Adolfo Cuevas
Adolfo Cuevas
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Assistant Professor of Social and Behavioral Sciences
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Professional overview
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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.
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Education
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PhD, Applied Psychology, Portland State UniversityMS, Applied Psychology, Portland State UniversityBA, Psychology, City College of New York, 2010Certificate, Applied Biostatistics, Harvard Catalyst
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Honors and awards
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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)
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Areas of research and study
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ObesityPsychosocial StressRacial/Ethnic Disparities
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Publications
Publications
Cumulative stress: A general “s” factor in the structure of stress
AbstractMann, F. D., Cuevas, A. G., & Krueger, R. F. (n.d.).Publication year
2021Journal title
Social Science and MedicineVolume
289AbstractObjective: 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
AbstractCuevas, A. G., Ho, T., Rodgers, J., DeNufrio, D., Alley, L., Allen, J., & Williams, D. R. (n.d.).Publication year
2021Journal title
Ethnicity and HealthVolume
26Issue
7Page(s)
949-962AbstractObjective: 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
AbstractCuevas, A. G., Mann, F. D., Williams, D. R., & Krueger, R. F. (n.d.).Publication year
2021Journal title
Proceedings of the National Academy of Sciences of the United States of AmericaVolume
118Issue
1AbstractAn 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
AbstractAbuelezam, N. N., Cuevas, A. G., El-Sayed, A. M., Galea, S., & Hawkins, S. S. (n.d.).Publication year
2021Journal title
American journal of preventive medicineVolume
60Issue
1Page(s)
64-71AbstractIntroduction: 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
AbstractCuevas, A. G., Greatorex-Voith, S., Assari, S., Slopen, N., & Economos, C. D. (n.d.).Publication year
2021Journal title
Journals of Gerontology - Series B Psychological Sciences and Social SciencesVolume
76Issue
8Page(s)
1580-1589AbstractObjectives: 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
AbstractAssari, 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
2021Journal title
ChildrenVolume
8Issue
5AbstractBackground: 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.Parents’ Perceived Neighborhood Safety and Children’s Cognitive Performance: Complexities by Race, Ethnicity, and Cognitive Domain
AbstractAssari, S., Boyce, S., Mistry, R., Thomas, A., Nicholson, H. L., Cobb, R. J., Cuevas, A. G., Lee, D. B., Bazargan, M., Caldwell, C. H., Curry, T. J., & Zimmerman, M. A. (n.d.).Publication year
2021Journal title
Urban ScienceVolume
5Issue
2AbstractBackground:Aim: To examine racial/ethnic variations in the effect of parents’ subjective neighborhood safety on children’s cognitive performance. Methods: This cross-sectional study included 10,027 children from the Adolescent Brain Cognitive Development (ABCD) study. The exposure variable was parents’ subjective neighborhood safety. The outcomes were three domains of children’s cognitive performance: general cognitive performance, executive functioning, and learning/memory. We used mixed-effects regression models for data analysis. Results: Overall, parents’ subjective neighborhood safety was positively associated with children’s executive functioning, but not general cognitive performance or learning/memory. Higher parents’ subjective neighborhood safety had a more positive influence on the executive functioning of non-Hispanic White than Asian American children. Higher parents’ subjective neighborhood safety was associated with higher general cognitive performance and learning/memory for non-White children relative to non-Hispanic White children. Conclusion: The race/ethnicity of children moderates the association between neighborhood safety and cognitive performance. This becomes more complicated, as the patterns seem to differ across ethnicity and cognitive domains. It is unknown whether the observed racial/ethnic variations in the effect of neighborhood safety on cognitive performance are neighborhood characteristics such as residential segregation. Addressing neighborhood inequalities is needed if we wish to reduce racial/ethnic inequities in the cognitive development of children.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 (1–).Publication year
2021Volume
94Page(s)
470Skin Tone, Discrimination, and Allostatic Load in Middle-Aged and Older Puerto Ricans
