Black Americans’ Diminished Return of Educational Attainment on Tobacco Use in Baltimore City

Journal of Racial and Ethnic Health Disparities · 5 authors, 5 centres

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TL;DR

This cross-sectional community survey found that while higher educational attainment was linked to lower odds of current smoking and menthol tobacco use for both Black and White adults in Baltimore City, the protective effect was significantly weaker for Black adults.

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This cross-sectional study analyzed data from a 2012–2013 community survey of 3501 adults in Baltimore City to examine racial differences in the association between educational attainment and tobacco use. Logistic regression models adjusted for age and gender showed that compared to those with less than a high school diploma, college graduates had lower odds of current smoking (AOR: 0.10) and menthol tobacco product use (AOR: 0.10). However, a significant interaction between race and education indicated the protective effect of college graduation on current smoking (AOR for interaction: 1.83) and menthol tobacco product use (AOR for interaction: 4.73) was weaker for Black adults than for White adults.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10645619

Black Americans’ Diminished Return of Educational Attainment on Tobacco Use in Baltimore City

Journal of Racial and Ethnic Health Disparities

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ABSTRACT

Abstract Background Socioeconomic status (SES) indicators such as educational attainment are fundamental factors affecting health. One mechanism through which education affects health is by reducing the likelihood of engaging in high-risk behaviors such as smoking. However, according to the marginalization-related diminished returns (MDRs) theory, the association between education and health may be weaker for marginalized populations such as Black than White, primarily due to racism and discrimination. However, little is known about the racial variations in the differential associations between educational attainment and tobacco use in a local setting. Aim This study aimed to investigate the differential association between educational attainment and tobacco use among racial groups in a community sample in Baltimore City. Methods This cross-sectional study used data from a community survey conducted in 2012–2013 in Baltimore City among adults aged 18 years or older. The participants were 3501 adults. Univariate, bivariate, and logistic regression analyses were performed using Stata to investigate the racial difference in the association between education and two outcomes: current smoking status and menthol tobacco product use. Results The study found that adults with a graduate degree were less likely to be current smokers (adjusted odds ratio [AOR]: 0.10, 95% confidence interval [CI]: 0.08–0.13) and menthol tobacco users (AOR: 0.10, 95% CI: 0.07–0.14) compared to those with less than high school diploma. The inverse associations between educational attainment and current smoking (AOR: 1.83, 95% CI: 1.05–3.21) and menthol tobacco product use (AOR: 4.73, 95% CI: 2.07–10.80) were weaker for Back individuals than those who were White. Conclusion Due to MDRs of educational attainment, while highly educated White adults show a low risk of tobacco use, educated Black adults remain at a disproportionately increased risk. The study emphasizes the need for better policies and programs that address minorities’ diminished return of education for tobacco use. Keywords: Smoking, Flavored tobacco, Social determinants, Educational attainment, Marginalized groups

CITATION EXPORT

Rifath Ara Alam Barsha, Shervin Assari, Mian B Hossain et al.. Black Americans’ Diminished Return of Educational Attainment on Tobacco Use in Baltimore City. Journal of Racial and Ethnic Health Disparities. (2023). https://doi.org/10.1007/s40615-023-01805-0

AUTHORS

5 · 5 CENTRES

Rifath Ara Alam Barsha, Shervin Assari, Mian B Hossain, Jummai Apata, Payam Sheikhattari

1Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
2Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA USA
3Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA USA
4School of Community Health and Policy, Morgan State University, Baltimore, MD USA
5The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD USA