ADOLFO CUEVAS

Adolfo Cuevas
ADOLFO CUEVAS

Assistant Professor of Social and Behavioral Sciences

Professional overview

Adolfo G. Cuevas, PhD is an Assistant Professor in GPH’s Department of Social and Behavioral Sciences, as well as a scholar in its Center for Anti-Racism, Social Justice and Public Health. He employs epidemiological, psychological and biological approaches to investigate the effects of discrimination and other psychosocial determinants of health and health inequities. As a community psychologist, he uses population-level datasets and advanced statistical methods to understand how psychosocial determinants “get under the skin” and increase the risk of aging-related diseases.

For his research work on race, racism and health, Dr. Cuevas was selected one of the National Minority Quality Forum's 40 Under 40 Leaders in Minority Health in 2018. He is also a recipient of the Diversity Scholar Award by the Nutrition Obesity Research Center at Harvard University. Prior to joining NYU, he was the Gerald R. Gill Assistant Professor of Race, Culture and Society at Tufts University.

Dr. Cuevas’ work has been published in scientific journals such as the Proceedings of the National Academy of Sciences and the American Journal of Public Health, and he has been featured in HuffPost and NPR's Code Switch. While at Tufts he directed a multidisciplinary team of researchers investigating the obesogenic effects of discrimination across the life course.

Dr. Cuevas received both his MS and his PhD in applied psychology at Portland State University, with a concentration in community psychology and research methods. He earned a BA in psychology at City College of New York, and received additional training as a cancer prevention postdoctoral fellow at the Harvard T.H. Chan School of Public Health.

Education

PhD, Applied Psychology, Portland State University
MS, Applied Psychology, Portland State University
BA, Psychology, City College of New York, 2010
Certificate, Applied Biostatistics, Harvard Catalyst

Honors and awards

National Institute of Health Loan Repayment-Renewal (2021)
Diversity Scholar Award, Nutrition Obesity Research Center, Harvard University (2019)
National Institute of Health Loan Repayment (2019)
40 Under 40 Leaders in Health, National Minority Quality Forum (2018)
Neubauer Faculty Fellowship, Tufts University (2017)
Portland African American Leadership Fellowship (2013)
National Cancer Institute R25E Summer Research Experience, The University of Texas MD, Anderson’s Cancer Prevention Research Training Program (2012)
Bernard R. Ackerman Foundation Award for Outstanding Scholarship (2010)
Search for Education, Elevation, and Knowledge Graduate of the Year (2010)
City University of New York Pipeline Fellowship (2009)
City University of New York Search for Education, Elevation, and Knowledge (SEEK) Scholarship (2009)
Psi Chi Honor Society (2009)
Dean’s List Scholar (20082009)
Chi Alpha Epsilon (XAE) Honor Society (2008)
City College of New York’s William Wright Scholarship (2008)
City College of New York Community Service Award (2008)
SEEK Scholarship (2008)

Areas of research and study

Obesity
Psychosocial Stress
Racial/Ethnic Disparities

Publications

Publications

Intersectional vulnerability in the relationship between discrimination and inflammatory gene expression

Cuevas, A. G., Freilich, C. D., Mann, F. D., Cole, S. W., & Krueger, R. F. (n.d.).

Publication year

2023

Journal title

Brain, Behavior, and Immunity - Health

Volume

27
Abstract
Abstract
Addressing social disparities in health and well-being requires understanding how the effects of discrimination become biologically embedded, and how embedding processes might vary across different demographic contexts. Emerging research suggests that a threat-related gene expression response may contribute to social disparities in health. We tested a contextual vulnerability model of discrimination embedding using an empirical intersectionality (interaction discovery) analysis of pro-inflammatory gene expression in a national sample of non-institutionalized, English-speaking adults with RNA biomarker data (n = 543). At the time of data collection, the average age of participants was 55 years (SD = 13.26) and approximately half identified as female (50.46%). Most participants identified as White (∼73%) and had some college experience (∼60%). Results showed significant variation in the strength of association between daily discrimination and inflammatory gene expression by race and sex (b = −0.022; 95% CI:-0.038,-0.005, p =.009) with the estimated marginal association larger for racially-minoritized males (b = 0.007; 95% CI:-0.003,0.017, p =.163), compared to White males (b = −0.006; 95% CI:-0.013,0.001, p =.076). This study indicates that the link between daily discrimination and inflammatory gene expression may vary by sociodemographic characteristics. To improve initiatives and policies aimed at ameliorating disparities within populations, greater attention is needed to understand how interlocking systems of inequalities contribute to physiological health.

Assessing the role of socioeconomic status and discrimination exposure for racial disparities in inflammation

Cuevas, A. G., Goler, E., Guetta, C. J., & Krueger, R. F. (n.d.).