AbstractCuevas, 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
2021Journal title
Psychosomatic MedicineVolume
83Issue
7Page(s)
805-812AbstractObjective 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
AbstractEvers, A. G., Somogie, J. A., Wong, I. L., Allen, J. D., & Cuevas, A. G. (n.d.).Publication year
2021Journal title
Journal of Clinical Sport PsychologyVolume
15Issue
3Page(s)
206-226AbstractThe 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
AbstractRodgers, J., Cuevas, A. G., Williams, D. R., Kawachi, I., & Subramanian, S. V. (n.d.).Publication year
2021Journal title
GeroScienceVolume
43Issue
2Page(s)
655-672AbstractEvidence 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.A national study of gender and racial differences in colorectal cancer screening among foreign-born older adults living in the US
AbstractCofie, L. E., Hirth, J. M., Cuevas, A. G., & Farr, D. (n.d.).Publication year
2020Journal title
Journal of Behavioral MedicineVolume
43Issue
3Page(s)
460-467AbstractThis study examined within group heterogeneity in colorectal cancer screening (CRCS) among foreign-born individuals. Data were from the 2010, 2013 and 2015 National Health Interview Survey data on older adults (N = 5529). In 2018, multivariable logistic regression analysis was conducted to determine whether gender and race/ethnicity were associated with CRCS after controlling for sociodemographic, health access, and acculturation related factors. Overall, Asians were significantly less likely to report CRCS compared with Whites (aOR 0.63, CI 0.52–0.76). Hispanic race/ethnicity was negatively associated with CRCS among men (aOR 0.68, CI 0.50–0.91), but not women compared to white men/women, respectively. Additionally, factors associated with CRCS include having fair/poor health, usual source of care, insurance, ≥ 10 years of US residency and citizenship. Screening disparities experienced by these immigrants may be addressed by improving healthcare access, especially for noncitizens and those with limited healthcare access.Assessing racial differences in lifetime and current smoking status & menthol consumption among Latinos in a nationally representative sample
AbstractCuevas, A. G., Ortiz, K., Lopez, N., & Williams, D. R. (n.d.).Publication year
2020Journal title
Ethnicity and HealthVolume
25Issue
5Page(s)
759-775AbstractObjective: To examine the relationship between race and smoking behaviors among Latinos/Hispanics. Design: Using data from the National Adult Tobacco Survey (NATS), we implemented Log-Poisson regression models for each dependent variable (smoking pattern and menthol cigarette use). Each analysis adjusted for age, gender, marital status, employment status, and socioeconomic status (SES). Final pooled cross-sectional sample included 505 Black-Latinos and 9078 White-Latinos. Results: While no racial differences were found in lifetime smoking status among Latinos, Black-Latinos had a 16.6% (95% CI: 0.274, 0.057) increased risk of menthol smoking compared to White-Latinos. Conclusions: The results indicate that menthol consumption is influenced by race among Hispanics/Latinos. To comprehensively address racial disparities among Latinos/Hispanics, further attention needs to be given to racial differences in smoking-related risks among Latinos/Hispanics.Assessing the Role of Health Behaviors, Socioeconomic Status, and Cumulative Stress for Racial/Ethnic Disparities in Obesity
AbstractCuevas, A. G., Chen, R., Slopen, N., Thurber, K. A., Wilson, N., Economos, C., & Williams, D. R. (n.d.).Publication year
2020Journal title
ObesityVolume
28Issue
1Page(s)
161-170AbstractObjective: This study aimed to examine the explanatory role of health behaviors, socioeconomic position (SEP), and psychosocial stressors on racial/ethnic obesity disparities in a multiethnic and multiracial sample of adults. Methods: Using data from the Chicago Community Adult Health Study (2001-2003), Oaxaca-Blinder decomposition analysis was conducted to quantify the extent to which health behaviors (fruit and vegetable consumption and physical activity), SEP, and cumulative stressors (e.g., perceived discrimination, financial strain) each explained differences in obesity prevalence in Black, US-born Hispanic, and non-US-born Hispanic compared with non-Hispanic White participants. Results: SEP and health behaviors did not explain obesity differences between racial/ethnic minorities and White individuals. Having high levels of stress in four or more domains explained 4.46% of the differences between Black and White individuals, whereas having high levels of stress in three domains significantly explained 14.13% of differences between US-born Hispanic and White. Together, the predictors explained less than 20% of differences between any racial/ethnic minority group and White individuals. Conclusions: Exposure to stressors may play a role in obesity disparities, particularly among Black and US-born Hispanic individuals. Other obesity-related risk factors need to be examined to understand the underlying mechanisms explaining obesity disparities.Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States
