Details:

Alternative Title:
Nicotine Tob Res
Personal Author:
Shenassa, Edmond D. ; Rossen, Lauren M. ; Cohen, Jonathan ; Morello-Frosch, Rachel ; Payne-Sturges, Devon C.
Shenassa, Edmond D. ; Rossen, Lauren M. ; Cohen, Jonathan ; Morello-Frosch, Rachel ; Payne-Sturges, Devon C. Less -
Description:
Introduction

Prior studies have found considerable racial and ethnic disparities in secondhand smoke (SHS) exposure. Although a number of individual-level determinants of this disparity have been identified, contextual determinants of racial and ethnic disparities in SHS exposure remain unexamined. The objective of this study was to examine disparities in serum cotinine in relation to area-level income inequality among 14 649 children from the National Health and Nutrition Examination Survey.

Methods

We fit log-normal regression models to examine disparities in serum cotinine in relation to Metropolitan Statistical Areas level income inequality among 14 649 nonsmoking children aged 3–15 from the National Health and Nutrition Examination Survey (1999–2012).

Result

Non-Hispanic black children had significantly lower serum cotinine than non-Hispanic white children (−0.26; 95% CI: −0.38, −0.15) in low income inequality areas, but this difference was attenuated in areas with high income inequality (0.01; 95% CI: −0.16, 0.18). Serum cotinine declined for non-Hispanic white and Mexican American children with increasing income inequality. Serum cotinine did not change as a function of the level of income inequality among non-Hispanic black children.

Conclusions

We have found evidence of differential associations between SHS exposure and income inequality by race and ethnicity. Further examination of environments which engender SHS exposure among children across various racial/ethnic subgroups can foster a better understanding of how area-level income inequality relates to health outcomes such as levels of SHS exposure and how those associations differ by race/ethnicity.

Implications

In the United States, the association between children’s risk of SHS exposure and income inequality is modified by race/ethnicity in a manner that is inconsistent with theories of income inequality. In overall analysis this association appears to be as predicted by theory. However, race-specific analyses reveal that higher levels of income inequality are associated with lower levels of SHS exposure among white children, while levels of SHS exposure among non-Hispanic black children are largely invariant to area-level income inequality. Future examination of the link between income inequality and smoking-related health outcomes should consider differential associations across racial and ethnic subpopulations.


Keywords:
[+]
Adolescent Child Child, Preschool Child Health Services Cotinine Ethnicity Female Humans Income Male Nutrition Surveys Smoking Socioeconomic Factors Tobacco Smoke Pollution United States
Source:
Nicotine Tob Res. 19(11):1292-1299
Pubmed ID:
27811157
Pubmed Central ID:
PMC5415442
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:cb2d02e473cd6d1d326c95984cd47b9d880246e2a0a98e7983d22f5ac1e4e075
Download URL:
https://stacks.cdc.gov/view/cdc/45528/cdc_45528_DS1.pdf
File Type:

Supporting Files

• nihms854395.nxml

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