Assari Shervin
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA.
Int J Travel Med Glob Health. 2020 Spring;8(2):66-72. doi: 10.34172/IJTMGH.2020.11.
Although socioeconomic status (SES) resources influence population and individual health behaviors, socially marginalized groups gain significantly less health from their SES indicators, such as education and income, compared to the socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). However, most of the MDRs literature is derived from studies that have defined marginalization based on race and ethnicity. As a result, more research is needed on MDRs due to immigration. To extend what is known about MDRs due to immigration, the current study compared a national sample of immigrants and non-immigrants for the effects of education and income on current cigarette smoking of adults in the United States.
This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14,149 individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12,166; 86.0%). The independent variables (IV) were education and income that were treated as categorical variables. The dependent variable was current cigarette smoking. Age, gender, race, ethnicity, marital status, employment, and region were confounders. Immigration was the moderator. Logistic regression was used for data analysis.
High education and income were associated with lower odds of current cigarette smoking. However, immigration showed significant statistical interactions with both education and income. These interactions were suggestive of smaller protective effects of high education and income on current cigarette smoking for immigrant than non-immigrant adults.
In line with the MDRs, the effects of education and income on tobacco use is weaker for immigrant than non-immigrant adults.
尽管社会经济地位（SES）资源会影响人群和个体的健康行为，但与社会特权群体相比，社会边缘化群体从其SES指标（如教育和收入）中获得的健康收益要少得多。这种模式被称为边缘化相关收益递减（MDRs）。然而，大多数MDRs文献来自于基于种族和民族定义边缘化的研究。因此，需要更多关于移民导致的MDRs的研究。为了扩展对移民导致的MDRs的了解，本研究比较了一个全国性的移民和非移民样本，以探讨教育和收入对美国成年人当前吸烟情况的影响。
这是一项横断面研究。2015年全国健康访谈调查（NHIS）纳入了14149名个体，其中移民1977人（14.0%），非移民12166人（86.0%）。自变量（IV）为教育和收入，作为分类变量处理。因变量是当前吸烟情况。年龄、性别、种族、民族、婚姻状况、就业和地区为混杂因素。移民是调节变量。采用逻辑回归进行数据分析。
高教育和高收入与当前吸烟几率较低相关。然而，移民与教育和收入均显示出显著的统计交互作用。这些交互作用表明，与非移民成年人相比，高教育和高收入对移民成年人当前吸烟的保护作用较小。
与MDRs一致，教育和收入对移民成年人烟草使用的影响比对非移民成年人的影响弱。