Publication year

2022

Journal title

Brain, Behavior, and Immunity

Volume

102

Page(s)

333-337
Abstract
Abstract
Socioeconomic status (SES) and discrimination have been implicated as social determinants of health and health disparities. Yet, very little research has been done to assess their contributing role in Black-White disparities in inflammation. Using data from the Midlife in the United States (2004–2006), we conducted Oaxaca-Blinder decomposition analysis to quantify the extent to which three indicators of SES (i.e., education, household income, and employment status) and three forms of discrimination exposures (i.e., everyday, lifetime, and workplace discrimination) explained Black-White differences in inflammation. Education, particularly having a college degree or more, explained 16.88% of the differences between Blacks and Whites. There was no evidence that household income and employment status explained Black-White inflammation differences. Lifetime discrimination significantly explained 18.18% of Black-White difference in inflammation burden. There was no evidence that everyday and workplace discrimination explained Black-White difference in inflammation burden. Together, the predictors explained 44.16% of inflammation differences between Black and White participants. Education and lifetime exposure to discrimination may play a role in inflammation disparities. Further research is needed to examine other dimensions of SES (e.g., wealth) and discrimination (e.g., racial segregation) that are associated with health to better understand the contributions of these key social determinants of Black-White inflammation disparities.

Contested racial identity and the health of women and their infants

Abuelezam, N. N., Cuevas, A. G., Galea, S., & Hawkins, S. S. (n.d.).

Publication year

2022

Journal title

Preventive Medicine

Volume

155
Abstract
Abstract
Contested racial identity— self-identified race not matching socially-assigned race—may be an indication of experiences with racism. We aimed to understand the relationship between contested racial identity and women's health behaviors, health outcomes, and infant health outcomes. We used 2012–2015 Massachusetts Pregnancy Risk Assessment Monitoring System data on 5735 women linked with infants' birth certificates. We conducted regression analyses to examine associations between contested racial identity with pregnancy and infant health outcomes and further sub-analyses among women who had experienced a contested racial identity. A total of 901 (15.7%) women reported a contested racial identity. When compared to those who did not, women who had a contested racial identity had lower odds of initiating prenatal care in the first trimester (AOR: 0.76, 95% CI: 0.62, 0.95) and higher odds of smoking (AOR: 1.70, 95% CI: 1.32, 2.19). Among women who had experienced a contested racial identity, those who were socially-assigned as White had decreased odds of having a low birth weight baby (AOR: 0.52, 95% CI: 0.28, 0.99) when compared to those socially-assigned as non-White. Contested racial identity is common; it affects the behaviors that women engage in and the outcomes they experience postpartum. Further, we found that there is a potential benefit to a White social ascription. This work adds to growing evidence of the impact of racism on maternal and infant health in the United States.

Examining the relationship between household wealth and colorectal cancer screening behaviors among U.S. men aged 45–75

Korous, K. M., Cuevas, A. G., Chahoud, J., Ogbonnaya, U. C., Brooks, E., & Rogers, C. R. (n.d.).

Publication year

2022

Journal title

SSM - Population Health

Volume

19
Abstract
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related death among men in the United States (U.S.), particularly among men aged 45 years and older. Early-detection screening remains a key method of decreasing CRC-related deaths, yet socioeconomic barriers exist to planning and completing CRC screening. While accumulating evidence shows income disparities in CRC screening prevalence, a dearth of research has investigated wealth disparities. This study aimed to determine whether household wealth was associated with CRC screening uptake and future screening intent. In February 2022, we sent an online survey to potential participants; U.S. men aged 45–75 years were eligible to participate. We examined four CRC screening behaviors as outcomes: ever completing a stool-based or exam-based screening test, current screening status, and future screening intent. Household net wealth, determined by self-reported household wealth and debt, was the primary predictor. We used logistic regression to estimate odds ratios (ORs) and their 95% confidence interval (CI). Of the study participants (N = 499), most self-identified as Non-Hispanic White, were aged 50–64 years, and had previously completed a CRC screening test. Results revealed that, among men aged 45–49 years, higher net wealth decreased the odds of ever completing a stool- or exam-based test (OR = 0.58, 95% CI: 0.33, 0.98; OR = 0.55, 95% CI: 0.31, 0.94, respectively). By contrast, among men aged 50–75 years, higher net wealth increased the odds of being current with CRC screening (OR = 1.40, 95% CI: 1.03, 1.92). Net wealth was unassociated with CRC screening intent. These findings suggest that household net wealth, rather than income, is an important socioeconomic factor to consider in relation to uptake of CRC early-detection screening. The financial and social cognitive mechanisms linking household wealth to CRC screening behaviors merit future research and intervention.

How Should Health Equity Researchers Consider Intersections of Race and Ethnicity in Afro-Latino Communities?

Cuevas, A. G. (n.d.).

Publication year

2022

Journal title

AMA journal of ethics

Volume

24

Issue

4

Page(s)

E283-E288
Abstract
Abstract
Although Afro-Latinos, or Black Hispanics, bear inequitable burden of disease risks, drivers of health inequity among members of this large Latino subgroup in the United States are understudied. This article proposes avenues for more rigorous research on how racial diversity within Latino populations is key to generating better understandings of mechanisms and causes of racial health inequity in US Latino communities.

Length of Residency in the United States and Obesity Across Race/Ethnicity

Cofie, L. E., & Cuevas, A. G. (n.d.).

