Next Article in Journal
Effect of Remineralizing Agents on Shear Bond Strength of Orthodontic Brackets—In Vitro Study
Next Article in Special Issue
Parents’ Experiences and Perceptions of Healthcare Transition in Adolescents with Asthma: A Qualitative Study
Previous Article in Journal
Evaluating the Difference in Neuropsychological Profiles of Individuals with FASD Based on the Number of Sentinel Facial Features: A Service Evaluation of the FASD UK National Clinic Database
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Brief Report

Parental Education and Adolescents’ Asthma: The Role of Ethnicity

Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA
Author to whom correspondence should be addressed.
Children 2023, 10(2), 267;
Submission received: 28 December 2022 / Revised: 20 January 2023 / Accepted: 29 January 2023 / Published: 31 January 2023
(This article belongs to the Special Issue Asthma and Its Impact in Adolescent: 2nd Edition)


While high parental education is associated with better health, this association may be weaker for ethnic minority than for ethnic majority families. It is unknown whether the association between parental education and adolescents’ asthma also varies by ethnicity. Aim: To study the association between parental education and adolescents’ asthma overall and by ethnicity. Methods: The current study used data from the Population Assessment of Tobacco and Health (PATH)-Adolescents study. All participants were 12 to 17-year-old non-smokers (n = 8652). The outcome of interest was adolescents’ asthma. The predictor of interest was baseline parental education, the covariates were age, sex, and number of parents present at baseline, and the moderator was ethnicity. Results: According to logistic regression analyses, higher parental education was predictive of adolescents’ asthma; however, this association was weaker for Latino than non-Latino adolescents (OR 1.771; CI 1.282–2.446). We did not find a significant difference in the effect of parental education on asthma of White and African American adolescents. Our stratified models also showed that higher parental education was associated with lower asthma for non-Latino but not for Latino adolescents. Conclusion: The effect of high parental education on adolescents’ asthma prevalence differs between Latino and non-Latino families, with Latino families showing weaker protective effects of parental education on adolescents’ asthma. Future research should test the role of exposure to environmental pollutants, neighborhood quality, and prevalence of smoking in social network members as well as other contextual factors at home, in school, and in the neighborhood that may increase prevalence of asthma in Latino adolescents regardless of their parental education. Given that these potential causes are multi-level, potential causes of such disparities should be tested in future multi-level research.

1. Background

Asthma is one of the leading chronic illnesses of adolescents in the United States and worldwide [1]. Asthma is also one of the leading causes of healthcare use by adolescents [2]. On average, in a classroom of 30 children, about three adolescents have asthma [3]. As such, up to ten percent of adolescents may have asthma [4]. Adolescent asthma is one of the main causes of poor quality of life and absenteeism from schools [5]. Given that adolescents asthma is a major public health challenge, we need to study its distribution in the society through epidemiological studies [6,7].
Adolescent asthma is not randomly distributed in communities, and is more common in disadvantaged areas of the society [8]. Adolescents who live in families with higher socioeconomic status (SES) backgrounds are less likely to be diagnosed by asthma [9]. In addition, adolescents with highly educated parents and high-income families may have a lower risk of asthma compared to those with lower education and lower incomes [10]. This is in part because SES protects populations and individuals against some of the causes of asthma, such as allergic responses to infections, stressors, and environmental pollutants and irritants [11].
Some of the mechanisms of the protective effects of SES against youth asthma include house quality, neighborhood quality, school quality, air pollution, and proximity to industrial complexes and freeways [11]. Another mechanism is high SES’s association with the lower tobacco use of peers, parents, family members, and relatives [12]. One of the other effects of high parental education on reducing adolescents’ asthma is the lower risk of exposure to pollutants in high SES environments [13]. For example, secondary tobacco exposure is less common for high SES families [14]. High SES adolescents even have lower cigarette availability in peers, friends, families, and communities [15]. Some other mechanisms are quality of community, neighborhood, school, and home [16].
However, the protective effects of parental education on adolescents’ tobacco use are shown to differ between diverse ethnic groups of adolescents [17]. Marginalization-related diminished returns (MDRs) theory [18] suggests that due to racism and social stratification, family-level resources and assets such as parental education may be associated with lower economic, behavioral, and developmental levels for ethnic minorities than for non-Latino White adolescents [19,20,21]. As a result, disparities such as tobacco use disparities in marginalized and racialized groups (compared to non-Latino White individuals) is sustained across all SES levels [22,23].
A growing body of research has documented ethnic differences in the effects of family SES on adolescents’ health and behaviors that may have implications for asthma [19,20,21,24,25]. The associations between parental education and behaviors that may be correlated with asthma are weaker for ethnic minorities than majority adolescents [26,27,28]. For example, SES’s effects on tobacco use are weaker in ethnic minority than ethnic majority adults and youth [18,19,20,21,24,25,29,30,31,32,33,34,35]. In addition, ethnic minority adolescents attend worse schools than White adolescents across all parental education levels [36]. Similarly, across all parental education levels, ethnic minority adolescents are more likely to have family members who use substances compared to their White peers [37]. These observations are explained via marginalization-related diminished returns (MDRs); family SES resources may generate fewer behavioral, developmental, and health outcomes for marginalized and racialized groups such as African Americans than for non-Latino Whites [22]. While most of the literature that has been produced is on the effects of SES on health outcomes for African Americans [18,19,21,24,25,38,39], SES factors such as parental education may also be associated with lower health gains for other ethnic minorities, such as Latinos and Asians, than for non-Latino White individuals [40]. As this process is similar among all racialized groups, we explain this phenomenon through racism and societal inequalities; even when SES resources are available, societal and environmental conditions such as social stratification, segregation, and racism make it more difficult for ethnic minorities than non-Latino White families to secure outcomes. In this view, what makes a large change for non-Latino Whites may generate smaller real-life changes for ethnic minority individuals [40,41]. However, as most of this is known for African Americans, more research is needed for Latinos.
As high parental education is associated with lower tobacco use in adolescents, it is possible that parental education would also be associated with a lower level of asthma, which would reflect the lower risk of transitioning to tobacco use in the future [42]. However, we are unaware of previous studies that have tested ethnic differences in the association between baseline parental education and subsequent asthma in adolescents.
Built on the MDRs literature on asthma and associated risk factors such as neighborhood quality, stress, environmental quality, and tobacco use [43,44], we conducted this study with two aims; the first was to test the association between parental education and adolescents’ asthma overall. The second aim was to test the variation of this association by ethnicity. Our first hypothesis was that overall, high parental education is associated with a lower prevalence of asthma in adolescents. Our second hypothesis was that this inverse association would be weaker for ethnic minorities than for non-Latino Whites.

