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Disparities in Health-Risk Behaviors and Health

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Special Issue Editors


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Guest Editor
1. Department of Sociology, Texas Woman’s University, 304 Administration Dr, Denton, TX 76204, USA
2. PERSEREC, Peraton, Seaside, CA 93955, USA
Interests: alcohol and drugs; mental health; disparities in health-risk behaviors and health; health and illness; deviance and crime; victimization

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Guest Editor
Department of Social Science, Delta State University, 1003 W Sunflower Rd, Cleveland, MS 38733, USA
Interests: substance use and misuse; health and health risk; victimization and victimization-related offending; race, gender, sexualities, and crime

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Guest Editor
School of Social Work, University of Alabama, Tuscaloosa, AL 35487, USA
Interests: access to health services; welfare policies; intimate partner violence; substance use and misuse; mental health and child welfare

Special Issue Information

Dear Colleagues,

Because they have become ingrained in our society and societies worldwide, disparities in health-risk behaviors and health require far-reaching investigation, supporting greater uniformity across groups. The deep-seated nature of discrimination, stigmatization, and marginalization in our social structure means that the human rights and health of too many individuals suffer while social injustice and inequity persist. Health and illness are linked to social structure by the lack of health information and access and health-risk behaviors such as use of tobacco, alcohol, and other substances; lack of adequate physical exercise; obesity. The aftereffects of health risk behavior are also found in the perpetration of violent and other criminal behaviors.

Since it emerged a year ago, the global COVID-19 pandemic has affected lives worldwide and lent further urgency to the challenge of eradicating health disparities. Structural disadvantages, such as those related to race or ethnicity, socioeconomic status, age, or specific health conditions, such as immunodeficiency or immunocompromised status, also create disadvantages in terms of severe illness from COVID-19. Relatively higher rates of confirmed infections and deaths have been observed among disadvantaged world citizens. Health disparities, such as this (along with disparities in health-behaviors), have racism at their core. As the global social movement Black Lives Matter illustrated in the second half of 2020, racism operates both on its own and intersectionally with other social statuses to create disparities in health-risk behaviors and health. These two global events, pandemic and BLM, have brought relief—quite glaringly—to institutionalized inequity and systemic discrimination characteristic of global public health systems. 

This Special Issue of International Journal of Environmental Research and Public Health plans to assemble papers identifying and discussing (1) social determinants of disparities in health-risk behaviors and health, (2) social mechanisms responsible for these persistent disparities, and (3) policies and practices recommended for reducing disparities. Submissions of research articles touching on the causes, dynamics, and consequences of disparities are enthusiastically invited. Use of qualitative, quantitative, and/or mixed methods in submitted research is welcome. 

Prof. Dr. Celia C. Lo
Dr. William Ash-Houchen
Prof. Dr. Tyrone C. Cheng
Guest Editors

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Keywords

Disparities

Health-Risk Behaviors

Health/Mental Health

Social Structure

Public Health

Acute and Chronic Illness

Access to and Quality of Health Care

Disability

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Published Papers (12 papers)