Publication year

2022

Journal title

Journal of Immigrant and Minority Health

Volume

25

Issue

1

Page(s)

241-245
Abstract
Abstract
We examined whether the association between length of US residency (LUSR) and obesity is dependent on race/ethnicity and sex, among foreign-born individuals. Adult’s body mass index (N = 151,756) were analyzed using the 2013–2017 National Health Interview Surveys. Among foreign-born adults living in the US < 5 years, non-Hispanic Blacks and Hispanics had the highest obesity prevalence compared to non-Hispanic Whites and Asians. Blacks and Hispanics also had the highest incremental percentage point increase in obesity (13%) between < 5 years and ≥ 15 years LUSR. Foreign-born black men had the lowest obesity prevalence among men in the US < 5 years (5.3%) but had the sharpest percentage point increase in obesity among men in the US ≥ 15 years (21%). Foreign-born black women in the US < 5 years had a 30.1% obesity prevalence. Obesity prevention interventions should account for differences in LSUR among foreign-born individuals.

Medical mistrust, discrimination, and COVID-19 vaccine behaviors among a national sample U.S. adults

Allen, J. D., Fu, Q., Shrestha, S., Nguyen, K. H., Stopka, T. J., Cuevas, A., & Corlin, L. (n.d.).

Publication year

2022

Journal title

SSM - Population Health

Volume

20
Abstract
Abstract
Background: COVID-19 vaccine uptake has been suboptimal and disparities in uptake have exacerbated health inequities. It has been postulated that mistrust in the healthcare system and experiences of discrimination or unfair treatment in other settings may be barriers to uptake of the COVID-19 vaccine, although few studies to date have investigated medical mistrust and perceived discrimination together. Method: We conducted a cross-sectional online survey between April 23-May 3, 2021, among a national sample of U.S. adults ages 18 years and older. We assessed receipt of and intention to be vaccinated for COVID-19 and associations with the validated Medical Mistrust Index and Everyday Discrimination Scale. Results: 1449 individuals responded, of whom 70.2% either had ≥1 dose of COVID-19 vaccine or reported that they were ‘very’ or ‘somewhat’ likely to be vaccinated in the future. In bivariate analyses, vaccination status was significantly associated with age, race/ethnicity, education, income, employment, marital status, health insurance, and political party affiliation. In multivariable analyses comparing those who had ≥1 vaccine dose or were likely to get vaccinated in the future with those who had not had any vaccine doses or did not intend to be vaccinated, each additional point in the Medical Mistrust Index was independently associated with a 16% decrease in the odds of vaccination (adjusted odds ratio = 0.84; 95% confidence interval = 0.81, 0.86). Discriminatory experiences were not associated with vaccination behavior or intention in bivariate or multivariable analyses. Conclusions: Medical mistrust is significantly associated with vaccination status and intentions. Increasing uptake of COVID-19 vaccines will likely require substantive efforts on the part of public health and healthcare officials to build trust with those who are not yet fully vaccinated. We recommend that these efforts focus on building the ‘trustworthiness’ of these entities, an approach that will require a paradigm shift away from a focus on correcting individual beliefs and knowledge, to acknowledging and addressing the root causes underlying mistrust.

Perceived intrinsic, social, and environmental barriers for weight management in older Hispanic/Latino adults with obesity

Dao, M. C., Yu, Z., Maafs-Rodríguez, A., Moser, B., Cuevas, A. G., Economos, C. D., & Roberts, S. B. (n.d.).

Publication year

2022

Journal title

Obesity Science and Practice
Abstract
Abstract
Background: The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in-depth information that can be applied to the development of well-tailored weight management interventions for this population. Objective: The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults. Methods: This community-based cross-sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m2). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019. Results: In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior. Conclusions: This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity. Clinical Trial Registry Number: NCT03978416 (ClinicalTrials.gov).

Racial Disparities in Cognitive Function Among Middle-Aged and Older Adults: The Roles of Cumulative Stress Exposures Across the Life Course

Chen, R., Weuve, J., Misra, S., Cuevas, A., Kubzansky, L. D., & Williams, D. R. (n.d.).

Publication year

2022

Journal title

Journals of Gerontology - Series A Biological Sciences and Medical Sciences

Volume

77

Issue

2

Page(s)

357-364
Abstract
Abstract
Background: Racial disparities in cognitive function are well documented, but factors driving these disparities remain underexplored. This study aims to quantify the extent to which cumulative stress exposures across the life course explain Black-White disparities in executive function and episodic memory in middle-aged and older adults. Method: Data were drawn from the 2004-2006 wave of the Midlife Development in the United States Study (MIDUS 2) and the MIDUS Refresher study (N = 5,947; 5,262 White and 685 Black). Cumulative stress exposures were assessed by 10 stressor domains (ie, childhood stress, stressful life events in adulthood, financial stress, work psychological stress, work physical stress, work-family conflicts, neighborhood disorder, relationship stress, perceived inequality, and perceived discrimination). Cognitive function was assessed using the Brief Test of Adult Cognition by Telephone. Marginal structural models were used to quantify the proportion of the effect of race/ethnicity status on cognitive function mediated through cumulative stress exposures. Results: After adjusting for age, sex, and sample, on average, Black participants had lower levels of executive function (difference:-0.83 SD units, 95% CI:-0.91,-0.75) and episodic memory (difference:-0.53 SD units, 95% CI:-0.60,-0.45) scores than White participants. Cumulative stress exposures accounted for 8.4% of the disparity in executive function and 13.2% of the disparity in episodic memory. Conclusions: Cumulative stress exposures across the life course explained modest proportions of Black-White disparities in cognitive function in this large cross-sectional study.

