Adolfo Cuevas

Associate Professor of Social and Behavioral Sciences

Professional overview

Adolfo G. Cuevas, PhD, is an Associate 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 University

MS, Applied Psychology, Portland State University

BA, Psychology, City College of New York, 2010

Certificate, Applied Biostatistics, Harvard Catalyst

Honors and awards

National Institute of Health Loan Repayment-Renewal (2021)

Diversity Scholar Award, Nutrition Obesity Research Center, Harvard University (2019)

National Institute of Health Loan Repayment (2019)

40 Under 40 Leaders in Health, National Minority Quality Forum (2018)

Neubauer Faculty Fellowship, Tufts University (2017)

Portland African American Leadership Fellowship (2013)

National Cancer Institute R25E Summer Research Experience, The University of Texas MD, Anderson’s Cancer Prevention Research Training Program (2012)

Bernard R. Ackerman Foundation Award for Outstanding Scholarship (2010)

Search for Education, Elevation, and Knowledge Graduate of the Year (2010)

City University of New York Pipeline Fellowship (2009)

City University of New York Search for Education, Elevation, and Knowledge (SEEK) Scholarship (2009)

Psi Chi Honor Society (2009)

Dean’s List Scholar (20082009)

Chi Alpha Epsilon (XAE) Honor Society (2008)

City College of New York’s William Wright Scholarship (2008)

City College of New York Community Service Award (2008)

SEEK Scholarship (2008)

Areas of research and study

Obesity

Psychosocial Stress

Racial/Ethnic Disparities

Publications

Publications

Intersectional vulnerability in the relationship between discrimination and inflammatory gene expression

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

Publication year

2023

Journal title

Brain, Behavior, and Immunity - Health

Volume

27

10.1016/j.bbih.2022.100580

Abstract

Abstract

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

Parental education and epigenetic aging in middle-aged and older adults in the United States : A life course perspective

Korous, K. M., Surachman, A., Rogers, C. R., & Cuevas, A. (n.d.).

Publication year

2023

Journal title

Social Science and Medicine

Volume

333

10.1016/j.socscimed.2023.116173

Abstract

Abstract

Epigenetic aging is one plausible mechanism by which socioeconomic status (SES) contributes to disparities in morbidity and mortality. Although the association between SES and epigenetic aging is well documented, the role of parental education into adulthood remains understudied. We examined (1) if parental education was independently associated with epigenetic aging, (2) whether upward educational mobility buffered this association, and (3) if the benefit of parental education was differentiated by race/ethnicity. Secondary data analysis of a subsample (n = 3875) of Non-Hispanic [NH] Black, Hispanic, NH White, and NH other race participants from the Venous Blood Study within Health and Retirement Study were examined. Thirteen clocks based on DNA methylation of cytosine-phosphate-guanine sites were used to calculate epigenetic aging. Participants' education (personal) and their report of their respective parent's education (parental; mother's and/or father's) were included as independent variables; several potential confounders were also included. Direct associations and interactions between parental and personal education were estimated via survey-weighted generalized linear models; marginal means for epigenetic aging were estimated and contrasts were made between the education subcategories. Analyses were also stratified by race/ethnicity. Our results showed that higher parental education was independently associated with slower epigenetic aging among four clocks, whereas higher personal education magnified this association among four different epigenetic clocks. Participants with the lowest parental and personal education had higher marginal means (i.e., accelerated aging) compared to participants with the highest parental and personal education, and there was little evidence of upward mobility. These associations were more frequently observed among NH White participants, whereas fewer were observed for Hispanic and NH Black participants. Overall, our findings support that early-life circumstances may be biologically embedded through epigenetic aging, which may also limit the biological benefits associated with one's own education.

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

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

Publication year

2023

Journal title

Obesity Science & Practice

Volume

9

Issue

2

Page(s)

145

Abstract

Abstract

~

The Influence of Contested Racial Identity and Perceived Everyday Discrimination Exposure on Body Mass Index in US Adults

Krobath, D. M., Cuevas, A., Allen, J. D., Chung, M., Economos, C. D., & Mistry, J. (n.d.).

