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

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

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

Publication year

2021

Journal title

Journals of Gerontology - Series B Psychological Sciences and Social Sciences

Volume

76

Issue

8

Page(s)

1580-1589

10.1093/geronb/gbaa142

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

Children

Volume

8

Issue

5

10.3390/children8050412

Abstract

Abstract

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

Parents’ Perceived Neighborhood Safety and Children’s Cognitive Performance : Complexities by Race, Ethnicity, and Cognitive Domain

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

Publication year

2021

Journal title

Urban Science

Volume

5

Issue

2

10.3390/urbansci5020046

Abstract

Abstract

Background: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. (n.d.).

Publication year

2021

Journal title

Brain, Behavior, and Immunity

Volume

94

Page(s)

470

10.1016/j.bbi.2021.02.024

Abstract

Abstract

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

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

Publication year

2021

Journal title

Psychosomatic Medicine

Volume

83

Issue

7

Page(s)

805-812

10.1097/PSY.0000000000000969

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

Journal of Clinical Sport Psychology

Volume

15

Issue

3

Page(s)

206-226

10.1123/JCSP.2019-0083

Abstract

Abstract

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

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

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

Publication year

2021

Journal title

GeroScience

Volume

43

Issue

2

Page(s)

655-672

10.1007/s11357-020-00319-5

Abstract

Abstract

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

Tip of the iceberg : Measuring racial discrimination in studies of health

Cuevas, A., & Boen, C. (n.d.).

Publication year

2021

Journal title

Stress and Health

Volume

37

Issue

5

Page(s)

1043-1050

10.1002/smi.3047

Abstract

Abstract

There is compelling evidence that racial discrimination is a risk factor for illness and disease. But what are health scientists measuring—and what do they think they are measuring—when they include measures of racial discrimination in health research? We synthesize theoretical conceptualizations of racial discrimination in health research and critically assess whether and how these concepts correspond (or not) to widely used measures of racial discrimination. In doing so, we show that while researchers often use terms such as ‘self-reported discrimination', ‘perceptions of discrimination', and ‘exposure to discrimination' interchangeably, these concepts are indeed unique, with each holding a distinct epistemological position and theoretical and methodological capacity to uncover the impact of racial discrimination on health and health disparities. Importantly, we argue that commonly used measures of self-reported or perceived racial discrimination are just the ‘tip of the iceberg' in terms of revealing the ways in which discrimination shapes health inequities. Scientists and practitioners must be cognizant of and intentional in their measurement choices and language, as the framing of these processes will inform policy and intervention efforts aimed at eliminating discrimination.

A national study of gender and racial differences in colorectal cancer screening among foreign-born older adults living in the US

Cofie, L. E., Hirth, J. M., Cuevas, A., & Farr, D. (n.d.).

Publication year

2020

Journal title

Journal of Behavioral Medicine

Volume

43

Issue

3

Page(s)

460-467

10.1007/s10865-019-00107-3

Abstract

Abstract

This 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

Cuevas, A., Ortiz, K., Lopez, N., & Williams, D. R. (n.d.).

Publication year

2020

Journal title

Ethnicity and Health

Volume

25

Issue

5

Page(s)

759-775

10.1080/13557858.2018.1447651

Abstract

Abstract

Objective: 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

Cuevas, A., Chen, R., Slopen, N., Thurber, K. A., Wilson, N., Economos, C., & Williams, D. R. (n.d.).

Publication year

2020

Journal title

Obesity

Volume

28

Issue

1

Page(s)

161-170

10.1002/oby.22648

Abstract

Abstract

Objective: 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

Assari, S., Cobb, S., Cuevas, A., & Bazargan, M. (n.d.).

Publication year

2020

Journal title

Frontiers in Psychiatry

Volume

11

10.3389/fpsyt.2020.535624

Abstract

Abstract

Objectives: 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

Cuevas, A., Ong, A. D., Carvalho, K., Ho, T., Chan, S. W., Allen, J. D., Chen, R., Rodgers, J., Biba, U., & Williams, D. R. (n.d.).

Publication year

2020

Journal title

Brain, Behavior, and Immunity

Volume

89

Page(s)

465-479

10.1016/j.bbi.2020.07.017

Abstract

Abstract

Exposure 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

Cuevas, A., Greatorex-Voith, S., Abuelezam, N., Eckert, N., & Assari, S. (n.d.).