AbstractAssari, S., Cobb, S., Cuevas, A. G., & Bazargan, M. (n.d.).Publication year
2020Journal title
Frontiers in PsychiatryVolume
11AbstractObjectives: Marginalization-related diminished returns (MDRs) refer to weaker health effects of educational attainment for socially marginalized groups compared to the socially privileged groups. Most of the existing literature on MDRs, however, has focused on marginalization due to race, ethnicity, and sexual orientation. Thus, very limited information exists on MDRs of educational attainment among immigrant populations in the United States. Aims: Building on the MDRs framework and using a nationally representative sample of US adults, we compared immigrant and native-born adults for the effects of educational attainment on psychological distress, self-rated health (SRH), and chronic diseases (CDs). Methods: The 2015 National Health Interview Survey (NHIS) has enrolled 33,672 individuals who were either immigrant (n = 6,225; 18.5%) or native born (n = 27,429; 81.5%). The independent variable (IV) was educational attainment, which was treated as a categorical variable. The dependent variables included psychological distress, SRH, and CDs, all of which were dichotomous variables. Age, gender, race, ethnicity, and region were confounders. Immigration (nativity status) was the moderator. Results: Higher educational attainment was associated with lower odds of psychological distress, poor SRH, and CDs. However, immigration showed a significant statistical interaction with college graduation on all outcomes, which were suggestive of smaller protective effects of college graduation on psychological distress, poor SRH, and CDs for immigrant than native-born adults. Conclusions: In the US, the associations between educational attainment and psychological distress, SRH, and CDs are all weaker for immigrant than native-born adults. To prevent health disparities, it is essential to decompose health inequalities that are due to low educational attainment from those that are due to diminished returns of educational attainment (i.e., MDRs). There is a need to help highly educated immigrant adults secure positive health outcomes, similar to their native-born counterparts. Such changes may require bold and innovative economic, public, and social policies that help immigrant adults to more effectively mobilize their educational attainment to secure tangible outcomes. Elimination of health disparities in the US requires efforts that go beyond equalizing access to education.Discrimination and systemic inflammation: A critical review and synthesis
AbstractCuevas, A. G., Ong, A. D., Carvalho, K., Ho, T., Chan, S. W. (Celine), Allen, J. D., Chen, R., Rodgers, J., Biba, U., & Williams, D. R. (n.d.).Publication year
2020Journal title
Brain, Behavior, and ImmunityVolume
89Page(s)
465-479AbstractExposure to discrimination or unfair treatment has emerged as an important risk factor for illness and disease that disproportionately affects racial and ethnic minorities. Discriminatory experiences may operate like other stressors in that they activate physiological responses that adversely affect the maintenance of homeostasis. Research suggests that inflammation plays a critical role in the pathophysiology of stress-related diseases. Recent findings on discrimination and inflammation are discussed. We highlight limitations in the current evidence and provide recommendations for future studies that seek to examine the association between discrimination and inflammation.Educational mobility and telomere length in middle-aged and older adults: testing three alternative hypotheses
AbstractCuevas, A. G., Greatorex-Voith, S., Abuelezam, N., Eckert, N., & Assari, S. (n.d.).Publication year
2020Journal title
Biodemography and Social BiologyVolume
66Issue
3Page(s)