2. Methods

This was a cross-sectional study with a nationally representative dataset. For this study, we conducted a secondary analysis of the baseline of the Population Assessment of Tobacco and Health (PATH-Adolescents) study data [45]. The PATH-Adolescents is the state-of-the-art study of tobacco use and associated health outcomes such as asthma in US adolescents [46]. Baseline data were collected for wave 1 in 2013–2014 [46].

2.1. Participants and Sampling

In the PATH study [47], participants are selected randomly. Stratified and clustered random samples were selected from all US states. Eligibility for the PATH sample included non-institutionalized members of US households. All participants were aged between 12 and 17 at baseline.

2.2. Analytical Sample

For this analysis, we limited the sample to non-Latino and Latino White adolescents who participated in the first wave of the PATH study, regardless of their smoking status. Only non-Latino or Latino White adolescents were enrolled. Overall, the number enrolled totaled 8652.

2.3. Study Variables

The study variables in this analysis included ethnicity, parental education, parents’ presence, age, sex/gender, and asthma. Age was a dichotomous variable 0 for lower than 15 and 1 for 15 and above. Gender was 1 for males and 0 for females. Parental education was the independent variable with five levels, and asthma was the outcome.

2.3.1. Asthma

Asthma was self-reported and measured using the following question: Have you ever been told by a doctor you have asthma? This item was coded as 1 (asthma) to 0 (non-asthma).

2.3.2. Parental Education

Parental education was a five-level variable, as below: 1 = “no or some high school,” 2 = “Completed high school,” 3 = “Completed college.” This variable was a categorical variable with the lowest education as the reference group.

2.3.3. One- or Two-Parent Household

Family structure was a dichotomous variable that reflected number of parents present in the household.

2.3.4. Ethnicity

Ethnicity was self-identified as non-Latino White or Latino White. Ethnicity was the effect modifier (moderator) and was coded 1 for Latino and 0 for non-Latino.

2.4. Data Analysis

Data analysis was performed using SPSS 24. SPSS was used for univariate, bivariate, and multivariable analysis. Univariate was used for descriptive statistics such as mean (standard deviation [SD]) and frequency (%). Bivariate included the Chi-square test. With the outcome being asthma, the predictor variable being parental education, the moderator (effect modifier) being ethnicity, and age, sex, and parents’ presence being the covariates, four linear regression models were applied for multivariable modeling. Model 1 and Model 2 were run in the pooled sample. Model 3 and Model 4 were performed on non-Latino and Latino adolescents. Model 1 did not have, and Model 2 had the interaction term between ethnicity and parental education, i.e., our predictor variable. The odds ratio (OR), SE, 95% CI, and p were reported from each model. We also statistically compared the variance explained by the models across Model 2 and Model 1. Our likelihood ratio test assessed the goodness of fit of Model 1 and Model 2, and showed a more considerable variance of the outcome explained by Model 2, with a statistically different model fit.

2.5. Institutional Review Board (IRB)

This study used publicly available PATH data. All data are fully de-identified. Thus, the study was not human subject research and was exempt from a full IRB review.

3. Results

8652 adolescents were entered our analysis. Descriptive data are reported in Table 1.
Table 2 presents the summary of logistic regressions for Model 1 and Model 2 that were fitted to the pooled sample. This model shows that higher parental education was associated with lower prevalence of asthma; however, this association was stronger for non-Latino than Latino adolescents.
Table 3 presents the summary of logistic regressions for Model 3 and Model 4 that were fitted to non-Latino and Latino adolescents, respectively. As these models show, higher parental education was associated with a lower asthma for non-Latino but not for Latino adolescents.