Publication year

2020

Journal title

Biodemography and Social Biology

Volume

66

Issue

3-4

Page(s)

220-235

10.1080/19485565.2021.1983760

Abstract

Abstract

Critical 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

Cuevas, A., Kawachi, I., Ortiz, K., Pena, M., Reitzel, L. R., & McNeill, L. H. (n.d.).

Publication year

2020

Journal title

Preventive Medicine Reports

Volume

18

10.1016/j.pmedr.2020.101098

Abstract

Abstract

Obesity 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

Cabral, J., & Cuevas, A. (n.d.).

Publication year

2020

Journal title

Journal of Racial and Ethnic Health Disparities

Volume

7

Issue

5

Page(s)

874-879

10.1007/s40615-020-00710-0

Abstract

Abstract

The 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

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

Publication year

2020

Journal title

Public Health Reports

Volume

135

Issue

5

Page(s)

658-667

10.1177/0033354920941146

Abstract

Abstract

Objectives: 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

Allen, J. D., Reich, A., Cuevas, A., & Ladin, K. (n.d.).

Publication year

2020

Journal title

JMIR mHealth and uHealth

Volume

8

Issue

5

10.2196/15502

Abstract

Abstract

Background: 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

Sociodemographic correlates of cancer fatalism and the moderating role of religiosity : Results from a nationally-representative survey

Leyva, B., Nguyen, A. B., Cuevas, A., Taplin, S. H., Moser, R. P., & Allen, J. D. (n.d.).

Publication year

2020

Journal title

Journal of Prevention and Intervention in the Community

Volume

48

Issue

1

Page(s)

29-46

10.1080/10852352.2019.1617521

Abstract

Abstract

In 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

Thurber, K. A., Long, J., Salmon, M., Cuevas, A., & Lovett, R. (n.d.).

Publication year

2020

Journal title

Public Health Nutrition

Volume

23

Issue

2

Page(s)

295-308

10.1017/S1368980019001812

Abstract

Abstract

Objective: 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

Milstein, G., Palitsky, R., & Cuevas, A. (n.d.).

Publication year

2020

Journal title

Journal of Prevention and Intervention in the Community

Volume

48

Issue

1

Page(s)

1-6

10.1080/10852352.2019.1617519

Abstract

Abstract

Religion 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?

Cuevas, A., Levine, S., & Purtle, J. (n.d.).

Publication year

2020

Journal title

Journal of Racial and Ethnic Health Disparities

Volume

7

Issue

1

Page(s)

109-116

10.1007/s40615-019-00639-z

Abstract

Abstract

High 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.

Can patient-centered communication reduce the effects of medical mistrust on patients' decision making?

Cuevas, A., O'Brien, K., & Saha, S. (n.d.).

Publication year

2019

Journal title

Health Psychology

Volume

38

Issue

4

Page(s)

325-333

10.1037/hea0000721

Abstract

Abstract

Objective: Mistrust in medical institutions has been implicated as a barrier that disproportionately affects the quality of health care received by patients. Although patient-centered communication has been shown to improve patient-provider relationships, little is known as to whether it may reduce the effects of medical mistrust on patients' decision-making and trust in physicians (physician mistrust). Method: In a laboratory study, 231 primary care patients (101 African American and 130 White participants) were randomly assigned to one of two conditions in which they viewed video recorded, standardized vignettes depicting a cardiologist recommending coronary bypass surgery to a patient diagnosed with angina and 3-vessel coronary artery disease. In each vignette, the cardiologist-actor demonstrated either low or high patient-centered communication behavior. Participants were asked to assume the role of the patient interacting with the video-recorded physician. Results: Hypotheses were partially supported. High levels of medical mistrust were associated with greater physician mistrust and lesser endorsement of the hypothetical bypass surgery. Among patients exposed to high patient-centered communication, the relationships between medical mistrust and both physician mistrust and surgery endorsement were weaker than among patients exposed to low patient-centered communication. Although African American patients reported greater medical mistrust compared with White patients, respondents' race did not moderate the relationships. Conclusions: Results suggest that mistrust toward health care may unfavorably affect interactions and patients' health-related outcomes. Physicians may buffer the effects of mistrust by using patient-centered communication skills such as soliciting the patient's concerns and priorities and being responsive to the health care needs which patients identify.