Stressful Life Events and Obesity in the United States: The Role of Nativity and Length of Residence

Cuevas, A. G., Stanton, M. V., Carvalho, K., Eckert, N., Ortiz, K., Assari, S., & Ransome, Y. (n.d.).

Publication year

2022

Journal title

American Journal of Health Promotion

Volume

36

Issue

1

Page(s)

190-193
Abstract
Abstract
Purpose: Obesity is a public health issue in the United States (US), that disproportionately affects marginalized group members. Stressful life events (SLE) have been implicated as an obesogenic risk factor. However, there is scant research examining of the role of nativity status and length of residence in the relationship between SLE and obesity. Design: Cross-sectional survey. Setting: Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Sample: A total of 34,653 participants were included in these analyses, of whom 10,169 (29.39%) had obesity. Measures: Obesity (measured using body mass index), stressful life events, race/ethnicity, gender, educational attainment, family income, marital status, current smoking status, and alcohol abuse. Analysis: Weighted logistic regression analysis. Results: A total of 10,169 (29.39%) had obesity. There was a significant interaction between SLE and nativity status/length of residence [F (3, 34,642) = 60.50, p < 0.01]. Based on stratified analyses, SLE were associated with greater odds of obesity for US-born individuals (OR = 1.07; 95% CI [1.05, 1.08]) and foreign-born individuals living in the US for ≥ 20 years (OR = 1.17; 95% CI [1.10, 1.25]). There was no evidence that SLE were associated with greater odds of obesity for foreign-born individuals living in the US <10 years (OR = 1.06; 95% CI [0.94, 1.21]) and 11-19 years (OR = 1.00; 95% CI [0.91, 1.09]). Conclusions: Number of SLE may be a risk factor for obesity, particularly for US-born adults and foreign-born adults living the US >20 years. Further research is needed to understand the pathways that may link SLE to obesity among these groups.

Technical report: an online international weight control registry to inform precision approaches to healthy weight management

Roberts, S. B., Das, S. K., Sayer, R. D., Caldwell, A. E., Wyatt, H. R., Mehta, T. S., Gorczyca, A. M., Oslund, J. L., Peters, J. C., Friedman, J. E., Chiu, C. Y., Greenway, F. L., Donnelly, J. E., Dao, M. C., Cuevas, A. G., Affuso, O., Wilkinson, L. L., Thomas, D., Al-Ozairi, E., Yannakoulia, M., Khazrai, Y. M., Manalac, R. J., Bachiashvili, V., & Hill, J. O. (n.d.).

Publication year

2022

Journal title

International Journal of Obesity

Volume

46

Issue

9

Page(s)

1728-1733
Abstract
Abstract
Background: Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations. Subjects/methods: The International Weight Control Registry (IWCR) has been launched to facilitate a deeper and broader understanding of the spectrum of factors contributing to success and challenges in weight loss and weight loss maintenance in individuals and across population groups. The IWCR registry aims to recruit, enroll and follow a diverse cohort of adults with varying rates of success in weight management. Data collection methods include questionnaires of demographic variables, weight history, and behavioral, cultural, economic, psychological, and environmental domains. A subset of participants will provide objective measures of physical activity, weight, and body composition along with detailed reports of dietary intake. Lastly, participants will be able to provide qualitative information in an unstructured format on additional topics they feel are relevant, and environmental data will be obtained from public sources based on participant zip code. Conclusions: The IWCR will be a resource for researchers to inform improvements in interventions for weight loss and weight loss maintenance in different countries, and to examine environmental and policy-level factors that affect weight management in different population groups. This large scale, multi-level approach aims to inform efforts to reduce the prevalence of obesity worldwide and its associated comorbidities and economic impacts. Trial registration: NCT04907396 (clinicaltrials.gov) sponsor SB Roberts; Tufts University IRB #13075.

The Association Between Post-Traumatic Stress and Depressive Symptoms Among Older Puerto Ricans in Boston: How Does Loneliness Matter?

Wang, K., Zhang, A., Cuevas, A. G., De Fries, C. M., Hinton, L., & Falcón, L. M. (n.d.).

Publication year

2022

Journal title

Journal of Aging and Health

Volume

34

Issue

6

Page(s)

786-793
Abstract
Abstract
Objectives: To examine the association between post-traumatic stress and depression and whether such an association differs by level of loneliness among older Puerto Ricans. Methods: Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depressive symptoms. Results: Post-traumatic stress was significantly associated with higher levels of depression. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness. Discussion: In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce comorbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.

The Association Between Veteran Status and Obesity Differs Across Race/Ethnicity

Cuevas, A. G., Cofie, L. E., & Nolte, S. (n.d.).