4. Discussion

The current study was performed with two main aims; one to evaluate the overall association between parental education and prevalence of asthma in US adolescents, and the other was to test variation in this association by ethnicity. The first aim showed an inverse association between parental education and prevalence of asthma overall, suggesting that high parental education, as a proxy of SES, is associated with lower prevalence of asthma. The second aim showed moderation of this association by ethnicity. The inverse association between parental education and adolescents’ asthma was weaker for Latino than non-Latino families.
The inverse association between parental education and prevalence of adolescents’ asthma is in line with theories of fundamental causes, social determinants, social status, status syndrome, and several other models that explain the lower risk of high SES populations and individuals [48,49,50,51,52,53,54,55,56,57,58,59]. According to ecological theories, individuals who live in proximity to low SES neighborhoods, peers, schools, families, and friends will have a higher risk of health problems [60]. Many mechanisms, such as parents and peer risk, quality of neighborhoods, schools, and homes, may explain why high SES is linked to lower prevalence of asthma [61,62,63,64,65,66,67,68,69,70,71].
Due to historical racism, social stratification, and segregation, however, ethnic differences exist in the living conditions of high SES individuals across ethnic groups [72,73,74,75]. Multiple studies have documented ethnic minorities’ relative disadvantage in the magnitude of the protective association between SES and health outcomes [18,19,20,21,24,25]. Most of the literature has shown weaker health effects of SES in ethnic minority than ethnic majority adolescents [76]. However, most of these weaker associations between SES and health outcomes are shown for African Americans rather than Latino individuals [18,19,20,21,24,25]. As most past studies are done on African Americans, more research is needed on Latinos. In addition, we are unaware of any past studies on Latino–non-Latino differences in the association between parental education and asthma.
As most past research has been conducted on African American, not Latino, individuals, our observation of a weaker association between parental education and asthma in Latino than non-Latino adolescents is a major advancement of the findings on MDRs. According to marginalization-related diminished returns, resources and assets generate fewer economic, behavioral, developmental, and health outcomes for marginalized groups than for White individuals.
This study expanded the MDR’s literature, which has, to date, been written on tobacco use [43,44]. Previous work has shown that SES–tobacco use is racialized [43,44]. A study showed that education–tobacco knowledge is also racialized in the US [77]. This finding may be because high-SES White adolescents attend better schools than high-SES ethnic minority adolescents [36]. In addition, there are many challenges in the daily lives of ethnic minority adolescents in US schools [78,79]. Ethnic differences in the returns of education may be because of discrimination in schools [78] or neighborhoods [80]. These MDRs are attributed to social forces rather than biological differences [81,82,83,84,85,86,87,88,89,90,91].

4.1. Limitations

Our study is not without methodological limitations. First, all variables were self-reported. Thus, our results may be affected by reporting bias and social desirability. Second, our variables were measured at the individual level (reported by adolescents). Some factors may belong to a family or a social network of adolescents. Third, we measured only a few potential confounders, such as gender and age. Other factors, such as the condition of the home, neighborhood SES, and proximity to freeways, were not assessed. In addition, this was a study with an imbalanced sample size (there were a larger number of non-Latino adolescents involved than Latino adolescents). However, our main inference was based on our pooled sample analysis with interaction rather than stratified models. Finally, our study did not evaluate sex differences in the relationship between ethnicity, parental education, and adolescents’ asthma. No causality can established from this study.

4.2. Conclusions

To conclude, while overall, high parental education is associated with lower asthma prevalence in adolescents, this inverse association is weaker for Latino than non-Latino adolescents. The diminished returns of parental education on reducing the prevalence of adolescent asthma in Latino families may be due to disproportionate environmental exposures that are related to structural inequalities of racialized families. It is necessary for researchers to explore this observation further.
The family, school, and neighborhood quality of Latino and non-Latino families vary due to the segregation of ethnic minority communities. Additional research is needed to test if ethnic minorities living in ethnic enclaves may show an increased prevalence of asthma across SES levels. Such research would contribute to our understanding of why and how the MDRs contribute to sustained ethnic disparities in asthma for Latino adolescents.

Author Contributions

Conceptualization: E.A., B.N. and A.Y.-B., Data Analysis: E.A. and B.N., Validation: B.N., First Draft: E.A. and B.N., Revision: E.A., B.N. and A.Y.-B. All authors have read and agreed to the published version of the manuscript.


Young-Brinn is supported by a research project funded and supported by the Tobacco-Related Disease Research Program (TRDRP) grant R00RG2347. As a scholar of the Clinical Research Education and Career Development (CRECD) program at Charles R. Drew University of Medicine and Science (CDU), Dr. Adinkrah’s research-related activities were supported by the NIMHD/NIH Award # R25 MD007610.

Institutional Review Board Statement

This study used publicly available PATH data. All data are fully de-identified. Thus, the study was not human subject research and was exempt from a full IRB review.

Informed Consent Statement

All youth provided assent. All adults provided consent.

Data Availability Statement

PATH data are available here: (accessed on 28 January 2023).

Conflicts of Interest

The authors declare no conflict of interest.