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Research

18 pages, 797 KiB  
Article
COVID-19 and Masking Disparities: Qualitative Analysis of Trust on the CDC’s Facebook Page
by Andrea Laurent-Simpson
Int. J. Environ. Res. Public Health 2023, 20(12), 6062; https://doi.org/10.3390/ijerph20126062 - 6 Jun 2023
Cited by 1 | Viewed by 1890
Abstract
This exploratory paper examines individual levels of risk assessment as impacting institutional trust in the CDC while also contributing to disparities in expressed willingness to mask early in the COVID-19 pandemic. Using both content and thematic analysis of the CDC’s Facebook (FB) page [...] Read more.
This exploratory paper examines individual levels of risk assessment as impacting institutional trust in the CDC while also contributing to disparities in expressed willingness to mask early in the COVID-19 pandemic. Using both content and thematic analysis of the CDC’s Facebook (FB) page from April 2020 and Gidden’s modern risk society theory, I consider how social media (SM) users retrospectively perceived a dramatic change in public health (PH) advisory—from the CDC advising against masking in February 2020 (Time 1) to advising the use of “do-it-yourself” (DIY) cloth masking in April 2020 (Time 2)—through a lens of prior, self-guided research. Expressed “knowledge” of masking as preventative (or not) yielded unwavering and sometimes increasing distrust in the CDC based on user perception of the “correct” advisory, regardless of the CDC’s position at Time 1 or Time 2. Simultaneously, disparities in masking behaviors appeared to be driven not by CDC guidance but by this same self-guided research. I show this via three themes: (1) claims of ineffectiveness for DIY masking (do not trust CDC now—no masking from the start); (2) conflict between the first and second CDC advisories on masking (do not trust CDC—either already masking anyway or will now); (3) disappointed in the CDC for length of time taken to make a DIY mask recommendation (do not trust CDC—either already masking anyway or will mask now). I discuss the imperative nature of two-way engagement with SM users by PH rather than using SM as a one-way mode of advisory dissemination. This and other recommendations may decrease disparities in preventative behaviors based on individual-level risk assessment as well as increase institutional trust and transparency. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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10 pages, 1606 KiB  
Article
Neighborhood Alcohol Outlet Density, Historical Redlining, and Violent Crime in NYC 2014–2018
by Sean J. Haley, Shari J. Jardine, Elizabeth A. Kelvin, Christopher Herrmann and Andrew R. Maroko
Int. J. Environ. Res. Public Health 2023, 20(4), 3212; https://doi.org/10.3390/ijerph20043212 - 12 Feb 2023
Cited by 5 | Viewed by 3251
Abstract
Alcohol outlets tend to cluster in lower income neighborhoods and do so disproportionately in areas with more residents of color. This study explores the association between on- and off-premise alcohol outlet density and history of redlining with violent crime in New York City [...] Read more.
Alcohol outlets tend to cluster in lower income neighborhoods and do so disproportionately in areas with more residents of color. This study explores the association between on- and off-premise alcohol outlet density and history of redlining with violent crime in New York City between 2014 and 2018. Alcohol outlet density was calculated using a spatial accessibility index. Multivariable linear regression models assess associations between the history of redlining, on-premise and off-premise alcohol outlet density with serious crime. Each unit increase in on- and off-premise alcohol density was associated with a significant increase in violent crime (β = 3.1, p < 0.001 on-premise and β = 33.5, p < 0.001 off premise). In stratified models (redlined vs not redlined community block groups) the association between off-premise alcohol outlet density and violent crime density was stronger in communities with a history of redlining compared to those without redlining (β = 42.4, p < 0.001 versus β = 30.9, p < 0.001, respectively). However, on-premise alcohol outlet density was only significantly associated with violent crime in communities without a history of redlining (β = 3.6, p < 0.001). The violent crime experienced by formerly redlined communities in New York City is likely related to a legacy of racialized housing policies and may be associated with state policies that allow for high neighborhood alcohol outlet density. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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11 pages, 512 KiB  
Article
Testing the Multiple Disadvantage Model of Health with Ethnic Asian Children: A Secondary Data Analysis
by Tyrone C. Cheng and Celia C. Lo
Int. J. Environ. Res. Public Health 2023, 20(1), 483; https://doi.org/10.3390/ijerph20010483 - 28 Dec 2022
Cited by 1 | Viewed by 1486
Abstract
This study of ethnic Asian children in the United States asked whether their health exhibited relationship with any of six factors: social disorganization, social structural factors, social relationships, the health of their parents, their access to medical insurance, acculturation. The sample of 1350 [...] Read more.
This study of ethnic Asian children in the United States asked whether their health exhibited relationship with any of six factors: social disorganization, social structural factors, social relationships, the health of their parents, their access to medical insurance, acculturation. The sample of 1350 ethnic Asian children was extracted from the 2018 National Survey of Children’s Health. Logistic regression results showed that these children’s excellent/very good/good health was associated positively with safe neighborhoods, family incomes, family cohesiveness, family support, and receipt of Temporary Assistance for Needy Families (TANF). In turn, health was associated negatively with single-mother households. Implications of the present results in terms of interventions promoting family support, TANF participation, safe neighborhoods, and professionals’ cultural competency are discussed. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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22 pages, 1174 KiB  
