Adolfo Cuevas
Adolfo Cuevas
Scroll
Assistant Professor of Social and Behavioral Sciences
-
Professional overview
-
Adolfo G. Cuevas, PhD, is an Assistant Professor in the Department of Social and Behavioral Sciences at NYU's School of Global Public Health, where he also co-directs the BioSocial Research Initiative (BSRI). His research examines how psychosocial stressors influence health across the lifespan, using epidemiological, psychological, and biological approaches to understand these relationships.
Dr. Cuevas currently leads three NIH-funded projects, totaling nearly $7 million, that investigate the effect of psychosocial stressors on biological dysregulation. These studies investigate how psychosocial stress contributes to biological dysregulation. His first project (R01DK137805; 2024–2029) addresses a key gap in the field by examining how social adversity affects allostatic load across three life course stages and identifying gene expression pathways that link adversity to biological stress. It is also the first study to assess how social relationships—such as kinship and community ties—buffer the impact of social adversity on gene expression and stress physiology. His two additional projects (R01DK137246 and R01MD019251) explore the role of neighborhood and interpersonal stress in obesity across developmental stages, from childhood to older adulthood, with a focus on molecular indicators of stress-related proinflammatory biology that may contribute to adipose tissue formation.
Dr. Cuevas’ work has appeared in leading journals including Annals of Internal Medicine, Proceedings of the National Academy of Sciences, Brain, Behavior, and Immunity, and American Journal of Public Health. It has also been featured by media outlets such as Forbes, USA Today, and NPR’s Code Switch.
In recognition of his contributions to research on stress and health, Dr. Cuevas has received numerous honors, including the Herbert Weiner Early Career Award, the National Minority Quality Forum’s 40 Under 40 Leaders in Minority Health Award, and the Diversity Scholar Award from 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. He earned his PhD and MS in applied psychology from Portland State University and completed postdoctoral training at the Harvard T.H. Chan School of Public Health.
-
Education
-
PhD, Applied Psychology, Portland State UniversityMS, Applied Psychology, Portland State UniversityBA, Psychology, City College of New York, 2010Certificate, 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
-
ObesityPsychosocial StressRacial/Ethnic Disparities
-
Publications
Publications
Experiences of patient-provider concordance in healthcare among All of Us participants, 2017–2023
AbstractHolm, J., Cuevas, A., Wang, V. H. C., Pagán, J. A., & Silver, D. (n.d.).Publication year
2025Journal title
Patient Education and CounselingVolume
139AbstractObjective: To examine differences in care experiences and preferences related to patient-provider relationships across both cultural and personal patient identities. Methods: Logistic regression was used to test the associations between patient characteristics and patient survey responses using 2017–2023 data from the All of Us dataset. Results: Nearly two thirds of the All of Us participants considered it important that their providers were like them (63.2 %) and could often see them (66.3 %). The odds of reporting that it was important that their providers were like them were higher among all groups compared to non-Hispanic White participants (non-Hispanic Black: aOR 2.59 95% Confidence Interval (CI) [2.41–2.78]; Hispanic: aOR 1.42 95% CI [1.33–1.51]; non-Hispanic Asian: aOR 1.45 95% CI [1.33–1.59]; non-Hispanic Other: aOR 1.16 95% CI [1.08–1.25]). Female participants (aOR 1.29 95% CI [1.25–1.33]), those that spoke a language other than English at home (aOR 1.45 95% CI [1.38–1.53]), those with Medicaid (aOR 1.23 95% CI [1.15–1.32]) or no insurance (aOR 1.17 95% CI [1.10–1.25]) compared to those privately insured, and those with a disability (aOR 1.15 95% CI [1.11–1.20]) were more likely to report that it was very/somewhat important their provider be similar to them. Conclusions: The results of this study suggest that the dimensions of patient identity contribute to inequities in receiving culturally concordant care. Practice implications: The significant subgroup differences across all survey questions suggest that previous interventions addressing cultural competence in providers may not reach all the patient populations. Instead of a one-size-fits-all approach to improving the care experiences of different patient populations, adopting the key behaviors derived from both patient-centered and culturally competent care and by using the guiding principles of cultural humility would enable providers to tailor care that is centered on patient needs and preferences.From Discrimination to Disease: The Role of Inflammation
AbstractCuevas, A. G., & Cole, S. W. (n.d.).Publication year
2025Journal title
Harvard Review of PsychiatryVolume
33Issue
2Page(s)
83-89AbstractDiscrimination is an established social determinant of mental health that contributes to psychiatric illness disparities among marginalized populations. There is emerging research elucidating the biological mechanisms connecting discrimination to mental health outcomes, revealing inflammation as a key pathway. This column synthesizes evidence from existing literature on the links between discrimination and inflammation, and outlines both the opportunities and challenges in this field. The discussion highlights the necessity of a multifaceted approach to address discrimination, and thus, reduce inflammation at both individual and population levels.Genetic and environmental contributions to the associations between midlife personality and late-life metabolic health
AbstractFreilich, C. D., Kunkel, J. J., Dugan, K. A., Vomacka, E. J., Cuevas, A. G., Markon, K., McGue, M., Roisman, G. I., & Krueger, R. F. (n.d.).Publication year
2025Journal title