  1. Gibson, P.; Henry, R.; Vimpani, G.; Halliday, J. Asthma knowledge, attitudes, and quality of life in adolescents. Arch. Dis. Child. 1995, 73, 321–326. [Google Scholar] [CrossRef]
  2. Guevara, J.P.; Wolf, F.M.; Grum, C.M.; Clark, N.M. Effects of educational interventions for self-management of asthma in children and adolescents: Systematic review and meta-analysis. BMJ 2003, 326, 1308–1309. [Google Scholar] [CrossRef] [Green Version]
  3. Al Ghobain, M.O.; Al-Hajjaj, M.S.; Al Moamary, M.S. Asthma prevalence among 16-to 18-year-old adolescents in Saudi Arabia using the ISAAC questionnaire. BMC Public Health 2012, 12, 239. [Google Scholar] [CrossRef] [Green Version]
  4. Barreto, M.L.; Ribeiro-Silva, R.d.C.; Malta, D.C.; Oliveira-Campos, M.; Andreazzi, M.A.; Cruz, A.A. Prevalence of asthma symptoms among adolescents in Brazil: National adolescent school-based health survey (PeNSE 2012). Rev. Bras. Epidemiol. 2014, 17, 106–115. [Google Scholar] [CrossRef]
  5. Brooks, C.R.; van Dalen, C.J.; Zacharasiewicz, A.; Simpson, J.L.; Harper, J.L.; Le Gros, G.; Gibson, P.G.; Pearce, N.; Douwes, J. Absence of airway inflammation in a large proportion of adolescents with asthma. Respirology 2016, 21, 460–466. [Google Scholar] [CrossRef]
  6. Almqvist, C.; Worm, M.; Leynaert, B.; Working Group of GA2LEN WP 2.5 Gender. Impact of gender on asthma in childhood and adolescence: A GA2LEN review. Allergy 2008, 63, 47–57. [Google Scholar] [CrossRef] [PubMed]
  7. Wehrmeister, F.C.; Menezes, A.M.B.; Cascaes, A.M.; Martínez-Mesa, J.; Barros, A.J. Time trend of asthma in children and adolescents in Brazil, 1998–2008. Rev. Saude Publica 2012, 46, 242–250. [Google Scholar] [CrossRef] [Green Version]
  8. Wright, R.J.; Subramanian, S.V. Advancing a multilevel framework for epidemiologic research on asthma disparities. Chest 2007, 132, 757S–769S. [Google Scholar] [CrossRef]
  9. Simon, P.A.; Zeng, Z.; Wold, C.M.; Haddock, W.; Fielding, J.E. Prevalence of childhood asthma and associated morbidity in Los Angeles County: Impacts of race/ethnicity and income. J. Asthma 2003, 40, 535–543. [Google Scholar] [CrossRef]
  10. Akinbami, L.J.; LaFleur, B.J.; Schoendorf, K.C. Racial and income disparities in childhood asthma in the United States. Ambul. Pediatr. 2002, 2, 382–387. [Google Scholar] [CrossRef]
  11. Cohn, L.; Elias, J.A.; Chupp, G.L. Asthma: Mechanisms of disease persistence and progression. Annu. Rev. Immunol. 2004, 22, 789–815. [Google Scholar] [CrossRef] [PubMed]
  12. Hiscock, R.; Bauld, L.; Amos, A.; Fidler, J.A.; Munafò, M. Socioeconomic status and smoking: A review. Ann. N. Y. Acad. Sci. 2012, 1248, 107–123. [Google Scholar] [CrossRef] [PubMed]
  13. Gecková, A.M.; Stewart, R.; van Dijk, J.P.; Orosová, O.G.; Groothoff, J.W.; Post, D. Influence of socio-economic status, parents, and peers on smoking behaviour of adolescents. Eur. Addict. Res. 2005, 11, 204–209. [Google Scholar] [CrossRef] [PubMed]
  14. Assari, S.; Bazargan, M. Second-Hand Smoke Exposure at Home in the United States; Minorities’ Diminished Returns. Int. J. Travel Med. Glob. Health 2019, 7, 135–141. [Google Scholar] [CrossRef]
  15. Glendinning, A.; Shucksmith, J.; Hendry, L. Family life and smoking in adolescence. Soc. Sci. Med. 1997, 44, 93–101. [Google Scholar] [CrossRef]
  16. Jessor, R.; Jessor, S.L. Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth; Academic Press: New York, NY, USA, 1977. [Google Scholar]
  17. Pezzella, F.S.; Thornberry, T.P.; Smith, C.A. Race socialization and parenting styles: Links to delinquency for African American and White adolescents. Youth Violence Juv. Justice 2016, 14, 448–467. [Google Scholar] [CrossRef]
  18. Assari, S.; Mistry, R. Educational Attainment and Smoking Status in a National Sample of American Adults; Evidence for the Blacks’ Diminished Return. Int. J. Environ. Res. Public Health 2018, 15, 763. [Google Scholar] [CrossRef] [Green Version]
  19. Assari, S.; Najand, B.; Young-Brinn, A. Minorities’ Diminished Returns of Family Socioeconomic Status on Youth Peers’ Tobacco Use. Int. J. Travel Med. Global Health 2022, 10, 159–165. [Google Scholar]
  20. Assari, S. Diminished Returns of Income Against Cigarette Smoking Among Chinese Americans. J. Health Econ. Dev. 2019, 1, 1–8. [Google Scholar]
  21. Assari, S.; Bazargan, M. Education Level and Cigarette Smoking: Diminished Returns of Lesbian, Gay, and Bisexual Individuals. Behav. Sci. 2019, 9, 103. [Google Scholar] [CrossRef] [Green Version]