Publication year

2022

Journal title

American Journal of Health Promotion

Volume

36

Issue

2

Page(s)

314-317
Abstract
Abstract
Purpose: This study aims to evaluate the interaction between veteran status and race/ethnicity on obesity status. Design: Cross-sectional survey Setting: The 2013–2017 National Health Interview Survey Sample: A total of 151,765 adults (8.62% veterans and 91.38 nonveterans) with 69.30% identifying as White, 13.05% identifying as Hispanic, 12.57% identifying as Black, and 5.08% identifying as Asian Measures: Obesity status (measured using self-reported body mass index), race/ethnicity, survey year, age, marital status, educational attainment, federal poverty level, health insurance, type of insurance, self-reported health status, and whether participant had a usual care source. Analysis: Weighted logistic regression analysis Results: In a fully adjusted model, there was no evidence that veterans overall had higher odds of obesity compared to nonveterans (adjusted odd ratio (aOR): 1.05, 95% CI:.99, 1.11). White veterans had lower odds of obesity compared to White nonveterans (OR:.93, 95% CI:.87,.98). Hispanic veterans had higher odds of obesity compared to Hispanic nonveterans (aOR: 1.53, 95% CI: 1.23, 1.90). There was no evidence of an association between veteran status and obesity status for Black and Asian adults. Conclusions: Effectual prevention strategies are needed to decrease obesity risks among active and retired Hispanic veterans.

The Relationship Between Subjective Social Status, Mental Health Disparities, and the Mediating Role of Discrimination Among Latinx Populations

Dawson, B. A., Carvalho, K., & Cuevas, A. (n.d.).

Publication year

2022

Journal title

Journal of Racial and Ethnic Health Disparities

Volume

10

Issue

1

Page(s)

350-356
Abstract
Abstract
Objectives: Subjective social status (SSS) has consistently been linked to health outcomes among Latinx populations, but less is known about how discrimination explains the relationship between SSS and health disparities. While SSS, an individual’s perception of her socioeconomic standing, is a robust predictor of health disparities in many societies, discriminatory experiences may impact the relationship between SSS and mental health and health outcomes. Subjective social status can negatively contribute to health disparities through several pathways including the stigma associated with lower social status and poverty. Experiencing discrimination can contribute to feelings of marginalization and therefore decrease individuals’ perception of their social status. This study tested discrimination as a mediator of SSS and health disparities among Latinx populations. Design: Using the National Latino and Asian American Study (NLAAS), we identified 2554 Latinx participants to be included in the sample. Participants reported ratings of mental and physical health and exposure to everyday discrimination. Mediation models were used to analyze everyday discrimination as a mediator of SSS and health outcomes. Results: The present results support that SSS is directly associated with ratings of mental and physical health in Latinx individuals. Discrimination was also found to mediate the relationship between SSS and health outcomes. Conclusions: These findings have practice implications for health disparities among Latinx populations. In particular, discrimination may be a major contributing factor to the role of SSS on health outcomes.

The weight of childhood adversity: evidence that childhood adversity moderates the impact of genetic risk on waist circumference in adulthood

Cuevas, A. G., Mann, F. D., & Krueger, R. F. (n.d.).

Publication year

2022

Journal title

International Journal of Obesity

Volume

46

Issue

10

Page(s)

1875-1882
Abstract
Abstract
Objective: The present study tested the interactive effects of childhood adversity and polygenic risk scores for waist circumference (PRS-WC) on waist circumference (WC). Consistent with a diathesis-stress model, we hypothesize that the relationship between PRS-WC and WC will be magnified by increasing levels of childhood adversity. Methods: Observational study of 7976 adults (6347 European Americans and 1629 African Americans) in the Health and Retirement Study with genotyped data. PRS-WC were calculated by the HRS administrative core using the weighted sum of risk alleles based on a genome-wide association study conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. Childhood adversity was operationalized using a sum score of three traumatic events that occurred before the age of 18 years. Results: There was a statistically significant interaction between PRS-WC and childhood adversity for European Americans, whereby the magnitude of PRS-WC predicting WC increased as the number of adverse events increased. Conclusions: This study supports the idea of the interactive effects of genetic risks and childhood adversity on obesity. More epidemiological studies, particularly with understudied populations, are needed to better understand the roles that genetics and childhood adversity play on the development and progression of obesity.

Cumulative stress: A general “s” factor in the structure of stress

Mann, F. D., Cuevas, A. G., & Krueger, R. F. (n.d.).

Publication year

2021

Journal title

Social Science and Medicine

Volume

289
Abstract
Abstract
Objective: The present study tested a hierarchical model of cumulative stress in a large probability sample of adults from the United States. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) models were used to develop and test a hierarchical model of cumulative stress. Structural equation models were used to estimate concurrent associations with demographic factors, polygenic risk scores, and physical health outcomes, as well as prospective associations with physical health outcomes. Results: A hierarchical model of cumulative stress was the best-fitting model, with a general “s-factor” capturing the tendency for subordinate dimensions of stress to correlate. Associations with demographic factors and polygenic risk scores for physical and psychological phenotypes provide evidence for the convergent validity of a general s-factor of cumulative stress. The general s-factor and subordinate factors of cumulative stress were also associated with physical health outcomes, concurrently and prospectively, including number of chronic conditions, body mass index, and difficulty with activities of daily living. Conclusions: Like other human individual differences, the co-occurrence of social stressors can be understood using a hierarchical model.