ObesityAbstractObjective: Personality traits such as conscientiousness and emotional stability are consistently linked with better metabolic health, but there is limited evidence on the etiology of these associations and their robustness across the life-span. Methods: Therefore, we estimated phenotypic, genetic, and unique environmental associations of traits indexed by the Multidimensional Personality Questionnaire in early-to-middle adulthood (mean age = 38.3 years) with BMI, waist circumference, high-density lipoprotein cholesterol, C-reactive protein, triglycerides, and glycated hemoglobin in older adulthood (mean age = 70.4 years) using the Minnesota Twin Registry sample (n = 950). Results: Traits that indexed emotional instability in midlife, such as alienation and stress reactivity, were significant predictors of several metabolic outcomes late in life (bivariate |r| ≤ 0.22), whereas negative associations with traits related to conscientiousness (e.g., control, constraint, achievement) tended to be more modest. For most traits that were phenotypically associated, we observed significant genetic correlations. Additionally, alienation and stress reactivity had weak-to-moderate unique environmental correlations with BMI, waist circumference, and C-reactive protein (re = 0.10–0.29). Conclusions: These results are consistent with an etiology of declining metabolic health into old age involving the propensity toward negative affective experiences decades prior, further validating the health relevance of individual differences in personality.Intersecting race/ethnicity and gender in physiological dysregulation profiles and associations with socioeconomic status among older adults in the United States
AbstractZhang, X., Krobath, D. M., Tembo, P., & Cuevas, A. G. (n.d.).Publication year
2025Journal title
SSM - Population HealthVolume
30AbstractAllostatic load, a cumulative indicator of physiological wear and tear resulting from chronic stress, is a robust predictor of disease and mortality risk. While prior research has documented racial/ethnic and gender variations in allostatic load, typically assessed by counting biomarkers at extreme levels, few studies have used latent class analysis (LCA) to examine multi-system physiological dysregulation or tested whether these patterns differ across the intersection of race/ethnicity and gender. This study analyzed data from 5743 Black and White adults aged 50 and older in the Health and Retirement Study to address this gap. Based on eight biomarkers representing metabolic, cardiovascular, and inflammatory systems, LCA identified four distinct dysregulation patterns that varied significantly by race and gender. The four classes included: (1) a Healthy Regulation class, identified across all groups but most prevalent among Black men; (2) a Hypertension Dysregulation class, identified specifically among Black men and White women; (3) a Metabolic and Inflammatory Dysregulation class, observed in both Black and White women; and (4) a Hypertension and Metabolic Dysregulation class, observed among Black women and White men. Association analyses revealed that higher educational attainment was significantly linked to reduced odds of metabolic-related dysregulation in all groups except Black men, underscoring the limitations of education alone in mitigating health risks for this group. These findings emphasize the value of an intersectionality framework for understanding how race and gender jointly shape physiological dysregulation patterns and highlight the need for tailored public health strategies that address the specific health risks faced by different population subgroups.Native Hawaiian and Other Pacific Islanders: Disparities in the Prevalence of Multiple Chronic Conditions
AbstractCabrera, J. D., Cuevas, A. G., Xu, S., & Chang, V. W. (n.d.).Publication year
2025Journal title
American Journal of Health PromotionVolume
39Issue
7Page(s)
1037-1041AbstractPurpose: To examine multimorbidity prevalence by race/ethnicity and unique health disparities for Native Hawaiian and Other Pacific Islanders (NHPI). Design: Cross-sectional study. Setting: This study uses combined data from the 2014 National Health Interview Survey (NHIS) and the 2014 NHPI-NHIS. Sample: 38,965 adults, including a representative sample of 2,026 NHPIs. Measures: Self-reported diagnoses of ten chronic conditions and race/ethnicity, including Non-Hispanic (NH) Whites, NH Blacks, NH Asians, NH NHPIs, Hispanics and NH Mixed Race. Covariates include age, sex, marital status, education, family income, and employment status. Analysis: We used multinomial logistic regression models to evaluate the adjusted association between race/ethnicity and number of chronic conditions: none, 1, and ≥ 2 (multimorbidity). Results: Compared to Whites, Asians and Hispanics (aRRR = 0.39, P < .001 and aRRR = 0.59, P < .001) had significantly lower odds of having multimorbidity relative to no chronic condition. In contrast, Black Americans and NHPIs (aRRR = 1.27, P < .001 and aRRR = 1.22, P < .05) had significantly higher odds of multimorbidity compared to Whites. Of note, NHPIs showed significantly higher odds of multimorbidity compared to Asians (aRRR = 3.07, P < .001). Conclusion: Our findings highlight significantly higher risk of multimorbidity for NHPIs relative to Whites as well as Asians. This underscores the importance of disaggregating NHPI data from Asians as a whole. Future studies should incorporate additional social factors relevant to the NHPI community.Racial Discrimination and Substance Use: Results from a 2023 Survey of Racism and Public Health in the United States
AbstractRouhani, S., Bather, J. R., Cuevas, A., Omari, I., Harris, A., McSorley, A. M., Rhodes-Bratton, B., & Goodman, M. (n.d.).Publication year
2025Journal title