  22. Assari, S. Unequal Gain of Equal Resources across Racial Groups. Int. J. Health Policy Manag. 2018, 7, 1–9. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  23. Assari, S. Understanding America: Unequal Economic Returns of Years of Schooling in Whites and Blacks. World J. Educ. Res. 2020, 7, 78–92. [Google Scholar] [CrossRef] [PubMed]
  24. Assari, S.; Mistry, R. Diminished Return of Employment on Ever Smoking Among Hispanic Whites in Los Angeles. Health Equity 2019, 3, 138–144. [Google Scholar] [CrossRef] [Green Version]
  25. Assari, S.; Bazargan, M.; Chalian, M. Social Determinants of Hookah Smoking in the United States. J. Ment. Health Clin. Psychol. 2020, 4, 21–27. [Google Scholar] [CrossRef]
  26. Fuller-Rowell, T.E.; Cogburn, C.D.; Brodish, A.B.; Peck, S.C.; Malanchuk, O.; Eccles, J.S. Racial discrimination, and substance use: Longitudinal associations and identity moderators. J. Behav. Med. 2012, 35, 581–590. [Google Scholar] [CrossRef] [PubMed]
  27. Fuller-Rowell, T.E.; Curtis, D.S.; Doan, S.N.; Coe, C.L. Racial disparities in the health benefits of educational attainment: A study of inflammatory trajectories among African American and white adults. Psychosom. Med. 2015, 77, 33–40. [Google Scholar] [CrossRef]
  28. Fuller-Rowell, T.E.; Doan, S.N. The social costs of academic success across ethnic groups. Child Dev. 2010, 81, 1696–1713. [Google Scholar] [CrossRef] [Green Version]
  29. Rahmani, A.; Najand, B.; Sonnega, A.; Akhlaghipour, G.; Mendez, M.F.; Assari, S. Intersectional Effects of Race and Educational Attainment on Memory Function of Middle-Aged and Older Adults With Alzheimer’s Disease. J. Racial Ethnic Health Disparities 2022, 1–11. [Google Scholar] [CrossRef]
  30. Assari, S.; Bazargan, M. Protective Effects of Educational Attainment Against Cigarette Smoking; Diminished Returns of American Indians and Alaska Natives in the National Health Interview Survey. Int. J. Travel Med. Glob. Health 2019, 7, 105–110. [Google Scholar] [CrossRef]
  31. Assari, S.; Smith, J.L.; Zimmerman, M.A.; Bazargan, M. Cigarette Smoking among Economically Disadvantaged African American Older Adults in South Los Angeles: Gender Differences. Int. J. Environ. Res. Public Health 2019, 16, 1208. [Google Scholar] [CrossRef] [Green Version]
  32. Assari, S.; Schaefer, J. Parental Educational Attainment and Frequency of Marijuana Use in Youth: Hispanics’ Diminished Returns. J. Educat. Cult. Stud. 2021, 5, p47. [Google Scholar] [CrossRef]
  33. Assari, S. Socioeconomic Status and Current Cigarette Smoking Status: Immigrants’ Diminished Returns. Int. J. Travel Med. Glob. Health 2020, 8, 66–72. [Google Scholar] [CrossRef] [PubMed]
  34. Assari, S.; Boyce, S.; Caldwell, C.H.; Bazargan, M. Parent Education and Future Transition to Cigarette Smoking: Latinos’ Diminished Returns. Front. Pediatr. 2020, 8, 457. [Google Scholar] [CrossRef] [PubMed]
  35. Assari, S.; Mistry, R.; Caldwell, C.H.; Bazargan, M. Protective Effects of Parental Education Against Youth Cigarette Smoking: Diminished Returns of Blacks and Hispanics. Adolesc. Health Med. Ther. 2020, 11, 63–71. [Google Scholar] [CrossRef] [PubMed]
  36. Boyce, S.; Bazargan, M.; Caldwell, C.H.; Zimmerman, M.A.; Assari, S. Parental Educational Attainment and Social Environment of Urban Public Schools in the U.S.: Blacks’ Diminished Returns. Children 2020, 7, 44. [Google Scholar] [CrossRef]
  37. Assari, S.; Caldwell, C.; Bazargan, M. Parental educational attainment and relatives’ substance use of American youth: Hispanics Diminished Returns. J. Biosci. Med. 2020, 8, 122–134. [Google Scholar] [CrossRef] [Green Version]
  38. Bazargan, M.; Cobb, S.; Castro Sandoval, J.; Assari, S. Smoking Status and Well-Being of Underserved African American Older Adults. Behav. Sci. 2020, 10, 78. [Google Scholar] [CrossRef] [Green Version]
  39. Harris, J.C.; Mereish, E.H.; Faulkner, M.L.; Assari, S.; Choi, K.; Leggio, L.; Farokhnia, M. Racial Differences in the Association Between Alcohol Drinking and Cigarette Smoking: Preliminary Findings from an Alcohol Research Program. Alcohol Alcohol. 2022, 57, 330–339. [Google Scholar] [CrossRef]
  40. Assari, S. General Self-Efficacy and Mortality in the USA; Racial Differences. J. Racial Ethn. Health Disparities 2017, 4, 746–757. [Google Scholar] [CrossRef]
  41. Assari, S. Race, sense of control over life, and short-term risk of mortality among older adults in the United States. Arch. Med. Sci. 2017, 13, 1233–1240. [Google Scholar] [CrossRef] [Green Version]