Developmental timing of initial racial discrimination exposure is associated with cardiovascular health conditions in adulthood

Cuevas, A. G., Ho, T., Rodgers, J., DeNufrio, D., Alley, L., Allen, J., & Williams, D. R. (n.d.).

Publication year

2021

Journal title

Ethnicity and Health

Volume

26

Issue

7

Page(s)

949-962
Abstract
Abstract
Objective: To examine the association between developmental timing of initial exposure to racial discrimination and cardiovascular health conditions. Design: Using data from the 1995 Detroit Area Study, logistic and negative binomial regression models were used to assess the association between timing of initial exposure to racial/ethnic discrimination, classified as early childhood (0-7), childhood (8-12), adolescence (13-19), and adulthood (>19), on physician-diagnosed cardiovascular health conditions during adulthood. Each analysis adjusted for age, gender, race/ethnicity, income, education, marital status, health-related behaviors, and pre-existing health conditions. Results: Of the 1,106 participants in the final sample, 520 identified as White and 586 identified as Black. Over half (64%) of the sample experienced at least one major cardiovascular health event at the time of the study, with 39% reporting two or more events. Results from logistic regression models showed that initial exposure to racial discrimination during early childhood was associated with a 2.96 (95%CI:1.15, 7.83) times greater odds of having any cardiovascular-related health condition later in life compared to individuals who reported no discrimination. Results from negative binomial regression models demonstrated that individuals who reported initial exposure to racial discrimination during early childhood and adolescence had a CVD incidence rate that was 1.63 (95%CI:1.11, 2.38) and 1.37 (95%CI:1.10, 1.69) times higher than individuals who reported no discrimination. Conclusion: Initial exposure to racial discrimination in early childhood and adolescence may increase the risk of cardiovascular conditions later in life. Clinicians and researchers should consider racial discrimination during childhood as a possible risk factor for illness and disease.

Discrimination and anxiety: Using multiple polygenic scores to control for genetic liability

Cuevas, A. G., Mann, F. D., Williams, D. R., & Krueger, R. F. (n.d.).

Publication year

2021

Journal title

Proceedings of the National Academy of Sciences of the United States of America

Volume

118

Issue

1
Abstract
Abstract
An established body of research indicates that discrimination is associated with increased symptoms of anxiety and negative affect. However, the association cannot be interpreted unambiguously as an exposure effect because a common set of genetic factors can simultaneously contribute to increased liability for symptoms of anxiety, negative affect, and the perception of discrimination. The present study elucidates the association between discrimination and anxiety/negative affect by implementing strict genetic controls in a large sample of adults. We used data from the biomarker project of the Study of Midlife Development in the United States (MIDUS), a national probability sample of noninstitutionalized, English-speaking respondents aged 25 to 74 y. Participants who consented to provide genetic data were biologically unrelated and of European ancestry as determined by genotype principal components analysis (n = 1,146). A single structural regression model was fit to the data with three measures of discrimination specified to load onto a latent factor and six measures of anxiety and negative affect specified to load onto a second latent factor. After accounting for potential genetic confounds—polygenic scores for anxiety, depression, and neuroticism and the first five genetic principal components—greater discrimination was associated with greater anxiety/negative affect (β = 0.53, SE = 0.04, P < 0.001). Findings suggest that measures of perceived discrimination should be considered environmental risk factors for anxiety/negative affect rather than indices of genetic liability for anxiety, depression, or neuroticism. Clinical interventions and prevention measures should focus on ways to mitigate the impact of discrimination to improve mental health at the population level.

Infant Health for Arab and Non-Arab Mothers Identifying as White, Black, or Other in Massachusetts

Abuelezam, N. N., Cuevas, A. G., El-Sayed, A. M., Galea, S., & Hawkins, S. S. (n.d.).

Publication year

2021

Journal title

American journal of preventive medicine

Volume

60

Issue

1

Page(s)

64-71
Abstract
Abstract
Introduction: This study quantifies the differences in infant outcomes by mother's self-identified race among Arab Americans and by self-identified race and ethnicity for Arabs and non-Arabs. Methods: This study used data from the Standard Certificate of Live Birth on 8,204 infants born to Arab and 325,354 infants born to non-Arab mothers between 2012 and 2016 in Massachusetts; data were analyzed between 2019 and 2020. Mothers’ race was categorized as White, Black, or Other. Mothers’ ethnicity was categorized as Arab or non-Arab. Outcomes included birth weight, preterm birth, low-birth weight, small for gestational age, and large for gestational age. Linear and logistic regression models assessed the association between race and infant health outcomes. Results: Black Arab mothers had higher odds of preterm birth (AOR=1.37, 95% CI=1.07, 1.76) and low-birth weight (AOR=1.35, 95% CI=0.99, 1.84) than White Arab mothers. Arab mothers who self-identified as Other had babies that were 51.4 grams lighter than babies born to White Arab mothers. White Arab mothers had higher odds of low birth weight (AOR=1.19, 95% CI=1.06, 1.34) and small-for-gestational-age babies (AOR=1.22, 95% CI=1.11, 1.36) but lower odds of large-for-gestational-age babies (AOR=0.77, 95% CI=0.70, 0.86) than White non-Arab mothers. Conclusions: Both ethnicity and race are important determinants of the health of Arab American infants. Arab ethnicity may play a negative role in the infant health of Arab Americans who identify as White. A better understanding of the lived experiences of Arab American mothers, with regard to their racial and ethnic identity, may help better inform clinical practice.