Substance Use and MisuseAbstractBackground: Racial/ethnic disparities in substance use outcomes continue to widen in the US. Despite increasing evidence of the myriad ways that racism impacts health, this has not been extensively studied with respect to substance use outcomes. The current study explores the association between self-reported exposure to racial discrimination across the life course and substance use disorders among US adults. Methods: We analyzed data from a web-based cross-sectional survey of adults in 13 states and Puerto Rico in March–April 2023. Exposure to racism in childhood, adolescence, adulthood, and within the past year was measured on a cumulative life course scale (range 0–4). Analyses were restricted to respondents identifying as White, Black, and/or Hispanic (N = 4,338). Multivariable models estimated the adjusted association between cumulative racial discrimination and lifetime substance use disorder (SUD) diagnosis. Among those with exposure to racial discrimination (N = 1,895), we explored correlates of coping with any form of discrimination by using substances. Results: We detected evidence of an interaction between race/ethnicity and cumulative racial discrimination, with a higher predicted probability of SUD associated with discrimination among those racialized as Black (non-Hispanic Black and Afro-Hispanic). There was evidence of a dose-response relationship between cumulative racial discrimination and the likelihood of coping through increased substance use. Conclusions: Experiences of racial discrimination over the life course may contribute to disparities in substance use outcomes. More research is needed to disentangle multiple, overlapping forms of discrimination faced by people who use different substances and how they may explain variation in outcomes among them.Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review
AbstractHarlan, E. A., Malley, K., Quiroga, G., Mubarak, E., Lama, P., Schutz, A., Cuevas, A., Hough, C. L., Iwashyna, T. J., Armstrong-Hough, M., & Valley, T. S. (n.d.).Publication year
2025Journal title
Critical Care ExplorationsVolume
7Issue
1Page(s)
e1193AbstractOBJECTIVES: Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure is critical to address this inequity. We conducted a systematic review to examine the inclusion of Hispanic patients in randomized controlled trials for AHRF and assessed language as a potential barrier to enrollment. DATA SOURCES: National Library of Medicine PubMed, Elsevier Embase, and Cochrane Central Register of Controlled Trials databases through January 2024. STUDY SELECTION: Randomized controlled trials assessing AHRF interventions enrolling U.S. patients receiving mechanical ventilation, noninvasive mechanical ventilation, or high-flow nasal cannula were included. The systematic review was registered prospectively through PROSPERO (CRD42023437828). DATA EXTRACTION: Two authors independently screened studies and extracted data for each included study. DATA SYNTHESIS: Ninety-four trials published from 1975 to 2023 were included; 33.0% (n = 31) of studies reported ethnicity, and 11.2% of participants in studies reporting race or ethnicity (1,320/11,780) were identified as Hispanic. The proportion of Hispanic-identified participants was significantly lower than the U.S. Hispanic population from 1996 to 2019 (p < 0.01). Starting in 2020, the proportion of Hispanic-identified participants was significantly higher than the U.S. population (27.8% vs. 19.1%; p < 0.01). Two studies (4.9%) reporting race or ethnicity excluded non-English speaking participants; the remainder did not specify language requirements for enrollment. CONCLUSIONS: Hispanic-identified individuals were underrepresented in trials for AHRF until 2020 when Hispanic patient representation increased during COVID-19. Exclusion of participants who do not speak English may represent a barrier to trial enrollment.Safeguarding SNAP as an Effective Antihunger Program: Myths and Potential Harms of Adding Diet Quality as a Core Objective
Krobath, D. M., Lawrence, J. A., Chrisinger, B. W., & Cuevas, A. G. (n.d.).Publication year
2025Journal title
American journal of public healthVolume
115Issue
1Page(s)
37-41A novel approach to model cumulative stress: Area under the s-factor curve
AbstractMann, F. D., Cuevas, A. G., Clouston, S. A., Freilich, C. D., Krizan, Z., Zuber, S., Wänström, L., Muniz-Terrera, G., O’Keefe, P., Voll, S., Hofer, S., Rodgers, J. L., & Krueger, R. F. (n.d.).Publication year
2024Journal title
Social Science and MedicineVolume
348AbstractObjective: Using a large longitudinal sample of adults from the Midlife in the United States (MIDUS) study, the present study extended a recently developed hierarchical model to determine how best to model the accumulation of stressors, and to determine whether the rate of change in stressors or traditional composite scores of stressors are stronger predictors of health outcomes. Method: We used factor analysis to estimate a stress-factor score and then, to operationalize the accumulation of stressors we examined five approaches to aggregating information about repeated exposures to multiple stressors. The predictive validity of these approaches was then assessed in relation to different health outcomes. Results: The prediction of chronic conditions, body mass index, difficulty with activities of daily living, executive function, and episodic memory later in life was strongest when the accumulation of stressors was modeled using total area under the curve (AUC) of estimated factor scores, compared to composite scores that have traditionally been used in studies of cumulative stress, as well as linear rates of change. Conclusions: Like endogenous, biological markers of stress reactivity, AUC for individual trajectories of self-reported stressors shows promise as a data reduction technique to model the accumulation of stressors in longitudinal studies. Overall, our results indicate that considering different quantitative models is critical to understanding the sequelae and predictive power of psychosocial stressors from midlife to late adulthood.Associations between perceived discrimination over the life course, subjective social status, and health literacy: A racial/ethnic stratification analysis