  42. Kelishadi, R.; Shahsanai, A.; Qorbani, M.; Motlagh, M.E.; Jari, M.; Ardalan, G.; Ansari, H.; Asayesh, H.; Heshmat, R. Tobacco use and influencing factors among Iranian children and adolescents at national and subnational levels, according to socioeconomic status: The Caspian-IV Study. Iran. Red Crescent Med. J. 2016, 18, e21858. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  43. Assari, S.; Lankarani, M.M. Education and Alcohol Consumption among Older Americans; Black-White Differences. Front. Public Health 2016, 4, 67. [Google Scholar] [CrossRef] [PubMed]
  44. Assari, S.; Farokhnia, M.; Mistry, R. Education Attainment and Alcohol Binge Drinking: Diminished Returns of Hispanics in Los Angeles. Behav. Sci. 2019, 9, 9. [Google Scholar] [CrossRef] [Green Version]
  45. Hyland, A.; Ambrose, B.K.; Conway, K.P.; Borek, N.; Lambert, E.; Carusi, C.; Taylor, K.; Crosse, S.; Fong, G.T.; Cummings, K.M. Design and methods of the Population Assessment of Tobacco and Health (PATH) Study. Tob. Control 2017, 26, 371–378. [Google Scholar] [CrossRef]
  46. Tourangeau, R.; Yan, T.; Sun, H.; Hyland, A.; Stanton, C.A. Population Assessment of Tobacco, and Health (PATH) reliability and validity study: Selected reliability and validity estimates. Tob. Control 2019, 28, 663–668. [Google Scholar] [CrossRef]
  47. Piesse, A.; Opsomer, J.; Dohrmann, S.; DiGaetano, R.; Morganstein, D.; Taylor, K.; Carusi, C.; Hyland, A. Longitudinal uses of the population assessment of tobacco and health study. Tob. Regul. Sci. 2021, 7, 3–16. [Google Scholar] [CrossRef] [PubMed]
  48. Marmot, M.G.; McDowall, M.E. Mortality decline and widening social inequalities. Lancet 1986, 2, 274–276. [Google Scholar] [CrossRef] [PubMed]
  49. Marmot, M. Economic and social determinants of disease. Bull. World Health Organ. 2001, 79, 988–989. [Google Scholar]
  50. Steptoe, A.; Kunz-Ebrecht, S.; Owen, N.; Feldman, P.J.; Rumley, A.; Lowe, G.D.; Marmot, M. Influence of socioeconomic status and job control on plasma fibrinogen responses to acute mental stress. Psychosom. Med. 2003, 65, 137–144. [Google Scholar] [CrossRef]
  51. Marmot, M. The Status Syndrome: How Social Standing Affects Our Health and Longevity; Bloomsbury Press: London, UK, 2004. [Google Scholar]
  52. Marmot, M. Social determinants of health inequalities. Lancet 2005, 365, 1099–1104. [Google Scholar] [CrossRef]
  53. Marmot, M.; Wilkinson, R. Social Determinants of Health; OUP: Oxford, UK, 2005. [Google Scholar]
  54. Singh-Manoux, A.; Richards, M.; Marmot, M. Socioeconomic position across the lifecourse: How does it relate to cognitive function in mid-life? Ann. Epidemiol. 2005, 15, 572–578. [Google Scholar] [CrossRef] [PubMed]
  55. Singh-Manoux, A.; Fonagy, P.; Marmot, M. The relationship between parenting dimensions and adult achievement: Evidence from the Whitehall II study. Int. J. Behav. Med. 2006, 13, 320–329. [Google Scholar] [CrossRef] [Green Version]
  56. Singh-Manoux, A.; Britton, A.; Kivimaki, M.; Gueguen, A.; Halcox, J.; Marmot, M. Socioeconomic status moderates the association between carotid intima-media thickness and cognition in midlife: Evidence from the Whitehall II study. Atherosclerosis 2008, 197, 541–548. [Google Scholar] [CrossRef]
  57. Laaksonen, E.; Lallukka, T.; Lahelma, E.; Ferrie, J.E.; Rahkonen, O.; Head, J.; Marmot, M.G.; Martikainen, P. Economic difficulties and physical functioning in Finnish and British employees: Contribution of social and behavioural factors. Eur. J. Public Health 2011, 21, 456–462. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  58. Ruiz, M.; Goldblatt, P.; Morrison, J.; Porta, D.; Forastiere, F.; Hryhorczuk, D.; Antipkin, Y.; Saurel-Cubizolles, M.J.; Lioret, S.; Vrijheid, M.; et al. Impact of Low Maternal Education on Early Childhood Overweight and Obesity in Europe. Pediatr. Perinat. Epidemiol. 2016, 30, 274–284. [Google Scholar] [CrossRef] [Green Version]
  59. Stringhini, S.; Carmeli, C.; Jokela, M.; Avendano, M.; McCrory, C.; d’Errico, A.; Bochud, M.; Barros, H.; Costa, G.; Chadeau-Hyam, M.; et al. Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: Multi-cohort population-based study. BMJ 2018, 360, k1046. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  60. Hibbs, S.; Rankin, K.M.; David, R.J.; Collins, J.W., Jr. The Relation of Neighborhood Income to the Age-Related Patterns of Preterm Birth Among White and African American Women: The Effect of Cigarette Smoking. Matern. Child Health J. 2016, 20, 1432–1440. [Google Scholar] [CrossRef] [PubMed]
  61. Mathur, C.; Stigler, M.H.; Perry, C.L.; Arora, M.; Reddy, K.S. Differences in prevalence of tobacco use among Indian urban youth: The role of socioeconomic status. Nicotine Tob. Res. 2008, 10, 109–116. [Google Scholar] [CrossRef] [PubMed]
