Assari Shervin, Chalian Hamid, Bazargan Mohsen
Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA.
Department of Radiology, Department of Radiology, Duke University Medical Center, Durham, USA.
J Ment Health Clin Psychol. 2020;4(1):21-27. doi: 10.29245/2578-2959/2020/1.1185. Epub 2020 Jan 17.
Educational attainment and income are two socioeconomic status indicators with strong protective effects against cigarette smoking. , however, refer to less than expected protective effects of socioeconomic status indicators for the members of the racial and ethnic minority groups, particularly Blacks and Hispanics, compared to non-Hispanic Whites.
Borrowing data from a nationally representative study in the US, this study tested whether racial and ethnic differences exist in the effects of educational attainment and poverty status on cigarette smoking of American adults.
This cross-sectional study entered 28,329 adult participants of the Population Assessment of Tobacco and Health (PATH; 2013). Both educational attainment and poverty status were the independent variables. The dependent variable was current hookah smoking. Age, gender, and region were the covariates. Race and ethnicity were the effect modifiers (moderators).
Overall, individuals with higher educational attainment were more likely to smoke a hookah. Individuals who lived out of poverty, however, had lower odds of current hookah smoking. Race and ethnicity both showed statistical interactions with both socioeconomic indicators suggesting that Blacks and Hispanics with high educational attainment and those who live out of poverty have disproportionately high odds of hookah smoking, compared to non-Hispanic Whites with high socioeconomic status.
In the United States, middle-class racial and ethnic minority people remain at higher risk of smoking hookah. As a result, we should expect a high tobacco burden in middle-class Black and Hispanic adults. We suggest that policymakers should not take an over-simplistic way and reduce the problem of race/ethnic inequalities in tobacco use to gaps in socioeconomic status between groups. Marginalization-related diminished returns generate tobacco disparities in higher socioeconomic status levels. Middle-class racial and ethnic minority people need extra support to stay healthy.
教育程度和收入是两个社会经济地位指标，对吸烟有很强的保护作用。然而，与非西班牙裔白人相比，种族和少数民族群体（尤其是黑人和西班牙裔）的社会经济地位指标的保护作用低于预期。
本研究借鉴美国一项具有全国代表性的研究数据，检验美国成年人的教育程度和贫困状况对吸烟的影响是否存在种族和民族差异。
这项横断面研究纳入了28329名烟草与健康人口评估（PATH；2013年）的成年参与者。教育程度和贫困状况均为自变量。因变量是当前水烟吸食情况。年龄、性别和地区为协变量。种族和民族为效应修饰因素（调节因素）。
总体而言，教育程度较高的个体更有可能吸食水烟。然而，非贫困个体当前吸食水烟的几率较低。种族和民族与这两个社会经济指标均显示出统计学上的交互作用，这表明与社会经济地位较高的非西班牙裔白人相比，教育程度较高且非贫困的黑人和西班牙裔吸食水烟的几率过高。
在美国，中产阶级种族和少数民族人群吸食水烟的风险仍然较高。因此，我们预计中产阶级黑人和西班牙裔成年人的烟草负担会很重。我们建议政策制定者不应采取过于简单的方式，将烟草使用中的种族/民族不平等问题简化为群体间社会经济地位的差距。与边缘化相关的收益递减在较高社会经济地位水平上产生了烟草差异。中产阶级种族和少数民族人群需要额外的支持来保持健康。