AbstractBather, J. R., Cuevas, A. G., Harris, A., Kaphingst, K. A., & Goodman, M. S. (n.d.).Publication year
2024Journal title
PEC InnovationVolume
5AbstractObjective: To analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL). Methods: 5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics. Results: The average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = −0.16, 95% CI: −0.23, −0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants. Conclusion: This analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL. Innovation: Our findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.Breaking Academic Silos: Pedagogical Recommendations for Equitable Obesity Prevention Training and Research During an Age of Nutrition Polarization
AbstractTaylor, S. F., Krobath, D. M., Cuevas, A. G., Hennessy, E., & Roberts, S. B. (n.d.).Publication year
2024Journal title
AJPM FocusVolume
3Issue
3AbstractIntroduction: Obesity is a preventable chronic condition and a risk factor for poor health and early mortality. Weight stigma and weight-neutral medicine are popular topics in social media that are often at odds with current medical guidelines on obesity treatment and prevention. This conflict may erode the public's trust in science, impede research progress on preventing obesity in marginalized groups, and uphold the ongoing and historical lack of diversity among nutrition trainees. Methods: The authors conducted a series of student-led dialogue sessions with nutrition graduate students in Boston, Massachusetts, from March to May 2023 to understand perceptions of obesity research, health equity, and racism and discrimination. This article summarizes the lessons learned and provides pedagogical recommendations for jointly addressing obesity at the population level and the recruitment, training, and retention of diverse scholars, clinicians, and public health practitioners. Results: Dialogue sessions revealed that students perceive a disproportionate focus on the harms of obesity as a chronic disease, highlighting that inadequate attention is given to weight stigma and discrimination. Some participants believed that weight-based discrimination is equally detrimental to individual health and wellbeing as having obesity. Discussions also emphasized the need to pinpoint the multidimensional and cultural manifestations of weight stigma, which necessitates collaboration across social sectors and academic disciplines. Students recognized the urgent need to apply an equity lens to obesity research and teaching but felt limited in their access to experts within nutrition science who specialize in racism, discrimination, eating disorders, and weight stigma. Conclusions: This study identified concrete opportunities for urgently needed new training and research in population-level obesity prevention, emphasizing antiracism, harm reduction, and elimination of stigma and bias across multiple levels of science and society. Overall, the decision to use the BMI within pedagogy and training must be explicitly stated—research, population surveillance, decision-making, or treatment pedagogy and training—while acknowledging its strengths and limitations across diverse settings. Finally, the social determinants of obesity should incorporate not only weight stigma but also racism and multiple forms of discrimination.Discrimination in Medical Settings across Populations: Evidence From the All of Us Research Program
AbstractWang, V. H. C., Cuevas, A. G., Osokpo, O. H., Chang, J. E., Zhang, D., Hu, A., Yun, J., Lee, A., Du, S., Williams, D. R., & Pagán, J. A. (n.d.).Publication year
2024Journal title
American journal of preventive medicineVolume
67Issue
4Page(s)
568-580AbstractIntroduction: Discrimination in medical settings (DMS) contributes to healthcare disparities in the United States, but few studies have determined the extent of DMS in a large national sample and across different populations. This study estimated the national prevalence of DMS and described demographic and health-related characteristics associated with experiencing DMS in seven different situations. Methods: Survey data from 41,875 adults participating in the All of Us Research Program collected in 2021–2022 and logistic regression were used to examine the association between sociodemographic and health-related characteristics and self-reported DMS among adults engaged with a healthcare provider within the past 12 months. Statistical analysis was performed in 2023–2024. Results: About 36.89% of adults reported having experienced at least one DMS situation. Adults with relative social and medical disadvantages had higher prevalence of experiencing DMS. Compared to their counterparts, respondents with higher odds of experiencing DMS in at least one situation identified as female, non-Hispanic Black, having at least some college, living in the South, renter, having other living arrangement, being publicly insured, not having a usual source of care, having multiple chronic conditions, having any disability, and reporting fair or poor health, p<0.05. Conclusions: The findings indicate a high prevalence of DMS, particularly among some population groups. Characterizing DMS may be a valuable tool for identifying populations at risk within the healthcare system and optimizing the overall patient care experience. Implementing relevant policies remains an essential strategy for mitigating the prevalence of DMS and reducing healthcare disparities.Education, Income, Wealth, and Discrimination in Black-White Allostatic Load Disparities
AbstractCuevas, A. G., McSorley, A. M., Lyngdoh, A., Kaba-Diakité, F., Harris, A., Rhodes-Bratton, B., & Rouhani, S. (n.d.).Publication year
2024Journal title
American journal of preventive medicineVolume
67Issue
1Page(s)