  62. Oddsberg, J.; Jia, C.; Nilsson, E.; Ye, W.; Lagergren, J. Maternal tobacco smoking, obesity, and low socioeconomic status during early pregnancy in the etiology of esophageal atresia. J. Pediatr. Surg. 2008, 43, 1791–1795. [Google Scholar] [CrossRef]
  63. Bhan, N.; Srivastava, S.; Agrawal, S.; Subramanyam, M.; Millett, C.; Selvaraj, S.; Subramanian, S.V. Are socioeconomic disparities in tobacco consumption increasing in India? A repeated cross-sectional multilevel analysis. BMJ Open 2012, 2, e001348. [Google Scholar] [CrossRef] [Green Version]
  64. Brown-Johnson, C.G.; England, L.J.; Glantz, S.A.; Ling, P.M. Tobacco industry marketing to low socioeconomic status women in the U.S.A. Tob. Control 2014, 23, e139–e146. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  65. Bhan, N.; Karan, A.; Srivastava, S.; Selvaraj, S.; Subramanian, S.; Millett, C. Have socioeconomic inequalities in tobacco use in India increased over time? trends from the national sample surveys (2000–2012). Nicotine Tob. Res. 2016, 18, 1711–1718. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  66. Pfortner, T.K.; Hublet, A.; Schnohr, C.W.; Rathmann, K.; Moor, I.; de Looze, M.; Baska, T.; Molcho, M.; Kannas, L.; Kunst, A.E.; et al. Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking. A multilevel study in 29 European countries. Addict. Behav. 2016, 53, 58–66. [Google Scholar] [CrossRef] [PubMed]
  67. Lee, J.G.; Sun, D.L.; Schleicher, N.M.; Ribisl, K.M.; Luke, D.A.; Henriksen, L. Inequalities in tobacco outlet density by race, ethnicity, and socioeconomic status, 2012, USA: Results from the ASPiRE Study. J. Epidemiol. Community Health 2017, 71, 487–492. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  68. Harlow, A.; Stokes, A.; Brooks, D. Socio-economic and racial/ethnic differences in e-cigarette uptake among cigarette smokers: Longitudinal analysis of the Population Assessment of Tobacco and Health (PATH) study. Nicotine Tob. Res. 2019, 21, 1385–1393. [Google Scholar] [CrossRef]
  69. Caryl, F.; Shortt, N.K.; Pearce, J.; Reid, G.; Mitchell, R. Socioeconomic inequalities in children’s exposure to tobacco retailing based on individual-level GPS data in Scotland. Tob. Control 2020, 29, 367–373. [Google Scholar] [CrossRef] [Green Version]
  70. Fakunle, D.O.; Curriero, F.C.; Leaf, P.J.; Furr-Holden, D.M.; Thorpe, R.J. Black, white, or green? The effects of racial composition and socioeconomic status on neighborhood-level tobacco outlet density. Ethn. Health 2021, 26, 1012–1027. [Google Scholar] [CrossRef]
  71. Hamad, R.; Brown, D.M.; Basu, S. The association of county-level socioeconomic factors with individual tobacco and alcohol use: A longitudinal study of U.S. adults. BMC Public Health 2019, 19, 390. [Google Scholar] [CrossRef] [Green Version]
  72. Williams, D.R. Race, socioeconomic status, and health the added effects of racism and discrimination. Ann. N. Y. Acad. Sci. 1999, 896, 173–188. [Google Scholar] [CrossRef] [Green Version]
  73. Williams, D.R. Miles to go before we sleep: Racial inequities in health. J. Health Soc. Behav. 2012, 53, 279–295. [Google Scholar] [CrossRef] [Green Version]
  74. Williams, D.R.; Cooper, L.A. Reducing racial inequities in health: Using what we already know to take action. Int. J. Environ. Res. Public Health 2019, 16, 606. [Google Scholar] [CrossRef] [Green Version]
  75. Williams, D.R.; Lawrence, J.A.; Davis, B.A. Racism, and health: Evidence and needed research. Annu. Rev. Public Health 2019, 40, 105–125. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  76. Martins, S.S.; Lee, G.P.; Kim, J.H.; Letourneau, E.J.; Storr, C.L. Gambling and sexual behaviors in African American adolescents. Addict. Behav. 2014, 39, 854–860. [Google Scholar] [CrossRef]
  77. Assari, S.; Bazargan, M. Educational Attainment and Tobacco Harm Knowledge among American Adults: Diminished Returns of African Americans and Hispanics. Int. J. Epidemiol. Res. 2020, 7, 6–11. [Google Scholar] [CrossRef]
  78. Assari, S. Are Teachers Biased against Black Children? A Study of Race, Amygdala Volume, and Problem Behaviors. J. Educ. Teach. Soc. Stud. 2021, 3, p1. [Google Scholar] [CrossRef]
  79. Assari, S.; Caldwell, C.H. Teacher Discrimination Reduces School Performance of African American Youth: Role of Gender. Brain Sci. 2018, 8, 183. [Google Scholar] [CrossRef] [Green Version]
  80. Assari, S. Does School Racial Composition Explain Why High-Income Black Youth Perceive More Discrimination? A Gender Analysis. Brain Sci. 2018, 8, 140. [Google Scholar] [CrossRef] [Green Version]
