use Among Youth.

BACKGROUND: The influence of socioeconomic disparities and multidimensional stressors on youth tobacco and marijuana use is recognized; however, the extent of these effects varies among different racial groups. Understanding the racial differences in the factors influencing substance use is crucial for developing tailored interventions aimed at reducing disparities in tobacco and marijuana use among adolescents. AIMS: This study aims to explore the differential effects of socioeconomic disparities and multidimensional stressors on tobacco and marijuana use between Black and White adolescents. METHODS: Utilizing longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, this research includes a cohort of pre-youth, monitored from the age of 9-10 years for a period of up to 36 months. We examined the impact of various socioeconomic status (SES) indicators and multidimensional stressors, including trauma, financial stress, racial discrimination, and family stress, alongside baseline average cortical thickness and the subsequent initiation of tobacco and marijuana use over the 36-month follow-up. RESULTS: Overall, 10,777 participants entered our analysis. This included 8263 White and 2514 Black youth. Our findings indicate significant differences in the pathways from SES indicators through stress types to cortical thickness between Black and White youths. Notably, cortical thickness's impact on the future initiation of tobacco and marijuana use was present in both groups. CONCLUSION: The study suggests that compared to White adolescents, Black adolescents' substance use and associated cortical thickness are less influenced by stress and SES indicators. This discrepancy may be attributed to the compounded effects of racism, where psychosocial mechanisms might be more diminished for Black youth than White youth. These findings support the theory of Minorities' Diminished Returns rather than the cumulative disadvantage or double jeopardy hypothesis, highlighting the need for interventions that address the unique challenges faced by Black adolescents.

What is Common Becomes Normal; Black-White Variation in the Effects of Adversities on Subsequent Initiation of Tobacco and Marijuana During Transitioning into Adolescence.

Background: While adversities across domains of finance, race, family, and life may operate as risk factors for initiation of substance use in adolescents, the influence of these factors may vary across racial groups of youth. Unfortunately, the existing knowledge is minimal about racial differences in the types of adversities that may increase the risk of subsequent substance use initiation during the transition into adolescence. Aim: To compare racial groups for the effects of adversities across domains of finance, race, family, and life on subsequent substance use initiation among pre-adolescents transitioning into adolescence. Methods: In this longitudinal study, we analyzed data from 6003 non-Latino White and 1562 non-Latino African American 9-10-year-old children transitioning into adolescence. Data came from the Adolescent Brain Cognitive Development (ABCD) study. Participants were followed for up to thirty-six months as they transitioned to adolescence. The independent variables were adversities related to the domains of finance, race, family, and life. The primary outcomes were time to first tobacco or marijuana use. Age, puberty, and gender were confounders. Cox regression models were used for data analysis. Results: For White youth, tobacco use was under influence of having two parents in the household (HR = .611; 95% CI = .419-.891), parental education (HR = .900; 95% CI = .833-.972), household income (HR = .899; 95% CI = .817-.990), racial stress (HR = 1.569; 95% CI = 1.206-2.039), and life stress (HR =1.098 ; 95% CI = 1.024-1.178) and marijuana use was under influence of neighborhood income (HR = .576; 95% CI = .332-.999) and financial stress (HR =4.273; 95% CI = 1.280-17.422). No adverse condition predicted tobacco or marijuana use of African American youth. Conclusion: The effects of adversities on substance use depend on race. While various types of adversities tend to increase subsequent initiation of tobacco and marijuana, such factors may be less influential for African American adolescents, who experience more of such adversities. What is common may become normal.