Antwan Jones

Segregation and cardiovascular illness: the role of individual and metropolitan socioeconomic status.

Demographic and epidemiologic research suggest that cardiovascular illness is negatively linked to socioeconomic status and positively related to racial residential segregation. Relying on 2005 data from the Behavior Risk Factor Surveillance Survey and the American Community Survey, this study examines how segregation and SES (individual and metropolitan) impact hypertension for a sample of 200,102 individuals. Multilevel analyses indicate that both segregation and hypersegregation are associated with hypertension, net of individual and spatial SES. While individual and metropolitan SES have independent effects on hypertension, these effects also differ across segregation type. In segregated and hypersegregated environments, highly educated and high-earning individuals seem to be protected against hypertension. In extremely hypersegregated areas, areas where there is very little interaction with non-black residents, SES does not have any protective benefit. These findings reveal that SES has differential effects across segregation types and that hypertension in disadvantaged (extremely hypersegregated) areas may be a function of structural constraints rather than socioeconomic position.

Differences in tobacco use between Canada and the United States

ObjectivesThis study explores differences in who smokes (smoker type) and exposure to smoking (pack-years) between Canada and the US. Both countries have policies to limit the number of smokers and smoking-related deaths.MethodsThis research uses The Joint Canada/United States Survey of Health (JCUSH) and employs multinomial logistic regression and ordinary least squares regression.ResultsIn Canada, native-born, young, White males without a degree, with poor health and who had been previously married predominate in smoking. This profile is the same for the US. However, different characteristics predict exposure to smoking for the two countries. Native-born males without a degree, with poor health and who had been previously married smoked more cigarettes per day in Canada. For the US, younger individuals smoked more cigarettes per day.ConclusionsIf countries want to focus on limiting the number of new cases of smokers, the target population is different from the target population that should be used if countries are interested in converting smokers into non-smokers, based on the demographic analyses presented.

Foreclosure Is Not an Equal Opportunity Stressor: How Inequality Fuels the Adverse Health Implications of the Nation's Financial Crisis

ABSTRACT: Foreclosure rates persist at high levels, segregation remains a central organizing feature of metropolitan regions, and a variety of health problems continue to plague metropolitan regions across the United States. Each of these issues is the subject of much policy debate and scholarly research. Missing from most of this discussion, however, is the intersection of these social forces. In recent years, a connection between foreclosures and health has been documented. A question that arises and is explored in this research is whether the impact of foreclosures on health is exacerbated by various measures of inequality. This article examines the emerging impact of foreclosures on health and the longstanding effects of racial and socioeconomic inequality (e.g., racial segregation, concentration of poverty, and income inequality) on health in major metropolitan areas. More importantly, multivariate statistical analyses are conducted to determine whether, and the extent to which, these indicators of inequality mediate the impact of foreclosures on health. The findings suggest policy implications for the development, expansion, and allocation of health care and financial services to address challenges posed by the ongoing foreclosure crises facing the nation’s metropolitan areas.

Rural, suburban and urban differences in the self-diagnosis of coronary heart disease in the United States.

This study explores rural, suburban and urban differences in coronary heart disease (CHD) using the 2005 Behavior Risk Factor Surveillance Survey conducted in the United States. Although areal context is not often considered in morbidity studies, this study evaluates the importance of place of residence given that areas offer differential access to health infrastructures and different contextual factors that could affect health. Also examined is the role of geographic heterogeneity on the recent racial divergence in CHD in the United States. Results indicate that area of residence is associated with CHD diagnosis, net of health and demographic variables. The area-stratified analysis documents that rural residents are most impacted by exercise and smoking, while being male or above age 50 are most detrimental for suburban residents. In addition, the racial divergence in CHD is driven by differences in rural locales. These findings indicate a disparate impact of geography on CHD and highlight the need for health research to take into account areal context.

IMMIGRANT NEIGHBORHOOD CONCENTRATION, ACCULTURATION AND OBESITY AMONG YOUNG ADULTS

ABSTRACT: Researchers repeatedly find that immigrants are healthier than their native-born counterparts. Among immigrant children, however, findings are mixed. Moreover, the effect of neighborhood context on obesity has not been fully examined. Using the National Longitudinal Study of Adult Health, this study investigates the linkages between acculturation, neighborhood characteristics, and obesity among young adults, including the potential for residing in an immigrant neighborhood, to mediate the adverse effects of low neighborhood socioeconomic conditions on obesity. Consistent with the unhealthy assimilation model, an immigrant health advantage is found for first generation Asians. Conversely, a greater likelihood of being obese is found for second and third and higher generation Hispanics relative to third and higher generation Whites. Further, a high concentration of immigrants and linguistically isolated households appear to work as a buffer against health risks that relate to obesity, particularly in poor neighborhoods.