97-104AbstractIntroduction: Allostatic load (AL) is a significant marker of aging, associated with disease and mortality. Research has elucidated the impact of education and income on AL. However, the roles of wealth and discrimination in contributing to AL and shaping AL disparities remain underexplored. This study aimed to investigate the association between wealth and AL, while also examining the independent contributions of education, income, wealth, and everyday discrimination in shaping AL disparities. Methods: Using 2016 data from the nationally representative Health and Retirement Study (N=3,866), this study employed multilinear regression analysis to quantify the association between education and income, wealth (calculated as assets minus debts), and everyday discrimination with AL. Oaxaca-Blinder decomposition analysis was conducted to determine the proportion of AL disparities between Black and White participants attributed to education and income, wealth, and everyday discrimination. Analyses were performed in 2023. Results: Having a college degree or more (b = −0.32; 95% CI: −0.46, −0.17), higher income (b = −0.06; 95% CI: −0.11, −0.01), and greater wealth (b = −0.11; 95% CI: −0.16, −0.07) were linked to reduced AL. Conversely, increased experiences of everyday discrimination were associated with heightened AL (b = 0.07; 95% CI: 0.01, 0.16). Collectively, differences in possessing a college degree or more, wealth, and exposure to discrimination accounted for about 18% of the observed Black-White AL disparities. Conclusions: Education, income, wealth, and experiences of discrimination may independently contribute to AL and partially explain Black-White disparities in AL. There is a need to elucidate the underlying mechanisms governing these relationships, particularly wealth, and extend the research to additional social determinants of racial health disparities.Intersectionality matters for hispanic health: A replication study using the All of Us Research Program
AbstractRodrigues, M., Risner, E., Rhodes-Bratton, B., Cook, S. H., & Cuevas, A. (n.d.).Publication year
2024Journal title
International Journal for Equity in HealthVolume
23Issue
1AbstractBackground: Despite research dedicated to understanding the health profiles and health-related outcomes of Hispanic individuals, the prevailing body of literature frequently homogenizes the Hispanic population, failing to address the role of race in Hispanic health discourse. Thus, the current study applies an intersectional lens to identify health differences and similarities among Hispanic subgroups. Methods: Sociodemographic characteristics and health domain variables (i.e., health status, health services, and health behaviors) from participants (N = 11,192) were included in the analyses. Bivariate Chi-squared tests examined the relationship between sociodemographic and health domain variables Black Hispanic individuals, white Hispanic individuals, and non-Hispanic Black individuals. Results: Findings suggest that Non-Hispanic Black American individuals reported the highest rates of hypertension (49.09%) and diabetes (19.62%) compared to Black-Hispanic individuals (22.45% and 12.98%) and white Hispanic individuals (22.22% and 8.02%). Black Hispanic individuals reported the greatest proportion of asthma diagnoses (35.10%) and those who saw a doctor in the previous year (95.52%) compared to white Hispanic individuals (26.84%, and 91.10%, respectively) and non-Hispanic Black individuals (21.74%, and 94.69%, respectively). Conclusion: Specifically, we found that several health behaviors and health-related outcomes significantly varied across different racial/ethnic groups, demonstrating the advantage of an intersectional approach to identify health disparities among racially diverse ethnic groups. Public Health significance: We encourage the development of health care services with an awareness of the complexities resulting from racial differences within the Hispanic diaspora.Love after lockup: examining the role of marriage, social status, and financial stress among formerly incarcerated individuals
AbstractBather, J. R., McSorley, A. M. M., Rhodes-Bratton, B., Cuevas, A., Rouhani, S., Nafiu, R. T., Harris, A., & Goodman, M. (n.d.).Publication year
2024Journal title
Health and JusticeVolume
12Issue
1AbstractBackground: Upon reintegration into society, formerly incarcerated individuals (FIIs) experience chronic financial stress due to prolonged unemployment, strained social relationships, and financial obligations. This study examined whether marriage and perceived social status can mitigate financial stress, which is deleterious to the well-being of FIIs. We also assessed whether sociodemographic factors influenced financial stress across marital status. We used cross-sectional data from 588 FIIs, collected in the 2023 Survey of Racism and Public Health. The financial stress outcome (Cronbach’s α = 0.86) comprised of five constructs: psychological distress, financial anxiety, job insecurity, life satisfaction, and financial well-being. Independent variables included marital and social status, age, race/ethnicity, gender identity, educational attainment, employment status, and number of dependents. Multivariable models tested whether financial stress levels differed by marital and perceived social status (individual and interaction effects). Stratified multivariable models assessed whether social status and sociodemographic associations varied by marital status. Results: We found that being married/living with a partner (M/LWP, b = -5.2) or having higher social status (b = -2.4) were protective against financial stress. Additionally, the social status effect was more protective among divorced, separated, or widowed participants (b = -2.5) compared to never married (NM, b = -2.2) and M/LWP (b = -1.7) participants. Lower financial stress correlated with Black race and older age, with the age effect being more pronounced among M/LWP participants (b = -9.7) compared to NM participants (b = -7.3). Higher financial stress was associated with woman gender identity (overall sample b = 2.9, NM sample b = 5.1), higher education (M/LWP sample b = 4.4), and having two or more dependents (overall sample b = 2.3, M/LWP sample b = 3.4). Conclusions: We provide novel insights into the interrelationship between marriage, perceived social status, and financial stress among FIIs. Our findings indicate the need for policies and programs which may target the family unit, and not only the individual, to help alleviate the financial burden of FIIs. Finally, programs that offer legal aid to assist in expungement or sealing of criminal records or those offering opportunities for community volunteer work in exchange for vouchers specific to legal debt among FIIs could serve to reduce financial stress and improve social standing.Multi-discrimination exposure and biological aging: Results from the midlife in the United States study