Publication year

2023

Journal title

Journal of Racial and Ethnic Health Disparities

10.1007/s40615-023-01774-4

Abstract

Abstract

Contested 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.

The relationship between subjective social status, mental health disparities, and the mediating role of discrimination among Latinx populations

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

Publication year

2023

Journal title

Journal of Racial and Ethnic Health Disparities

Volume

10

Issue

1

Page(s)

350

Abstract

Abstract

~

Use of Bland-Altman Analysis to Examine the Racial and Ethnic Representativeness of Study Populations in Community-Based Pediatric Health Research

Krobath, D. M., Naumova, E. N., Cuevas, A., Sacheck, J. M., Wilson, N. L., & Economos, C. D. (n.d.).

Publication year

2023

Journal title

JAMA network open

Volume

6

Issue

5

Page(s)

E2312920

10.1001/jamanetworkopen.2023.12920

Abstract

Abstract

Importance: Children from marginalized racial and ethnic groups are underrepresented in health research. To improve external validity and routinize race and ethnicity reporting, a specific and standardized methodology for quantifying representativeness of participant populations is needed. Objective: To develop a standardized method for quantifying the racial and ethnic representativeness of study samples. Design, Setting, and Participants: In this cross-sectional study, data from 7 US community-based health studies (conducted between 2003 and 2017) were retrospectively pooled to assess the school-level representativeness of enrolled samples by race and ethnicity. The sampling frame for the study was constructed using the National Center of Education Statistics Common Core of Data, which provides year-specific racial and ethnic counts by grade. Representativeness was quantified by aggregating children's data at the school level, reported individually for Asian, Black, Hispanic or Latino, Native Hawaiian or other Pacific Islander, White, or multiple races. In this analysis, the Asian and Native Hawaiian or other Pacific Islander subgroups were combined. Data were analyzed from April 1 to June 15, 2022. Exposure: Community-based nutritional health studies conducted with children in grades 1 to 8. Main Outcomes and Measures: Visual comparisons of percentage expected and percentage observed of the pooled sample by race and ethnicity were performed using scatterplots and Bland-Altman plots. Spearman rank-order correlation was used to assess associations. Results: This study included 104 study schools (N = 5807 children) located in California, Kentucky, Massachusetts, Mississippi, and South Carolina. Bland-Altman analysis revealed notable patterns and variability in the representativeness of racial and ethnic groups. Differences in the overall representativeness of Asian or Native Hawaiian or other Pacific Islander children (0.45 percentage points [95% CI, -7.76 to 8.66]), Black children (0.12 percentage points [95% CI, -15.73 to 15.96]), and White children (-0.72 percentage points [95% CI, -23.60 to 22.16]) were negligible, but measures of spread suggested that target population demographics affected representativeness differently across groups. Conclusions and Relevance: The results of this cross-sectional study suggest that replicating, testing, and scaling the proposed method for quantifying racial and ethnic representativeness, which uses measures of spread, could improve the transparency of race and ethnicity reporting during publication and lead to a more externally valid health evidence base. During implementation, investigators should adopt community-based research methods and allocate appropriate resources during recruitment, including a priori assessment of population demographics, as these conditions may affect racial and ethnic study enrollment differently. Prioritizing these methodological decisions could alleviate rising inequities..

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

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

Publication year

2022

Journal title

Brain, Behavior, and Immunity

Volume

102

Page(s)

333-337

10.1016/j.bbi.2022.03.005

Abstract

Abstract

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

Contested racial identity and the health of women and their infants

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

Publication year

2022

Journal title

Preventive Medicine

Volume

155

10.1016/j.ypmed.2022.106965

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

SSM - Population Health

Volume

19

10.1016/j.ssmph.2022.101222

Abstract

Abstract

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

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

Cuevas, A. (n.d.).