Article
Online Dating and Mental Health among Young Sexual Minority Black Men: Is Ethnic Identity Protective in the Face of Sexual Racism?
by Ryan M. Wade and Matthew M. Pear
Int. J. Environ. Res. Public Health 2022, 19(21), 14263; https://doi.org/10.3390/ijerph192114263 - 1 Nov 2022
Cited by 9 | Viewed by 3133
Abstract
Racialized Sexual Discrimination (RSD), also known as ‘sexual racism,’ is pervasive within online dating venues. RSD is associated with poor mental health outcomes among young sexual minority Black men (YSMBM), and there is limited research on factors that may mitigate this association. Ethnic [...] Read more.
Racialized Sexual Discrimination (RSD), also known as ‘sexual racism,’ is pervasive within online dating venues. RSD is associated with poor mental health outcomes among young sexual minority Black men (YSMBM), and there is limited research on factors that may mitigate this association. Ethnic identity has been identified as a potential protective factor for racial/ethnic minorities who encounter racialized stressors, though some evidence suggests that ethnic identity may also intensify the negative effects of racial discrimination. Using data from a cross-sectional web-survey of YSMBM (n = 690), a series of linear regression models were estimated to examine the moderating effect of ethnic identity search and ethnic identity commitment on the relationship between RSD and depressive symptoms/feeling of self-worth. Results indicated that having moderate-to-high scores on commitment attenuated the association between being physically objectified by White men and higher depressive symptoms. However, having high scores on commitment intensified the association between being rejected by Black men and lower feelings of self-worth. Stronger identity commitment may be protective against objectification from White men, though it may also exacerbate negative outcomes related to in-group discrimination. These findings may have important implications for the development of individual and group-level interventions addressing ethnic identity among YSMBM. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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13 pages, 1728 KiB  
Article
Former Incarceration, Time Served, and Perceived Oral Health among African American Women and Men
by Ryan D. Talbert and Emma D. Macy
Int. J. Environ. Res. Public Health 2022, 19(19), 12906; https://doi.org/10.3390/ijerph191912906 - 8 Oct 2022
Cited by 7 | Viewed by 2073
Abstract
A large body of research has documented the far-reaching health consequences of mass incarceration in the United States. Yet, less scholarship has examined the relationship between former incarceration and oral health, a key reflection of health and disease occurring within the rest of [...] Read more.
A large body of research has documented the far-reaching health consequences of mass incarceration in the United States. Yet, less scholarship has examined the relationship between former incarceration and oral health, a key reflection of health and disease occurring within the rest of the body. Using data extracted from the National Survey of American Life (n = 3343), this study examines associations among former incarceration status, duration of detention, and self-reported oral health among African American women and men. Results from gender-stratified ordered logistic models reveal that formerly incarcerated African American men and women experience significantly poorer oral health than their never incarcerated counterparts even after controlling for important social determinants of health. Furthermore, oral health is curvilinearly associated with the length of time that men are incarcerated such that odds of poor health decrease as detention duration increases up to approximately 15 years incarcerated. After 15 years of detainment, the odds of poor health tend to increase as duration increases. Findings extend research identifying gendered spillover health consequences of contact with the criminal legal system. Health professionals and policymakers should be conscious of incarceration as an important deleterious experience for the immediate and long-term condition of people’s teeth, mouth, and gums. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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19 pages, 403 KiB  
Article
Kinky Sex and Deliberate Partner Negotiations: Case Studies of Canadian Transgender Men Who Have Sex with Men, Their HIV Risks, Safer Sex Practices, and Prevention Needs
by Renato M. Liboro, Charles Fehr and George Da Silva
Int. J. Environ. Res. Public Health 2022, 19(18), 11382; https://doi.org/10.3390/ijerph191811382 - 9 Sep 2022
Viewed by 2367
Abstract
Growing research in the last two decades has begun to investigate the HIV risks and sexual health practices of transgender men, especially as a subpopulation of men who have sex with men (MSM) that likely shares certain HIV risks and sexual health practices [...] Read more.