Neighborhood disadvantage, physical activity barriers, and physical activity among African American breast cancer survivors

In view of evidence that African American cancer survivors experience the greatest challenges in maintaining adequate levels of physical activity, this cross-sectional study was designed to determine whether individual and residential environment characteristics are associated with physical activity in this population. A total of 275 breast cancer survivors completed self-report items measuring sociodemographic variables, physical activity, and select barriers to physical activity in Spring of 2012. Neighborhood disadvantage variables were extracted from national databases. Regression models were computed to assess relationships. Traditional correlates of smoking status and the presence of health complications were associated with physical activity. In addition, the relative number of renters versus homeowners in ones neighborhood was associated with lower levels of physical activity in the context of individual level barriers (i.e., interest and space), which were also associated with lower levels of physical activity. Higher renter rates and individual barriers both contribute to lower levels of physical activity in African American breast cancer survivors. These data suggest that the potential for constant residential turnover (via rentership) and perceived barriers may increase physical inactivity even where facilities may be available.

Residential Segregation and Diabetes Risk among Latinos

OBJECTIVE To examine whether residence in ethnically segregated metropolitan areas is associated with increased diabetes risk for Latinos in the United States. METHODS Population data from the 2005 Behavioral Risk Factor Surveillance System and the 2005 American Community Survey were used to determine whether higher levels of Latino-White segregation across metropolitan statistical areas (MSAs) in the United States is associated with increased diabetes risk among Latinos (n=7462). RESULTS No significant relationship (P<.05) between levels of segregation and diabetes risk was observed. CONCLUSION The research literature examining the impact of residential segregation on health outcomes remains equivocal for Latinos.

INTERGENERATIONAL EDUCATIONAL ATTAINMENT, FAMILY CHARACTERISTICS AND CHILD OBESITY.

This study used US National Longitudinal Study of Youth data to explore how exposure to different socioeconomic conditions (proxied by maternal education) before birth can shape child weight. Using endogenous selection regression models, the findings suggest that educational selectivity affects weight gain. Mothers whose mothers graduated from high school were more likely to complete high school, and mothers reared in an intact family had higher levels of education. However, mothers who had given birth as a teenager had the same educational outcomes as mothers who gave birth in their post-teenage years. Based on this intergenerational educational selectivity, caretaking (e.g. breast-feeding) was found to be associated with a lower child body mass index (BMI), while negative maternal characteristics (e.g. mothers with high BMIs) were associated with higher child BMIs. Thus, educational selectivity influences child health through values passed on to the child and the lifestyle in which the child is reared. Maternal education may be tied to parenting, which relates to child obesity risk.

Residential instability and obesity over time: the role of the social and built environment.

This research uses the National Longitudinal Study of Adult Healths Obesity and Neighborhood Environment (ONE) to examine the relationship between residential instability and change in obesity in the United States. Mobility is thought to be related to obesity because it conditions what kinds of amenities are present in the areas where people live and what level of motivation individuals have to take advantage of these amenities. Thus, this research uses spatial measures as potential confounders for the mobility-health relationship. Results suggest that mobility is a protective factor against weight gain over time. However, the effect of mobility is completely explained by the environmental characteristics. After adjusting for changes in physical activity resources and the crime rate, adolescents who move and adolescents who do not move have precisely the same risk of being obese. Mobility is thus a function of the change in environmental characteristics. Implications for developing the built environment are discussed.

Disability, Health and Generation Status: How Hispanics in the US Fare in Late Life

Using prospective data from a cohort of elderly Hispanics, this study explores how first-, second- and 1.5-generation Latinos differ in their levels and trajectories of disability. The results indicate that compared to second-generation elderly Hispanics, first- and 1.5-generation Hispanics had higher levels of disability. In addition, 1.5-generation elderly Hispanics had higher average ADL and IADL limitations than second-generation Hispanics at the beginning, and over time, this difference increasingly diverged. Currently married individuals had lower levels of disability than formerly married Hispanics. Also, marriage at any point in time significantly limits variability in disability in the sample, indicating that readily available spousal support is significant in diminishing generation differences in disability. Implications from these findings for future research are discussed.