Publication year

2022

Journal title

AMA journal of ethics

Volume

24

Issue

4

Page(s)

E283-E288

10.1001/amajethics.2022.283

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

Journal of Immigrant and Minority Health

10.1007/s10903-022-01362-4

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

SSM - Population Health

Volume

20

10.1016/j.ssmph.2022.101278

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

Obesity Science and Practice

10.1002/osp4.631

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

Journals of Gerontology - Series A Biological Sciences and Medical Sciences

Volume

77

Issue

2

Page(s)

357-364

10.1093/gerona/glab099

Abstract

Abstract

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

Socially Assigned Race and the Health of Racialized Women and Their Infants

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

Publication year

2022

Journal title

Health Equity

Volume

6

Issue

1

Page(s)

845-851

10.1089/heq.2022.0079

Abstract

Abstract

Introduction: While historically most public health research has relied upon self-identified race as a proxy for experiencing racism, a growing literature recognizes that socially assigned race may more closely align with racialized lived experiences that influence health outcomes. We aim to understand how women's health behaviors, health outcomes, and infant health outcomes differ for women socially assigned as nonwhite when compared with women socially assigned as white in Massachusetts. Methods: Using data from the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) Reactions to Race module, we documented the associations between socially assigned race (white vs. nonwhite) and women's health behaviors (e.g., initiation of prenatal care, breastfeeding), women's health outcomes (e.g., gestational diabetes, depression before pregnancy), and infant health outcomes (e.g., preterm birth, low birth weight [LBW]). Multivariable models adjusted for age, marital status, education level, nativity, receipt of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) assistance during pregnancy, infant sex, plurality, and gestational age. Additional models adjusted for treatment by race, how often one thinks about race, and nativity. Results: Women socially assigned as nonwhite had higher odds of breastfeeding (adjusted odds ratio [AOR]: 1.86, 95% confidence interval [CI]: 1.54 to 2.25), lower odds of consuming alcohol (AOR: 0.27, 95% CI: 0.24 to 0.31), and lower odds of smoking (AOR: 0.30, 95% CI: 0.24 to 0.38) compared with those socially assigned as white. However, women socially assigned as nonwhite had higher odds of reporting gestational diabetes (AOR: 1.97, 95% CI: 1.49 to 2.61). Mothers socially assigned as nonwhite also had higher odds of giving birth to an LBW (AOR: 1.66, 95% CI: 1.29 to 2.14) and small-for-gestational age (AOR: 1.46, 95% CI: 1.19 to 1.80) infant compared with women socially assigned as white. Discussion: In comparison with women socially assigned as white, we observed poorer health outcomes for women who were socially assigned nonwhite despite engaging in more beneficial pregnancy-related health behaviors. Socially assigned race can provide an important context for women's experiences that can influence their health and the health of their infants.

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

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

Publication year

2022

Journal title

American Journal of Health Promotion

Volume

36

Issue

1

Page(s)

190-193

10.1177/08901171211034410

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

International Journal of Obesity

Volume

46

Issue

9

Page(s)

1728-1733

10.1038/s41366-022-01158-4

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

Journal of Aging and Health

Volume

34

Issue

6-8

Page(s)

786-793

10.1177/08982643211064123

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

American Journal of Health Promotion

Volume

36

Issue

2

Page(s)

314-317

10.1177/08901171211052994

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

Journal of Racial and Ethnic Health Disparities

10.1007/s40615-021-01226-x

Abstract

Abstract

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

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

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

Publication year

2022

Journal title

International Journal of Obesity

Volume

46

Issue

10

Page(s)

1875-1882

10.1038/s41366-022-01191-3

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

Social Science and Medicine

Volume

289

10.1016/j.socscimed.2021.114405

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

Ethnicity and Health

Volume

26

Issue

7

Page(s)

949-962

10.1080/13557858.2019.1613517

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

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

Volume

118

Issue

1

10.1073/PNAS.2017224118

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

American journal of preventive medicine

Volume

60

Issue

1

Page(s)

64-71

10.1016/j.amepre.2020.06.032

Abstract

Abstract

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