Intra-Ethnic Racial Differences in Waterpipe Tobacco Smoking among Latinos?

Ortiz, K., Cuevas, A., Salloum, R., Lopez, N., & LaVeist-Ramos, T. (n.d.).

Publication year

2019

Journal title

Substance Use and Misuse

Volume

54

Issue

1

Page(s)

1-10

10.1080/10826084.2018.1480040

Abstract

Abstract

Background and Objectives: This study examined differences in waterpipe smoking (both lifetime and current) by race and ethnicity. More specifically, we evaluated intra-ethnic racial differences among Latinos using a nationally representative sample. Methods: Pooled data from the National Adult Tobacco Survey (NATS) [2012-2014] was used, in which Log-Poisson multivariable regression models were deployed to determine the prevalence of waterpipe smoking behavior. Models were stratified by gender and we further investigated acculturation, controlling for relevant sociodemographic characteristics. Results: In fully-adjusted models assessing lifetime WTS, Black Latinos and White Latinos exhibited an increase prevalence of lifetime WTS compared to their non-Hispanic white counterparts. Once stratifying by gender, Black Latino men (PR = 1.49; 95% CI = 1.16, 1.90) exhibited increased prevalence of lifetime WTS compared to their non-Hispanic white men counterparts; although white Latino men (PR = 0.88; 95% CI = 0.80, 0.98) exhibited decreased prevalence compared to their non-Hispanic white male counterparts. Similar trends were found for current WTS among men. In fully adjusted models assessing lifetime WTS, among women, only white Latina's (PR = 1.23; 95% CI = 1.04, 1.46) exhibited increased prevalence compared to their non-Hispanic white women counterparts. When evaluating current WTS, Black Latina's (PR = 2.19; 95% CI = 1.32, 3.65) and white Latinas (PR = 1.28; 95% CI = 1.00, 1.63) exhibited increased prevalence of WTS compared to their non-Hispanic white women counterparts. Conclusions/Importance: Among the U.S. general adult population, intra-ethnic racial differences in WTS behaviors exist among Latinos; and is shaped by gender. Future efforts to eliminate racial disparities in WTS should be attentive intra-ethnic racial differences among Latinos.

Psychosocial Stress and Overweight and Obesity : Findings from the Chicago Community Adult Health Study

Cuevas, A., Chen, R., Thurber, K. A., Slopen, N., & Williams, D. R. (n.d.).

Publication year

2019

Journal title

Annals of Behavioral Medicine

Volume

53

Issue

11

Page(s)

964-974

10.1093/abm/kaz008

Abstract

Abstract

Background: Psychosocial stress has been implicated as a risk factor for overweight and obesity. However, research on psychosocial stressors and overweight and obesity has typically focused on single stressors in isolation, which may overestimate the impact of a specific stressor and fail to describe the role of cumulative stress on overweight and obesity risk. Purpose: This study explores the association between overweight/obesity and cumulative exposure to a wide range of psychosocial stressors, among a multiracial/ethnic sample of adults. Methods: Using secondary data from the Chicago Community Adult Health Study (n = 2,983), we conducted multinomial logistic regression analyses to quantify associations between eight psychosocial stressors, individually and in combination, and measured overweight and obesity, adjusted for sociodemographic factors, alcohol use and smoking. Results: In separated covariate-adjusted models, childhood adversities (odds ratio [OR] = 1.16; confidence interval [CI] = [1.03, 1.30]), acute life events (OR = 1.18; CI = [1.04, 1.34]), financial strain (OR = 1.30; CI = [1.15, 1.47]), and relationship stressors (OR = 1.18; CI = [1.04, 1.35]) were associated with increased odds of obesity. In a model adjusted for all stressors simultaneously, financial strain was the only stressor independently associated with overweight (OR = 1.17; CI = [1.00, 1.36]) and obesity (OR = 1.21; CI = [1.05, 1.39]). Participants with stress exposure in the highest quintile across 2, 3, or ≥4 (compared to no) types of stressors had significantly higher odds of obesity. Conclusions: Multiple types of stressors may be risk factors for obesity, and cumulative exposure to these stressors may increase the odds of obesity. Reducing exposure to stressors at the population level may have the potential to contribute to reducing the burden of obesity.