  81. Assari, S. Family Income reduces risk of obesity for white but not black children. Children 2018, 5, 73. [Google Scholar] [CrossRef] [Green Version]
  82. Assari, S. Socioeconomic status and self-rated oral health; Diminished return among hispanic whites. Dent. J. 2018, 6, 11. [Google Scholar] [CrossRef] [Green Version]
  83. Assari, S. High income protects whites but not African Americans against risk of depression. Healthcare 2018, 6, 37. [Google Scholar] [CrossRef] [Green Version]
  84. Assari, S. The benefits of higher income in protecting against chronic medical conditions are smaller for African Americans than whites. Healthcare 2018, 6, 2. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  85. Assari, S. Life expectancy gain due to employment status depends on race, gender, education, and their intersections. J. Racial Ethn. Health Disparities 2018, 5, 375–386. [Google Scholar] [CrossRef] [PubMed]
  86. Assari, S.; Caldwell, C.H.; Zimmerman, M.A. Family structure and subsequent anxiety symptoms; minorities’ diminished return. Brain Sci. 2018, 8, 97. [Google Scholar] [CrossRef]
  87. Assari, S.; Preiser, B.; Kelly, M. Education and income predict future emotional well-being of whites but not blacks: A ten-year cohort. Brain Sci. 2018, 8, 122. [Google Scholar] [CrossRef] [Green Version]
  88. Assari, S. Blacks’ diminished return of education attainment on subjective health; mediating effect of income. Brain Sci. 2018, 8, 176. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  89. Assari, S. Social epidemiology of perceived discrimination in the United States: Role of race, educational attainment, and income. Int. J. Epidemiol. Res. 2020, 7, 136–141. [Google Scholar] [CrossRef]
  90. Assari, S.; Boyce, S.; Bazargan, M.; Caldwell, C.H.; Zimmerman, M.A. Place-Based Diminished Returns of Parental Educational Attainment on School Performance of Non-Hispanic White Youth. Front. Educ. 2020, 5, 30. [Google Scholar] [CrossRef]
  91. Rodriguez, J.; Koo, C.; Di Pasquale, G.; Assari, S. Black-White differences in perceived lifetime discrimination by education and income in the MIDUS Study in the U.S. J. Biosoc. Sci. 2022, 1–17. [Google Scholar] [CrossRef]
Table 1. Descriptive data overall in adolescents (n = 8652).
Table 1. Descriptive data overall in adolescents (n = 8652).
n = 6449
n = 2203
n = 8652
  12–14321249.81191 54.1440350.9
Two-parent household
Parental education
  High School graduated578589.7131559.7710082.1
  College graduated242737.630313.8273031.6
Table 2. Pooled sample models in US adolescents.
Table 2. Pooled sample models in US adolescents.
Odds RatioLower BoundUpper BoundSig.
Model 1 (all, main effects)
Latino 0.9660.8411.1090.624
Male 1.4181.2661.5890.000
Two-parent household0.9000.7911.0250.112
Parental education (High School graduated)1.0440.8891.2260.602
Parental education (College graduated)0.8800.7731.0000.050
Model 2 (all, M1 + ethnicity interaction)
Latino 0.6250.4780.8170.001
Male 1.4131.2611.5830.000
Age1.0350.925 1.1590.547
Two-parent household0.9040.7941.0290.127
Parental education (High School graduated)0.8040.6530.9890.039
Parental education (College graduated)0.8870.7701.0230.100
Latino × parental education (High School graduated)1.7711.2822.4460.001
Latino × parental education (College graduated)1.0710.746 1.5370.710
Outcome: asthma score; data: Population Assessment of Tobacco and Health (PATH).
Table 3. Stratified models in non-Latino and Latino adolescents.
Table 3. Stratified models in non-Latino and Latino adolescents.
Odds RatioLower BoundUpper BoundSig.
Model 3 (non-latino)
Male 1.3811.2111.574 0.000
Age1.1020.967 1.2550.145
Two-Parent Household0.9200.7881.0730.289
Parental education (High School graduated)0.8030.6520.9890.039
Parental education (College graduated)0.8880.7701.0240.101
Model 4 (Latino)
Male 1.5111.2031.8970.000
Two-Parent household0.8640.6791.0990.235
Parental education (High School graduated)1.4171.1061.8150.006
Parental education (College graduated)0.9580.6861.3370.802
Outcome: asthma score; data: Population Assessment of Tobacco and Health (PATH).
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Adinkrah, E.; Najand, B.; Young-Brinn, A. Parental Education and Adolescents’ Asthma: The Role of Ethnicity. Children 2023, 10, 267.

AMA Style

Adinkrah E, Najand B, Young-Brinn A. Parental Education and Adolescents’ Asthma: The Role of Ethnicity. Children. 2023; 10(2):267.

Chicago/Turabian Style

Adinkrah, Edward, Babak Najand, and Angela Young-Brinn. 2023. "Parental Education and Adolescents’ Asthma: The Role of Ethnicity" Children 10, no. 2: 267.

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop