Articles

Background:</b> Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. <b>Aims:</b> This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. <b>Methods:</b> A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. <b>Results:</b> Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. <b>Conclusion:</b> Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.

<b>Background: </b>Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. <b>Objectives: </b>This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. <b>Methods: </b>The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. <b>Results</b>: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. <b>Conclusions: </b>Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.

<b>Background:</b> As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural mechanisms underlying reward processing and the propensity for self-reported reward salience and substance use, research exploring the association between NAcc rsFC and brain networks beyond the default mode network (DMN) and prefrontal cortex (PFC) is limited. <b>Objective:</b> To investigate the role of the resting-state functional connectivity of the NAcc with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network in the association between socioeconomic status, self-reported reward salience, and future substance use. <b>Methods:</b> Data were obtained from the Adolescent Brain Cognitive Development (ABCD) study. NAcc rsFC with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network was assessed at baseline. Socioeconomic status was measured using family income. Self-reported reward salience was assessed using validated psychometric scales. Substance use outcomes were tracked longitudinally over the study period. Structural Equation Modeling was employed to examine the covariances between family income, NAcc rsFC, reward salience, and subsequent substance use. <b>Results:</b> Higher baseline family income was positively associated with baseline NAcc rsFC (B = 0.092, p < 0.001) and negatively associated with baseline reward salience (B = -0.040, p = 0.036) and future substance use (B = -0.081, p < 0.001). Baseline NAcc rsFC was strongly and positively associated with reward salience (B = 0.734, p < 0.001) and future substance use up to age 13 (B = 0.124, p < 0.001). Additionally, baseline reward salience was positively associated with future substance use (Covariance = 0.176, p < 0.001). <b>Conclusion:</b> The findings suggest that NAcc rsFC with brain networks beyond the DMN or PFC may contribute to the links between low parental socioeconomic status, reward salience, and substance use risk. Expanding the understanding of NAcc rsFC provides new insights into the neural mechanisms underlying these associations. These results have important implications for developing targeted interventions aimed at preventing substance use, particularly among low-income youth with heightened reward salience. Further research is needed to explore causal pathways and moderating factors influencing these relationships.

<b>Background: </b>Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. <b>Objective: </b>To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. <b>Methods: </b>Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. <b>Results:</b> In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, <i>p</i> < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, <i>p</i> < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, <i>p</i> < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, <i>p</i> < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, <i>p</i> < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, <i>p</i> < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. <b>Conclusion:</b> Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.

<b>Background: </b>Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, and those living in disadvantaged areas. While MDRs have been documented for various marginalized demographic groups, the role of trauma in moderating socioeconomic outcomes remains underexplored. <b>Objective:</b> This study examines whether lifetime trauma exposure diminishes the positive association between educational attainment and poverty-to-income ratio (PIR), a key indicator of economic well-being. <b>Methods:</b> Using data from the National Survey of American Life (NSAL), we analyzed a nationally representative sample of 6,008 adults, including Black, White, Latino, and Other racial/ethnic groups. We employed linear regression models to evaluate the association between the independent variable educational attainment and the outcome PIR. We then tested lifetime trauma as a moderator of this association. Models controlled for age, gender, employment, and race/ethnicity. <b>Results:</b> Educational attainment was positively associated with PIR across all groups, but the strength of this association was significantly attenuated for individuals with a history of lifetime trauma. These effects were independent of covariates. <b>Conclusions:</b> These findings extend the MDRs framework by highlighting trauma as a potential contributor to diminished returns of education on socioeconomic wellbeing. Structural inequities that increase trauma exposure in minoritized populations may also limit the economic benefits of education, particularly for groups with multiple trauma exposures. Policies aimed at addressing economic inequality must integrate social policies that reduce trauma and stress.

<b>Background:</b><b> </b>Despite advancements in smoking cessation interventions, few programs have demonstrated sustained effectiveness among low-income, underserved populations. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program was developed to address this gap and support tobacco cessation in these communities. However, it remains unclear whether self-reported outcome measures in this context are in line with more objective outcome measures.<b> </b><b>Aims:</b><b> </b>This study aimed to validate self-reported quit rates using the Fagerström Test for Nicotine Dependence (FTND) as a gold standard outcome measure for evaluation of the effectiveness of the CEASE smoking cessation intervention compared to a self-help approach among low-income, underserved adult smokers. <b>Methods:</b><b> </b>A quasi-experimental design was employed to evaluate this community-based intervention. Although participants were initially assigned to three groups, this report focuses on two arms that show the major difference in the efficacy of the program: (1) the self-help group (reference; Arm 1) and (2) the in-person CEASE group (Arm 2). Outcomes included successful quitting, assessed through self-reports, and changes in FTND scores. To examine the concordance between these measures, we tested whether changes in FTND scores fully explained the relationship between the intervention and self-reported quitting. Potential confounders included demographic, socioeconomic, and health-related variables. Data were analyzed using regression and structural equation modeling (SEM). <b>Results:</b><b> </b>The majority of participants were Black Americans, followed by White individuals and those of other racial backgrounds. The CEASE intervention (Arm 2) demonstrated effectiveness in reducing nicotine dependence (measured by FTND) and increasing self-reported quit rates compared to the self-help group. Importantly, changes in FTND scores fully explained the effect of the CEASE intervention on self-reported quitting, highlighting the program’s impact on addiction severity. <b>Conclusion:</b><b> </b>Successful quitting measured using self-report is in line with the decline in nicotine addiction severity among low-income racial minority populations. CEASE holds promise as a scalable solution to address smoking disparities in underserved communities.

<b>Background: </b>Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents.<b> </b><b>Objective: </b>This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers.<b> </b><b>Methods: </b>Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race.<b> </b><b>Results: </b>Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. <b>Conclusions: </b>This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.

Background:</b> Smoking cessation interventions are critical for underserved populations, particularly among low-income individuals who may benefit from tailored support. However, the effectiveness of different intervention formats remains unclear, particularly as virtual and hybrid models gain popularity. <b>Aims:</b> This study compares the effectiveness of three smoking cessation intervention arms in a quasi-experimental design: Self-help group (Arm 1), In-person group (Arm 2), and Virtual/hybrid group (Arm 3). The primary outcome was the rate of successful quit across these different intervention modalities. <b>Methods:</b> The study utilized a community-based intervention approach, controlling for potential confounders. The communities were randomized, and this process was blinded. The effectiveness of the In-person group and the Virtual/hybrid group was compared to the Self-help group. The odds ratio (OR) for successful quit rates was calculated for each group, with corresponding 95% confidence intervals (CIs). <b>Results:</b> Participants included 50.4% of women, 82.8% were Black Americans, 11.6% Whites, and 3.4% other races. In-person group (Arm 2) showed a higher rate of successful quit compared to the Self-help group (OR = 2.67, 95% CI = 1.05, 6.79). Virtual/hybrid group (Arm 3) was not associated with a significantly higher quit rate compared to the Self-help group (OR = 1.48, 95% CI = 0.57, 3.83). <b>Conclusion:</b> The In-person group, which utilizes the CEASE curriculum and incorporates peer motivation, proved to be significantly more effective than both the Self-help and Virtual/hybrid groups. The findings suggest that low-income, underserved smokers may not be fully prepared to benefit from virtual interventions, or the current curriculum may need adaptation to better serve their needs in a virtual format.

Background. </b>Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. <b>Objective. </b>This study investigates whether school poverty and associated peer deviance and delinquent behaviors explain the disproportionately higher tobacco use among Black youth from high-income backgrounds, using data from the Adolescent Brain Cognitive Development (ABCD) study. <b>Methods. </b>We conducted a longitudinal analysis of Black youth from high-income families within the Adolescent Brain Cognitive Development (ABCD) study. A total of 8,777 youth was included in our analysis. We examined the associations between household income and tobacco use, with school poverty and associated peer deviance and delinquent behaviors as mediators. Race was considered as a moderator. <b>Results. </b>Compared to their high-income White counterparts,<b> </b>Black youth from high-income backgrounds were more likely to live in areas with higher school poverty, which exposed them to increased levels of peer deviance and delinquent behaviors compared to their White counterparts. These exposures, in turn, were associated with higher rates of tobacco use among Black youth. Thus, higher school poverty, along with the related peer deviance and delinquent behaviors, contributed to the elevated tobacco use observed among Black adolescents from high-income backgrounds. <b>Conclusion. </b>The study suggests that residing in areas with school poverty, peer deviance, and youth delinquency may explain Minorities' Diminished Returns, which are defined as the weaker protective effects of socioeconomic status on tobacco use among Black youth. Interventions aiming to prevent tobacco use need to include structural components addressing these broader social determinants of health.

Background: </b>Social determinants of health (SDOH) significantly influence health behaviors, including tobacco use among youth. Adversities such as perceived discrimination, perceived neighborhood stress, life trauma, and financial strain are stressors that may mediate the relationship between various SDOH and youth tobacco use. This study aims to investigate whether multidimensional adversities mediate the effects of SDOH on tobacco use among youth. <b>Methods:</b> Data from the Adolescent Brain Cognitive Development (ABCD) study were used to test our hypotheses. The sample included a diverse cohort of youth aged 9-10 years old followed until they were 15-16 years old. We examined the effects of baseline parental education, household income, neighborhood income, and family structure on subsequent youth tobacco use. Structural equation models were used to test if adversities (perceived discrimination, life trauma, financial strain) operate as potential mediators. <b>Results:</b> All ABCD participants were eligible for our analysis, regardless of race, ethnicity, or SDOHs (n = 11,878). The findings indicated that the effects of parental education, household income, neighborhood income, and family structure on youth tobacco use were partially mediated by adversities. Higher levels of parental education and household income were associated with lower tobacco use, and this relationship was weakened when accounting for adversities. Similarly, stable family structures and higher neighborhood income were linked to reduced tobacco use, with adversities playing a mediating role. <b>Conclusions:</b> Multidimensional adversities partially mediate the relationship between SDOH at baseline and subsequent youth tobacco use. Interventions aimed at reducing youth tobacco use should address both the social determinants and multiple adversities experienced by adolescents. Policies to improve the educational and economic situations of families, enhance neighborhood environments, and support stable family structures all reduce youth tobacco use, with lower exposure to adversities explaining this effect.

<b>Background:</b> Minorities’ Diminished Returns (MDRs) theory posits that socioeconomic resources have weaker protective effects on health and behavior for racial and ethnic minorities compared to Whites. This study examines whether tobacco susceptibility, defined as curiosity, intention, and openness to future tobacco use, mediates the diminished returns of family income on tobacco initiation among Black adolescents. <b>Methods</b><b>: </b>Data from the Adolescent Brain Cognitive Development (ABCD) Study were analyzed. Participants were followed from age 9 to 16. All participants were tobacco naïve at baseline.<b> </b>Tobacco susceptibility was assessed through self-reported measures of curiosity, intention, and openness to future tobacco use. Structural equation modeling (SEM) was used to examine the relationship between family income, tobacco susceptibility, and tobacco initiation. <b>Results</b><b>: </b>Overall,<b> </b>10,653 Black or White youth entered our analysis.<b> </b>The analysis revealed that higher family income was less effective in preventing tobacco initiation among Black adolescents. Tobacco susceptibility significantly predicted tobacco initiation and partially mediated the relationship between family income and tobacco initiation. <b>Conclusions</b><b>: </b>Tobacco susceptibility explains some of the diminished returns of family income on tobacco initiation among Black adolescents. Interventions aimed at reducing tobacco susceptibility may enhance the protective effects of family income and help mitigate health disparities.

Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.

<b>Background:</b> Parental education is a key determinant of household income, but its benefits are not uniformly distributed across racial groups. According to the Minorities' Diminished Returns (MDRs) theory, the socioeconomic benefits of resources such as parental education are systematically lower for minority families, particularly Blacks who have been subjected to slavery, segregation, racism, and discrimination. <b>Objective:</b> This study aims to investigate the diminished returns of parental education on household income among Black college students in the US. <b>Methods:</b> Using data from the Higher Education Research Institute (HERI) Freshman Student Survey, we analyzed the associations between race, parental education, and household income. The sample included 2,235,733 students, comprising 2,191,543 White and 441,90 Black freshman college students. We conducted regression analyses to examine the association between parental education and household income, adjusting for relevant covariates. <b>Results:</b> Our findings indicated that higher parental education is associated with higher household income in the pooled sample. We also found a positive association between parental education and household income for both Black and White college students. However, the magnitude of this positive association was significantly smaller for Black students compared to White students, demonstrating diminished returns of parental education on household income for Black families. <b>Discussion:</b> The results support the theory of Minorities' Diminished Returns, highlighting the need for policies that address the systemic barriers contributing to sustained economic inequality. These barriers go beyond parental education, resulting in income differences between similarly educated White and Black families.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

<b>Background: </b>High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. <b>Methods: </b>Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. <b>Results: </b>The study confirmed the role of our proposed serial mediators for Blacks’ weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. <b>Conclusions: </b>The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

Background: </b>Racial disparities in educational outcomes persist in the United States, with Black individuals experiencing lower levels of educational attainment and a higher rate of school disciplinary actions compared to their White counterparts. Parental education is a known predictor of offspring educational attainment, but its effects may vary by race. Understanding the role of household income in mediating these effects is crucial for developing targeted policy interventions to reduce educational inequalities. <b>Objectives: </b>This study aimed to examine the role of household income in mediating the differential effects of maternal education on two youth educational outcomes (educational attainment by age 22 and school disciplinary action) in Black and White families. <b>Methods: </b>Data were drawn from the 22 years of follow-up of the Future of Families and Child Wellbeing Study (FFCWS), a longitudinal study following a cohort of children born in large U.S. cities between 1998 and 2000. Participants included 1,647 Black and 689 White young adults who were followed from birth to age 22. Maternal education, household income, family structure, and paternal incarceration were assessed at baseline (birth), and two youth educational outcomes, namely educational attainment and any school disciplinary action, were assessed at age 22 (emerging adulthood). Using structural equation modeling (SEM), mediation analysis was conducted to examine whether household income partially mediates the effects of maternal education on youth educational outcomes, with race (Black vs. White) as the moderator. <b>Results: </b>The results indicated that maternal education was positively associated with youth educational attainment and negatively associated with school disciplinary actions in the pooled sample that included both Black and White families. However, the effect of parental education on educational attainment at age 22 was weaker for Black than White families. Household income partially mediated racial differences in the effect of maternal education on youth educational attainment. The results suggest that lower household income in Black families is why we observe a weaker effect of parental education on youth educational attainment for Black youth compared to White youth. <b>Conclusion</b><b>s</b>: Findings suggest that the lower household income of families is one of the reasons high maternal education levels are associated with lower youth educational attainment in Black than White families. Addressing income disparities through tax policies may help reduce racial disparities in education and promote educational equity for Black youth.

Occupational lead (Pb) exposure continues to be an important public health problem globally, yet data is lacking on the associated risks and resources available for the prevention of Pb related diseases in low middle income countries (LMICs) like The Gambia. In this study, we used a case-control design to compare blood lead levels (BLLs) between the exposed (auto repair workers) and unexposed (healthcare workers) populations in The Greater Banjul Area. The data was analyzed using Chi square test of independence to determine the characteristic factors associated with BLL. Multivariate logistic regression was used to test the relationship between BLLs for auto repair and healthcare workers and their experiences. The results of this study indicated 82.1% of cases had higher BLLs compared to 52.9% of controls. Also, the proportion of workers with elevated BLLs was higher for certain factors including more than 80% of those with greater than 10 of years job experience, more than 70% of those who worked greater than 5 days a week, worked more than 8 hours per day, did not use personal protective equipment (PPE), were illiterate or had no formal education, and smoked or ate at work. The study results have implications for policies and practice in the auto repair industry and related workplaces in The Gambia and other LMICs with similar settings. Based on the findings of this study, it is essential to initiate discussions to establish national occupational health policies in The Gambia aimed at protecting workers and the general population.

In February 2020, a family of four required between $14,196 pesos and $15,667 pesos per month to obtain a salary that exceeds the welfare or poverty line. This is an income that most Mexican households do not obtain. There is little social mobility in Mexico, where three quarters of the population born in households at the bottom of the social ladder do not manage to rise above the poverty line, even so, I believe that it is advisable to pursue undergraduate and especially graduate studies. By 2020, a person with a graduate degree will receive 6.6 times more than a person with a primary school education, 4.5 times more than a person with a secondary school education, 3.8 times more than a person with a high school education and 2 times more than a person with a bachelor's degree. In terms of gender, women with high school, undergraduate and graduate degrees receive the equivalent of 70% of the salary of men.In December 2021, more than 1.8 million Instituto Mexicano del Seguro Social (IMSS) affiliates receive a salary higher than $30,170 pesos, of which more than 830 thousand receive a salary higher than $47,140 pesos, corresponding to 3.2% and 1.5% of the 56.9 million people that make up the economically active employed population (formal and informal).