AbstractCuevas, A. G., Cole, S. W., Belsky, D. W., McSorley, A. M., Shon, J. M., & Chang, V. W. (n.d.).Publication year
2024Journal title
Brain, Behavior, and Immunity - HealthVolume
39AbstractDiscrimination is a social determinant of health and health disparities for which the biological mechanisms remain poorly understood. This study investigated the hypothesis that discrimination contributes to poor health outcomes by accelerating biological processes of aging. We analyzed survey and blood DNA methylation data from the Midlife in the United States (MIDUS) study (N = 1967). We used linear regression analysis to test associations of everyday, major, and workplace discrimination with biological aging measured by the DunedinPACE, PhenoAge, and GrimAge2 epigenetic clocks. MIDUS participants who reported more discrimination tended to exhibit a faster pace of aging and older biological age as compared to peers who reported less discrimination. Effect-sizes for associations tended to be larger for the DunedinPACE pace-of-aging clock (effect-size range r = 0.1–0.2) as compared with the PhenoAge and GrimAge2 biological-age clocks (effect-sizes r < 0.1) and for experiences of everyday and major discrimination as compared with workplace discrimination. Smoking status and body-mass index accounted for roughly half of observed association between discrimination and biological aging. Reports of discrimination were more strongly associated with accelerated biological aging among White as compared with Black participants, although Black participants reported more discrimination overall and tended to exhibit older biological age and faster biological aging. Findings support the hypothesis that experiences of interpersonal discrimination contribute to accelerated biological aging and suggest that structural and individual-level interventions to reduce discrimination and promote adaptive coping have potential to support healthy aging and build health equity.Neighborhood Opportunity and Obesity in Early Adolescence: Differential Associations by Sex
AbstractErtel, K. A., Okuzono, S. S., Beyer, L. N., Pintro, K., Cuevas, A. G., & Slopen, N. (n.d.).Publication year
2024Journal title
Journal of Adolescent HealthVolume
75Issue
2Page(s)
314-322AbstractPurpose: Though research indicates that certain aspects of adverse neighborhood conditions may influence weight development in childhood and adolescence, it is unknown if the Child Opportunity Index (COI), a composite measure of 29 indicators of neighborhood conditions, is associated with weight outcomes in adolescence. We hypothesized that lower COI would be associated with higher overweight and obesity in cross-sectional and longitudinal modeling in a national sample of 9 year olds and 10 year olds and that this association would be different by sex. Methods: Using data from the Adolescent Brain Cognitive Development study (n = 11,857), we examined the cross-sectional association between COI quintile and overweight and obesity in 9 year olds and 10 year olds. Additionally, we used hazard ratios to examine incident overweight and obesity across three waves of data collection. Results: Due to the interaction between sex and COI (p < .05), we present sex-specific models. There was a stepwise bivariate association, in which higher COI was associated with lower obesity prevalence. This pattern held in multilevel models, with a stronger association in females. In models adjusted for individual and household characteristics, female adolescents in the lowest quintile COI neighborhoods had 1.81 (95% confidence interval: 1.32, 2.48) times the odds of obesity compared to those in the highest quintile. In longitudinal models, the COI was associated with incident obesity in females only: adjusted hazard ratio = 4.27 (95% confidence interval: 1.50, 12.13) for lowest compared to highest COI. Discussion: Neighborhood opportunity is associated with risk of obesity in pre-adolescence into mid-adolescence. Females may be particularly influenced by neighborhood conditions.Racial Discrimination, Religious Coping, and Cardiovascular Disease Risk Among African American Women and Men
AbstractAshe, J., Bentley-Edwards, K., Skipper, A., Cuevas, A., Vieytes, C. M., Bah, K., Evans, M. K., Zonderman, A. B., & Waldstein, S. R. (n.d.).Publication year
2024Journal title
Journal of Racial and Ethnic Health DisparitiesAbstractObjective: This cross-sectional study examined whether religious coping buffered the associations between racial discrimination and several modifiable cardiovascular disease (CVD) risk factors—systolic and diastolic blood pressure (BP), glycated hemoglobin (HbA1c), body mass index (BMI), and cholesterol—in a sample of African American women and men. Methods: Participant data were taken from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (N = 815; 55.2% women; 30–64 years old). Racial discrimination and religious coping were self-reported. CVD risk factors were clinically assessed. Results: In sex-stratified hierarchical regression analyses adjusted for age, socioeconomic status, and medication use, findings revealed several significant interactive associations and opposite effects by sex. Among men who experienced racial discrimination, religious coping was negatively related to systolic BP and HbA1c. However, in men reporting no prior discrimination, religious coping was positively related to most risk factors. Among women who had experienced racial discrimination, greater religious coping was associated with higher HbA1c and BMI. The lowest levels of CVD risk were observed among women who seldom used religious coping but experienced discrimination. Conclusion: Religious coping might mitigate the effects of racial discrimination on CVD risk for African American men but not women. Additional work is needed to understand whether reinforcing these coping strategies only benefits those who have experienced discrimination. It is also possible that religion may not buffer the effects of other psychosocial stressors linked with elevated CVD risk.The cost of doubt: assessing the association between attributional ambiguity and mental health
AbstractCuevas, A. G., Williams, D. R., Krobath, D. M., Lyngdoh, A., Kaba-Diakité, F., & Allen, J. D. (n.d.).Publication year
2024Journal title
BMC public healthVolume
24Issue
1AbstractObjective: To quantify the association between attributional ambiguity–the uncertainty of whether an experience is discrimination–and mental health. Methods: Using a nationally representative sample of U.S. adults recruited through an online survey by Ipsos (April 23 and May 3, 2021), attributional ambiguity was quantified by asking participants if they experienced anything in the past 6 months that they were unsure was discrimination. The survey also assessed the degree to which these experiences caused participants to feel bothered and to ruminate on them. Multiple linear regression models were used to analyze associations between attributional ambiguity and depressive symptoms and mental health status. Results: Black and Hispanic participants reported higher rates of attributional ambiguity than White participants. Experiencing attributional ambiguity was associated with higher levels of depressive symptoms and poorer self-reported mental health status. Among those who reported attributional ambiguity, increases in bother and rumination scores were positively associated with depressive symptoms. Conclusion: Attributional ambiguity is an important yet overlooked social determinant of mental health. More research is needed to fully understand the impact of this stressor on population health, particularly among minoritized populations.The Influence of Contested Racial Identity and Perceived Everyday Discrimination Exposure on Body Mass Index in US Adults
AbstractKrobath, D. M., Cuevas, A. G., Allen, J. D., Chung, M., Economos, C. D., & Mistry, J. (n.d.).Publication year
2024Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
11Issue
5Page(s)
3182-3191AbstractContested racial identity—the discrepancy between one’s self-identified race and socially assigned race—is a social determinant of health and may contribute to overweight and obesity. Obesity is associated with a host of short- and long-term health conditions, including cardiovascular disease, a leading cause of death. Individuals racialized as Black, Hispanic, and Latino are at the greatest risk of obesity. Previous research indicates that experiencing interpersonal discrimination is associated with higher body mass index (BMI) in adults, and individuals with a contested racial identity are disproportionately exposed to interpersonal discrimination. However, the association between BMI and contested racial identity is unknown. This cross-sectional study measured the relationship between contested racial identity and perceived everyday discrimination on BMI in a nationally representative sample of US adults. Contested racial identity was measured with a binary variable indicating agreement between participants’ self-identified race and socially assigned race. Weighted unadjusted and adjusted multiple linear regression models quantified the associations between BMI and contested racial identity with and without the mean discrimination score. Covariates included nativity status, income, education, racial identity salience, gender, and age. Among 1689 participants, 18.3% had a contested racial identity. Contested identity was associated with significantly higher BMI (β = 1.01, 95% CI = 0.06, 1.92), but the relationship was attenuated when adjusting for interpersonal discrimination, suggesting that individuals with contested identity may face a greater risk of obesity due to their disproportionately high exposure to interpersonal racial discrimination. Further research is needed to elucidate the impact of racism on BMI and obesity risk.Association of Racial Discrimination With Adiposity in Children and Adolescents
AbstractCuevas, A. G., Krobath, D. M., Rhodes-Bratton, B., Xu, S., Omolade, J. J., Perry, A. R., & Slopen, N. (n.d.).Publication year
2023Journal title
JAMA network openVolume
6Issue
7AbstractIMPORTANCE Childhood obesity is a major public health issue and is disproportionately prevalent among children from minority racial and ethnic groups. Personally mediated racism (commonly referred to as racial discrimination) is a known stressor that has been linked to higher body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) in adults, but little is known about the association of racial discrimination and childhood and adolescent adiposity. OBJECTIVE To assess the prospective association between self-reported experiences of racial discrimination and adiposity (BMI and waist circumference) in a large sample of children and adolescents in the Adolescent Brain Cognitive Development (ABCD) study. DESIGN, SETTING, AND PARTICIPANTS This cohort study used complete data from the ABCD study (2017 to 2019), involving a total of 6463 participants. The ABCD study recruited a diverse sample of youths from across the US, with rural, urban, and mountain regions. Data were analyzed from January 12 to May 17, 2023. EXPOSURE The child-reported Perceived Discrimination Scale was used to quantify racial discrimination, reflecting participants’ perceptions of being treated unfairly by others or unaccepted by society based on their race or ethnicity. MAIN OUTCOMES AND MEASURES Weight, height, and waist circumference were measured by trained research assistants. BMI z scores were computed by applying the US Centers for Disease Control and Prevention’s age and sex-specific reference standards for children and adolescents. Waist circumference (inches) was quantified as the mean of 3 consecutive measures. Measurements were taken from time 1 (ie, 2017 to 2019) and time 2 (ie, 2018 to 2020). RESULTS Of the 6463 respondents with complete data, 3090 (47.8%) were female, and the mean (SD) age was 9.95 (0.62) years. Greater racial discrimination exposure at time 1 was associated with higher BMI z score in both unadjusted (β, 0.05; 95% CI, 0.02-0.08) and adjusted regression models (β, 0.04; 95% CI, 0.01-0.08). Discrimination at time 1 was associated with higher waist circumference in unadjusted (β, 0.35; 95% CI, 0.15-0.54) and adjusted (β, 0.24; 95% CI, 0.04-0.44) models. CONCLUSIONS AND RELEVANCE In this cohort study of children and adolescents, racial discrimination was positively associated with adiposity, quantified by BMI z score and waist circumference. Interventions to reduce exposure to racial discrimination in early life may help reduce the risk of excess weight gain across throughout life.Discrimination Exposure and Polygenic Risk for Obesity in Adulthood: Testing Gene-Environment Correlations and Interactions
AbstractCuevas, A. G., Mann, F. D., & Krueger, R. F. (n.d.).Publication year
2023Journal title
Lifestyle GenomicsVolume
16Issue
1Page(s)
90-97AbstractIntroduction: Exposure to discrimination has emerged as a risk factor for obesity. It remains unclear, however, whether the genotype of the individual can modulate the sensitivity or response to discrimination exposure (gene × environment interaction) or increase the likelihood of experiencing discrimination (gene-environment correlation). Methods: This was an observational study of 4,102 white/European Americans in the Health and Retirement Study with self-reported, biological assessments, and genotyped data from 2006 to 2014. Discrimination was operationalized using the average of nine Everyday Discrimination Scale items. Polygenic risk scores (PRSs) for body mass index (BMI) and waist circumference (WC) were calculated using the weighted sum of risk alleles based on studies conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. Results: We found that greater PRS-BMI was significantly associated with more reports of discrimination (β = 0.04 ± 0.02; p = 0.037). Further analysis showed that measured BMI partially mediated the association between PRS-BMI and discrimination. There was no evidence that the association between discrimination and BMI, or the association between discrimination and WC, differed by PRS-BMI or PRS-WC, respectively. Conclusion: Our findings suggest that individuals with genetic liability for obesity may experience greater discrimination in their lifetime, consistent with a gene-environment correlation hypothesis. There was no evidence of a gene-environment interaction. More genome-wide association studies in diverse populations are needed to improve generalizability of study findings. In the meantime, prevention and clinical intervention efforts that seek to reduce exposure to all forms of discrimination may help reduce obesity at the population level.Genetic Liability, Exposure Severity, and Post-Traumatic Stress Disorder Predict Cognitive Impairment in World Trade Center Responders
AbstractMann, F. D., Clouston, S. A., Cuevas, A., Waszczuk, M. A., Kuan, P. F., Carr, M. A., Docherty, A. R., Shabalin, A. A., Gandy, S. E., & Luft, B. J. (n.d.).Publication year
2023Journal title
Journal of Alzheimer's DiseaseVolume
92Issue
2Page(s)
701-712AbstractBackground: There is a high incidence of cognitive impairment among World Trade Center (WTC) responders, comorbid with post-traumatic stress disorder (PTSD). Yet, it remains unknown whether genetic liability for Alzheimer's disease, PTSD, educational attainment, or for a combination of these phenotypes, is associated with cognitive impairment in this high-risk population. Similarly, whether the effects of genetic liability are comparable to PTSD and indicators of exposure severity remains unknown. Objective: In a study of 3,997 WTC responders, polygenic scores for Alzheimer's disease, PTSD, and educational attainment were used to test whether genome-wide risk for one or more of these phenotypes is associated with cognitive impairment, controlling for population stratification, while simultaneously estimating the effects of demographic factors and indicators of 9/11 exposure severity, including symptoms of PTSD. Results: Polygenic scores for Alzheimer's disease and educational attainment were significantly associated with an increase and decrease, respectively, in the hazard rate of mild cognitive impairment. The polygenic score for Alzheimer's disease was marginally associated with an increase in the hazard rate of severe cognitive impairment, but only age, exposure severity, and symptoms of PTSD were statistically significant predictors. Conclusion: These results add to the emerging evidence that many WTC responders are suffering from mild cognitive impairments that resemble symptoms of Alzheimer's disease, as genetic liability for Alzheimer's disease predicted incidence of mild cognitive impairment. However, compared to polygenic scores, effect sizes were larger for PTSD and the type of work that responders completed during rescue and recovery efforts.Intersectional vulnerability in the relationship between discrimination and inflammatory gene expression
AbstractCuevas, A. G., Freilich, C. D., Mann, F. D., Cole, S. W., & Krueger, R. F. (n.d.).Publication year
2023Journal title
Brain, Behavior, and Immunity - HealthVolume
27AbstractAddressing 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.Length of Residency in the United States and Obesity Across Race/Ethnicity
AbstractCofie, L. E., & Cuevas, A. G. (n.d.).Publication year
2023Journal title
Journal of Immigrant and Minority HealthVolume
25Issue
1Page(s)
241-245AbstractWe 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.