220-235AbstractCritical period, social mobility, and social accumulation are three hypotheses that may explain how educational mobility impacts health. Thus far, there is little evidence on how these processes are associated with biological aging as measured by telomere length. Using cross-sectional data from the 2008 Health and Retirement Study, we examined the association between educational mobility (parental education and contemporaneous education) and telomere length. The final model is adjusted for sociodemographic factors and socioeconomic status, childhood adversity, and health behaviors/risk factors, as well as depressive symptoms. A total of 1,894 participants were included in the main analyses. High parental education was associated with longer telomere length in a fully adjusted model (B = 0.03, CI [0.002,0.07]). Downwardly mobile individuals (high parental education and low contemporaneous education) had longer telomere length compared to stably low individuals in a fully adjusted model (B = 0.05, CI [0.004,0.09]). There was support for the critical period hypothesis and partial support for the change hypothesis. There was no evidence to support the social accumulation hypothesis. Prospective studies are needed to understand the mechanism that can help further explain the association between educational mobility and telomere length.Greater social cohesion is associated with lower body mass index among African American adults
AbstractCuevas, A. G., Kawachi, I., Ortiz, K., Pena, M., Reitzel, L. R., & McNeill, L. H. (n.d.).Publication year
2020Journal title
Preventive Medicine ReportsVolume
18AbstractObesity remains a public health issue, especially for Blacks (or African Americans). Obesity is thought to reflect a complex interaction of socioenvironmental, biological, and cognitive factors. Yet, insufficient attention has been given to psychosocial factors like social cohesion within the African American community. Using multivariable linear regression, we examined the association between social cohesion, measured by the Social Cohesion and Trust scale, and body mass index (BMI) with cross-sectional data (n = 1467) from a cohort study (2008–2009). Greater social cohesion was associated with lower BMI (b = -0.88; 95% CI: −1.45, −0.32) in an unadjusted model. The association was strengthened after further adjusting for relevant covariates (i.e., individual-level sociodemographic factors, health behaviors, and depressive symptoms) (b = -1.26; 95% CI: −1.94, −0.58). Future research should examine potential mechanisms underlying the association between social cohesion and BMI with longitudinal data. In the meantime, obesity prevention and intervention measures should consider promoting social ties and bonds to lower BMI in African American communities.Health Inequities Among Latinos/Hispanics: Documentation Status as a Determinant of Health
AbstractCabral, J., & Cuevas, A. G. (n.d.).Publication year
2020Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
7Issue
5Page(s)
874-879AbstractThe Hispanic/Latino population is the largest minority group in the USA. Research has documented health disadvantages of undocumented Latinos/Hispanics compared to their documented counterparts. The economic and social conditions that influence immigrant health may operate differently for undocumented immigrants compared to their documented counterparts. Access to healthcare, access to health-protective resources (social, economic, and political contributors), and immigration enforcement actions are three mechanisms that affect immigrants and contribute to the social and health inequities within the Latino/Hispanic population. We argue that social factors within these three mechanisms distinctly affect undocumented immigrants. We discuss these factors by synthesizing the existing literature on documentation status and health. In doing so, we highlight opportunities for future research and provide recommendations for policies and interventions that can ease the taxing effects of documentation status on health among Latinos/Hispanics.Maternal Health Behaviors and Infant Health Outcomes Among Arab American and Non-Hispanic White Mothers in Massachusetts, 2012-2016
AbstractAbuelezam, N. N., Cuevas, A. G., Galea, S., & Hawkins, S. S. (n.d.).Publication year
2020Journal title
Public Health ReportsVolume
135Issue
5Page(s)
658-667AbstractObjectives: The health profile of Arab American mothers and infants may differ from that of non–Arab American mothers and infants in the United States as a result of social stigma experienced in the historical and current sociopolitical climate. The objective of our study was to compare maternal health behaviors, maternal health outcomes, and infant health outcomes of Arab American mothers and non-Hispanic white mothers in Massachusetts and to assess the role of nativity as an effect modifier. Methods: Using data from Massachusetts birth certificates (2012-2016), we conducted adjusted logistic and linear regression models for maternal health behaviors, maternal health outcomes, and infant health outcomes. We used Arab ethnicity as the exposure of interest and nativity as an effect modifier. Results: Arab American mothers had higher odds than non-Hispanic white mothers of initiating breastfeeding (adjusted odds ratio [aOR] = 2.61; 95% CI, 2.39-2.86), giving birth to small-for-gestational-age infants (aOR = 1.28; 95% CI, 1.18-1.39), and having gestational diabetes (aOR = 1.31; 95% CI, 1.20-1.44). Among Arab American mothers, non–US-born mothers had higher odds than US-born mothers of having gestational diabetes (aOR = 1.80; 95% CI, 1.33-2.44) and lower odds of initiating prenatal care in the first trimester (aOR = 0.41; 95% CI, 0.33-0.50). In linear regression models, infants born to non–US-born Arab American mothers weighed 42.1 g (95% CI, −75.8 to −8.4 g) less than infants born to US-born Arab American mothers. Conclusion: Although Arab American mothers engage in positive health behaviors, non–US-born mothers had poorer maternal health outcomes and access to prenatal care than US-born mothers, suggesting the need for targeted interventions for non–US-born Arab American mothers.Preparing African American men to make informed prostate cancer screening decisions: Development and pilot testing of an interactive online decision aid
AbstractAllen, J. D., Reich, A., Cuevas, A. G., & Ladin, K. (n.d.).Publication year
2020Journal title
JMIR mHealth and uHealthVolume
8Issue
5AbstractBackground: African American men are at a higher risk of developing and dying from prostate cancer compared to white men. The serum prostate-specific antigen (PSA) screening test has a high risk of false-positive results and overdiagnosis; therefore, it is not routinely recommended. Rather, men are encouraged to make individualized decisions with their medical providers, after being fully informed about its potential benefits, limitations, and risks. Objective: This study aimed to describe the development and pilot testing of an interactive Web-based decision aid (DA; Prostate Cancer Screening Preparation [PCSPrep]) for African American men, designed to promote informed decision making for prostate cancer screening. Methods: Four focus groups (n=33) were conducted to assess men’s reactions to DAs developed in prior studies and gather information to modify the content and format. The pilot test employed a pre-posttest evaluation design. A convenience sample of 41 men aged 45-70 years with no history of prostate cancer was recruited from community settings. Participants completed online surveys before and after using PCSPrep that assessed prostate cancer screening knowledge, decision self-efficacy, decisional conflict, and preparation for decision making. Results: Use of PCSPrep was associated with a significant increase in prostate cancer knowledge (49% vs 62% correct responses; P<.001), and men also experienced less decisional conflict (24 vs 15 on a scale of 0-100; P=.008). No changes in self-efficacy about decision making or screening preferences were observed. Most men (81%) reported that using PCSPrep prepared them to make informed decisions in partnership with their provider. Conclusions: PCSPrep was an acceptable DA that improved men’s knowledge, reduced decisional conflict, and promoted the perception of being prepared for shared decision making. Further research is needed to test the DA in a larger randomized trial.Sociodemographic correlates of cancer fatalism and the moderating role of religiosity: Results from a nationally-representative survey
AbstractLeyva, B., Nguyen, A. B., Cuevas, A., Taplin, S. H., Moser, R. P., & Allen, J. D. (n.d.).Publication year
2020Journal title
Journal of Prevention and Intervention in the CommunityVolume
48Issue
1Page(s)
29-46AbstractIn general, it has been found that cancer fatalism is negatively associated with important cancer prevention and control behaviors, whereas religiosity is positively associated with these behaviors. Yet, the notion that religiosity gives rise to fatalistic beliefs that may discourage health behaviors is deeply ingrained in the public health literature. In addition, racial/ethnic group membership is associated with higher reports of cancer fatalism, though this association may be confounded by socioeconomic status (SES). A better understanding of the relationships between racial/ethnic group membership, SES, and religiosity may contribute to the development of effective interventions to address cancer fatalism and improve health behaviors. In this study, we examined associations between racial/ethnic group membership, SES, and cancer fatalism as the outcome. In addition, we tested whether religiosity (as measured by religious service attendance) moderated these relationships.Sugar-sweetened beverage consumption among Indigenous Australian children aged 0-3 years and association with sociodemographic, life circumstances and health factors
AbstractThurber, K. A., Long, J., Salmon, M., Cuevas, A. G., & Lovett, R. (n.d.).Publication year
2020Journal title
Public Health NutritionVolume
23Issue
2Page(s)
295-308AbstractObjective: To explore beverage intake and associations between sugar-sweetened beverage (SSB) intake and sociodemographic, life circumstances, health and well-being factors in a national cohort of Indigenous children.Design: We calculated prevalence ratios for any SSB consumption across exposures, using multilevel Poisson regression (robust variance), adjusted for age group and remoteness. A key informant focus group contextualised these exploratory findings.Setting: Diverse settings across Australia.Participants: Families of Indigenous children aged 0-3 years, in the Longitudinal Study of Indigenous Children.Results: Half (50·7 %, n 473/933) of children had ever consumed SSB at survey, increasing from 29·3 % of 0-12-month-olds to 65·7 % of 18-36-month-olds. SSB consumption prevalence was significantly lower in urban and regional v. remote areas, and in families experiencing socio-economic advantage (area-level advantage, caregiver employed, financial security), better life circumstances (caregiver social support, limited exposure to stressors) and caregiver well-being (non-smoking, social and emotional well-being, physical health). SSB consumption prevalence was significantly lower among those engaged with health services (adequate health-service access, regular prenatal check-ups), except SSB consumption prevalence was higher among those who received home visits from an Aboriginal Health Worker compared with no home visits. Key informants highlighted the role of water quality/safety on SSB consumption.Conclusions: A substantial proportion of Indigenous children in this sample consumed SSB from an early age. Health provider information needs to be relevant to the context of families' lives. Health system strategies must be paired with upstream strategies, such as holistic support programmes for families, reducing racism and improving water quality.The religion variable in community health promotion and illness prevention
AbstractMilstein, G., Palitsky, R., & Cuevas, A. (n.d.).Publication year
2020Journal title
Journal of Prevention and Intervention in the CommunityVolume
48Issue
1Page(s)
1-6AbstractReligion is a source of beliefs and practices, which can in turn influence health behaviors. Therefore, religious communities represent potential public health partners to improve well-being across economic and ethnic diversity. This issue of the Journal of Prevention & Intervention in the Community presents six empirical studies with a breadth of methodologies, and a range of subjects. The associations of religion with cancer fatalism, prenatal substance abuse, bereavement, suicide prevention, clergy mental health and attitudes toward the Affordable Care Act are reported here. These research findings support the key importance of community. Like community, religion is complex. This issue's studies demonstrate the need to include ethnicity in analyses as well as the necessity to measure both religious belief and practice. Consistently, religious community participation predicted more positive outcomes than one's level of belief.What Predicts a Mayoral Official’s Opinion about the Role of Stress in Health Disparities?
AbstractCuevas, A. G., Levine, S., & Purtle, J. (n.d.).Publication year
2020Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
7Issue
1Page(s)
109-116AbstractHigh stress is a public health issue in the United States (US), that disproportionately affects socially-marginalized group members, including racial and ethnic minorities and those of low socioeconomic status. While city governments have the potential to reduce stress exposure and health disparities through municipal policies, very little is known about factors that are associated with mayor officials’ beliefs about stress as a determinant of disparities. This information is important because it can inform the design of interventions to educate city policymakers about evidence related to stress and health disparities. Using data from a 2016 survey of 230 mayor officials (101 mayors, 129 senior staff), multivariable logistic regression was used to determine the extent to which respondents’ individual characteristics (e.g., ideology, highest level of education) and the characteristics of their city’s population (e.g., percentage of residents non-white) were associated with their identification of stress as a factor that has a “very strong effect” on health disparities. Forty-four percent of respondents identified stress as having a very strong effect on health disparities. In the fully adjusted model, every percentage point increase in the proportion of a respondent’s city population that was non-White increased the odds of identifying stress as having a very strong effect on health disparities by 2% [adjusted odds ratio (aOR) = 1.02; 95% CI = 1.00,1.04]. Interventions are needed to increase city policymakers’ knowledge about the role of stress in the production of health disparities, which could, in turn, help cultivate political will for city policies that reduce disparities.