Longitudinal analysis of psychosocial stressors and body mass index in middle-aged and older adults in the United States

Cuevas, A. G., Greatorex-Voith, S., Assari, S., Slopen, N., & Economos, C. D. (n.d.).

Publication year

2021

Journal title

Journals of Gerontology - Series B Psychological Sciences and Social Sciences

Volume

76

Issue

8

Page(s)

1580-1589
Abstract
Abstract
Objectives: Psychosocial stress may be a risk factor for obesity and overweight in middle-aged and older adults. However, research on psychosocial stress and excess body weight has typically been cross-sectional and focused on single stressors. Methods: Using 3 waves of data from the Health and Retirement Study, we conducted longitudinal analyses to assess associations between 5 psychosocial stressors-individually and in combination-and body mass index (BMI), adjusting for sociodemographic factors, alcohol use, and smoking history. We tested interaction effects between race and gender with stressors on BMI. Results: A total of 3,956 participants were included in the main analyses. Most participants were White (88.04%) and more than half were female (60.39%). Perceived discrimination, financial stress, and relationship stress were positively associated with BMI. A greater cumulative stress burden was associated with higher BMI. In stratified analyses, greater financial stress was associated with higher BMI among White participants, whereas greater neighborhood stress was associated with lower BMI among Black participants. Greater relationship stress, financial stress, cumulative high stress, and overall cumulative stress burden were associated with higher BMI for women, but not men. Discussion: Different sources of stress may be risk factors to weight gain and affect BMI in adults. White and female adults may be more susceptible to the obesogenic effects of stressors. Reducing exposure to stress may help reduce the burden of high BMI among middle-aged and older adults.

Parental educational attainment, the superior temporal cortical surface area, and reading ability among american children: A test of marginalization-related diminished returns

Assari, S., Boyce, S., Bazargan, M., Thomas, A., Cobb, R. J., Hudson, D., Curry, T. J., Nicholson, H. L., Cuevas, A. G., Mistry, R., Chavous, T. M., Caldwell, C. H., & Zimmerman, M. A. (n.d.).

Publication year

2021

Journal title

Children

Volume

8

Issue

5
Abstract
Abstract
Background: Recent studies have shown that parental educational attainment is associated with a larger superior temporal cortical surface area associated with higher reading ability in children. Simultaneously, the marginalization-related diminished returns (MDRs) framework suggests that, due to structural racism and social stratification, returns of parental education are smaller for black and other racial/ethnic minority children compared to their white counterparts. Purpose: This study used a large national sample of 9–10-year-old American children to investigate associations between parental educational attainment, the right and left superior temporal cortical surface area, and reading ability across diverse racial/ethnic groups. Methods: This was a cross-sectional analysis that included 10,817 9–10-year-old children from the Adolescent Brain Cognitive Development (ABCD) study. Parental educational attainment was treated as a five-level categorical variable. Children’s right and left superior temporal cortical surface area and reading ability were continuous variables. Race/ethnicity was the moderator. To adjust for the nested nature of the ABCD data, mixed-effects regression models were used to test the associations between parental education, superior temporal cortical surface area, and reading ability overall and by race/ethnicity. Results: Overall, high parental educational attainment was associated with greater superior temporal cortical surface area and reading ability in children. In the pooled sample, we found statistically significant interactions between race/ethnicity and parental educational attainment on children’s right and left superior temporal cortical surface area, suggesting that high parental educational attainment has a smaller boosting effect on children’s superior temporal cortical surface area for black than white children. We also found a significant interaction between race and the left superior temporal surface area on reading ability, indicating weaker associations for Alaskan Natives, Native Hawaiians, and Pacific Islanders (AIAN/NHPI) than white children. We also found interactions between race and parental educational attainment on reading ability, indicating more potent effects for black children than white children. Conclusion: While parental educational attainment may improve children’s superior temporal cortical surface area, promoting reading ability, this effect may be unequal across racial/ethnic groups. To minimize the racial/ethnic gap in children’s brain development and school achievement, we need to address societal barriers that diminish parental educational attainment’s marginal returns for middle-class minority families. Social and public policies need to go beyond equal access and address structural and societal barriers that hinder middle-class families of color and their children. Future research should test how racism, social stratification, segregation, and discrimination, which shape the daily lives of non-white individuals, take a toll on children’s brains and academic development.

Reply to Letter to the Editor: ‘Discrimination and systemic inflammation: A critical review and synthesis’

Cuevas, A. G. (n.d.). In Brain, Behavior, and Immunity.

Publication year

2021

Volume

94

Page(s)

470

Skin Tone, Discrimination, and Allostatic Load in Middle-Aged and Older Puerto Ricans

Cuevas, A. G., Abuelezam, N. N., Chan, S. W., Carvalho, K., Flores, C., Wang, K., Mattei, J., Tucker, K. L., & Falcon, L. M. (n.d.).

Publication year

2021

Journal title

Psychosomatic Medicine

Volume

83

Issue

7

Page(s)

805-812
Abstract
Abstract
Objective A growing body of research suggests that skin tone may be a health risk indicator for Hispanics. Black and darker-skinned Hispanics have worse mental and physical outcomes than White and lighter-skinned Hispanics. Discrimination exposure has been implicated as a risk factor that may explain the association between skin tone and health. However, there is scant research examining the interrelationship between skin tone, discrimination, and health, particularly among Puerto Ricans. We examine the interrelationships between two measures of skin tone, two measures of discrimination, and allostatic load (AL) among Puerto Rican adults. Methods Using cross-sectional data from wave 3 of the Boston Puerto Rican Health Study (n = 882), we examined the indirect association (IA) of skin tone on physiological dysregulated systems, also known as AL, through major discrimination and everyday discrimination. We tested these associations using two distinct measures of skin tone: interviewer-ascribed skin tone and spectrophotometer-measured skin tone. Results Interviewer-ascribed skin tone was indirectly associated with AL through major discrimination (IA = 0.03, 95% confidence interval = 0.004 to 0.06). However, there was no evidence of an IA of interviewer-ascribed skin tone on AL through everyday discrimination (IA = -0.01, 95% confidence interval = -0.03 to 0.01). In addition, there was no evidence that spectrophotometer-measured skin tone was indirectly associated with AL through major discrimination or everyday discrimination. Conclusions The sociocultural significance of skin tone may affect how Puerto Ricans are perceived and treated by others, which can, in turn, have physiological health consequences. Future research is needed to replicate these findings and examine the interrelationship between skin tone, discrimination, and other health outcomes.

The Adaptation and Evaluation of a Pilot Mindfulness Intervention Promoting Mental Health in Student Athletes

Evers, A. G., Somogie, J. A., Wong, I. L., Allen, J. D., & Cuevas, A. G. (n.d.).

Publication year

2021

Journal title

Journal of Clinical Sport Psychology

Volume

15

Issue

3

Page(s)

206-226
Abstract
Abstract
The objective of this study was to examine the effectiveness of a pilot mindfulness program for student athletes by assessing mental health, mindfulness ability, and perceived stress before and after the intervention. The mindfulness program was adapted from a program developed at the University of Southern California. The four-session intervention taught the basics of mindfulness, self-care skills, and guided meditations. Participants completed surveys before and after the interven-tion. Mindfulness ability was assessed with the Cognitive and Affective Mindfulness Scale, mental health was assessed with a modified Short Form Health Survey, and stress was assessed with the Perceived Stress Scale. After the intervention, participants reported improvement in mindfulness ability, t(28) = −2.61, p = .014, mental health, t(28) = −2.87, p = .008, and a trending improvement in perceived stress, t(28) = 1.86, p = .073. A short mindfulness program may be effective for improving mental health and mindfulness ability in collegiate student athletes.

The relative contributions of behavioral, biological, and psychological risk factors in the association between psychosocial stress and all-cause mortality among middle- and older-aged adults in the USA

Rodgers, J., Cuevas, A. G., Williams, D. R., Kawachi, I., & Subramanian, S. V. (n.d.).

Publication year

2021

Journal title

GeroScience

Volume

43

Issue

2

Page(s)

655-672
Abstract
Abstract
Evidence of an association between psychosocial stress and mortality continues to accumulate. However, despite repeated calls in the literature for further examination into the physiological and behavioral pathways though which stress affects health and mortality, research on this topic remains limited. This study addresses this gap by employing a counterfactual-based mediation analysis of eight behavioral, biological, and psychological pathways often hypothesized to play a role in the association between stress and health. First, we calculated the survival rate of all-cause mortality associated with cumulative psychosocial stress (high vs. low/moderate) using random effects accelerated failure time models among a sample of 7108 adults from the Midlife in the United States panel study. Then, we conducted a multiple mediator mediation analysis utilizing a counterfactual regression framework to determine the relative contributions of each mediator and all mediators combined in the association between stress and mortality. Exposure to high psychosocial stress was associated with a 0.76 times reduced survival rate over the follow-up period 1995–2015, while adjusting for age, sex, race, income, education, baseline health, and study design effects. The mediators accounted for 49% of this association. In particular, smoking, sedentary behavior, obesity/BMI, and cardiovascular disease displayed significant indirect effects and accounted for the largest reductions in the total effect of stress on mortality, with natural indirect effects of 14%, 12%, 11%, and 4%, respectively. In conclusion, traditional behavioral and biological risk factors play a significant role in the association between psychosocial stress and mortality among middle and older adults in the US context. While eliminating stress and the socioeconomic disparities that so often deliver people into high-stress scenarios should be the ultimate goal, public health interventions addressing smoking cessation, physical activity promotion, and cardiovascular disease treatment may pay dividends for preventing premature mortality in the near-term.