Growing research in the last two decades has begun to investigate the HIV risks and sexual health practices of transgender men, especially as a subpopulation of men who have sex with men (MSM) that likely shares certain HIV risks and sexual health practices with cisgender MSM, the sociodemographic group that continues to be at highest risk for HIV in many developed countries since the start of the epidemic. As part of our Community-Based Participatory Research project and larger strengths-based qualitative study that was dedicated to examine multiple factors that promote resilience to HIV utilizing the perspectives and lived experiences of middle-aged and older MSM, the case studies we present in this article feature the distinct insights and experiences of three HIV-negative transgender MSM from Downtown Toronto, Ontario, Canada, who participated in our one-on-one interviews. The three case studies provide not only an enlightening snapshot of some of the specific contexts, HIV risks, safer sex practices, and HIV prevention needs of transgender MSM, but also a unique opportunity to critically reflect on the potential implications of the insights and experiences that were shared by our participants, particularly for adapting and developing current and future HIV services and programs to maximally benefit transgender MSM. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
13 pages, 537 KiB  
Article
Neighborhood Disadvantage and Poor Health: The Consequences of Race, Gender, and Age among Young Adults
by C. André Christie-Mizell
Int. J. Environ. Res. Public Health 2022, 19(13), 8107; https://doi.org/10.3390/ijerph19138107 - 1 Jul 2022
Cited by 5 | Viewed by 2773
Abstract
The objective of this study is to examine the relationship between neighborhood disadvantage and poor self-rated health for a nationally representative sample of Blacks and Whites in young adulthood, 18 to 30 years old. Data were from 16 waves (1997–2013) of the National [...] Read more.
The objective of this study is to examine the relationship between neighborhood disadvantage and poor self-rated health for a nationally representative sample of Blacks and Whites in young adulthood, 18 to 30 years old. Data were from 16 waves (1997–2013) of the National Longitudinal Survey of Youth 1997 cohort (N = 6820 individuals; observations = 58,901). Utilizing the stress process model and generalized estimating equations to account for the correlated nature of multiple responses over time, results show that neighborhood disadvantage increases the odds of poor health for all groups. This positive association is strongest in the most disadvantaged neighborhoods and is heightened as young adults age. There are also notable race and gender differences. For example, Blacks, who live in the most highly disadvantaged neighborhoods, seem to be somewhat shielded from the most deleterious effects of poor neighborhood conditions compared to their White counterparts. Despite greater proportions of Blacks residing in harsh neighborhood environments, Black men experience better health than all other groups, and the health of Black women is no worse compared to White men or women. Limitations and directions for future research are discussed. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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12 pages, 332 KiB  
Article
Exploring Preventive Healthcare in a High-Risk Vulnerable Population
by Trisha L. Amboree, Jane R. Montealegre, Kayo Fujimoto, Osaro Mgbere, Charles Darkoh and Paige Padgett Wermuth
Int. J. Environ. Res. Public Health 2022, 19(8), 4502; https://doi.org/10.3390/ijerph19084502 - 8 Apr 2022
Cited by 5 | Viewed by 3113
Abstract
This study describes preventive care behaviors and explores opportunities to deliver preventive sexual healthcare to a high-risk vulnerable population. Data from the National HIV Behavioral Surveillance (NHBS) system high-risk heterosexuals (HET) cycle (2019) in Houston, Texas, was used to describe preventive care utilization [...] Read more.
This study describes preventive care behaviors and explores opportunities to deliver preventive sexual healthcare to a high-risk vulnerable population. Data from the National HIV Behavioral Surveillance (NHBS) system high-risk heterosexuals (HET) cycle (2019) in Houston, Texas, was used to describe preventive care utilization and assess the relationship between healthcare utilization and sociodemographic characteristics. More than 47% reported having no usual source of healthcare, and 94.6% reported receiving no non-HIV STI testing in the past 12 months. Additionally, many sociodemographic factors were associated with healthcare utilization and having a usual source of healthcare. Future efforts should be targeted at increasing preventive healthcare utilization among high-risk vulnerable populations as well as implementing more preventive sexual healthcare services in the community health centers where these populations most frequently encounter healthcare. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
15 pages, 469 KiB  
Article
Local Ties, Trans-Local Ties, and Substance Use among Rural-to-Urban Migrants in China
by Xi Chen, Hua Zhong and Serena Yunran Zhang
Int. J. Environ. Res. Public Health 2022, 19(7), 4233; https://doi.org/10.3390/ijerph19074233 - 1 Apr 2022
Cited by 3 | Viewed by 2080
Abstract
China has witnessed unprecedented rural-to-urban migration since the early 1980s. While trying to assimilate into the city, rural-to-urban migrants still maintain close ties with their home communities. This study examines how local ties and trans-local ties of rural-to-urban migrants affect their alcohol and [...] Read more.
China has witnessed unprecedented rural-to-urban migration since the early 1980s. While trying to assimilate into the city, rural-to-urban migrants still maintain close ties with their home communities. This study examines how local ties and trans-local ties of rural-to-urban migrants affect their alcohol and tobacco use. Data were obtained from the 2016 and 2018 China Labor-force Dynamics Survey, a nationally representative sample of adults aged over 15 in 29 provinces in China. Participants included 1426 rural-to-urban migrant workers and 6438 urban residents in China. We found that compared to urban natives, rural-to-urban migrants had higher tobacco use prevalence (logit = 0.19, 95% CI = [0.03, 0.35]; p < 0.05) and more frequent alcohol use (logit = 0.27, 95% CI = [0.11, 0.42]; p < 0.001) after adjusting for sociodemographic characteristics. Migrants with more local social ties engaged in more frequent drinking (having >10 local friends vs. having 0 local friends: logit = 0.58, [0.10, 1.06], p < 0.05), whereas trans-local ties were not a significant correlate. In contrast, migrants who returned to their hometown more times (an indicator of trans-local ties) were more likely to be current tobacco users (logit = 0.01, 95% CI = [0.00, 0.02], p < 0.01) after adjusting for sociodemographic variables. These findings extended the research on social networks and health behaviors by identifying how local and trans-local ties differentially affected the vulnerabilities of tobacco and alcohol use among rural-to-urban migrants in China. The findings suggested that policies and interventions on reducing migrants’ health risk behaviors should focus on the role of different types of social ties. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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9 pages, 4053 KiB  
Article
An Epidemiologic Analysis of Associations between County-Level Per Capita Income, Unemployment Rate, and COVID-19 Vaccination Rates in the United States
by Yuqi Guo, Andrea R. Kaniuka, Jingjing Gao and Omar T. Sims
Int. J. Environ. Res. Public Health 2022, 19(3), 1755; https://doi.org/10.3390/ijerph19031755 - 3 Feb 2022
Cited by 14 | Viewed by 4949
Abstract
The purpose of this longitudinal study was to examine associations between per capita income, unemployment rates, and COVID-19 vaccination rates at the county-level across the United States (U.S.), as well as to identify the interaction effects between county-level per capita income, unemployment rates, [...] Read more.
The purpose of this longitudinal study was to examine associations between per capita income, unemployment rates, and COVID-19 vaccination rates at the county-level across the United States (U.S.), as well as to identify the interaction effects between county-level per capita income, unemployment rates, and racial/ethnic composition on COVID-19 vaccination rates. All counties in the U.S. that reported COVID-19 vaccination rates from January 2021 to July 2021 were included in this longitudinal study (n = 2857). Pooled ordinary least squares (OLS) with fixed-effects were employed to longitudinally examine economic impacts on racial/ethnic disparities on county-level COVID-19 vaccination rates. County-level per capita income and county-level unemployment rates were both positively associated with county-level COVID-19 vaccination rates across the U.S. However, the associations were divergent in the context of race/ethnicity. Public health efforts to bolster COVID-19 vaccination rates are encouraged to consider economic factors that are associated with decreases in COVID-19 vaccination rates. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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13 pages, 339 KiB  
Article
Support for Health Insurance Coverage for Legal Abortion in the United States
by Charley Henderson and Philip Q. Yang
Int. J. Environ. Res. Public Health 2022, 19(1), 433; https://doi.org/10.3390/ijerph19010433 - 31 Dec 2021
Cited by 1 | Viewed by 3013
Abstract
The use of health insurance to cover legal abortion is a controversial issue on which Americans are sharply divided. Currently, there is a lack of research on this issue as data became available only recently. Using data from the newly released General Social [...] Read more.
The use of health insurance to cover legal abortion is a controversial issue on which Americans are sharply divided. Currently, there is a lack of research on this issue as data became available only recently. Using data from the newly released General Social Survey in 2018, this study examines who is more or less likely to support health insurance coverage for legal abortion. The results show that the support and opposition were about evenly divided. The findings from the logistic regression analysis reveal that, holding other variables constant, Democrats, liberals, urban residents, the more educated, and the older were more likely to support health insurance coverage for legal abortion while women, Southerners, Christians, the currently married, and those with more children were less likely to favor it, compared to their respective counterparts. Additionally, the effect of education was stronger for liberals than for non-liberals. Race, family income, and full-time work status make no difference in the outcome. The findings have significant implications for research and practices in health insurance coverage for legal abortion. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
15 pages, 379 KiB  
Article
Gender and Childhood Victimization: A Longitudinal Study of Heavy Drinking in Young Adulthood
by William Ash-Houchen, Celia C. Lo, Heather M. Gerling and Tyrone C. Cheng
Int. J. Environ. Res. Public Health 2021, 18(21), 11089; https://doi.org/10.3390/ijerph182111089 - 21 Oct 2021
Viewed by 2067
Abstract
The present longitudinal study, for 12 years, followed a group of young adults, examining (1) whether/how victimization in childhood increased the likelihood of heavy drinking; (2) whether depression mediated the strain–heavy drinking relationship; and (3) whether/how relationships among strain, depression, and heavy drinking [...] Read more.
The present longitudinal study, for 12 years, followed a group of young adults, examining (1) whether/how victimization in childhood increased the likelihood of heavy drinking; (2) whether depression mediated the strain–heavy drinking relationship; and (3) whether/how relationships among strain, depression, and heavy drinking differed across two gender groups. Data came from the National Longitudinal Survey of Youth 1997 cohort, dating 2004–2015 (5 interview waves and 22,549 person-wave measurements total). We linked consumption of 5+ drinks (during the month prior) to four discrete measures of violent victimization, to one measure of stressful events, and to depression. We needed to consider repeat measures of the same variables over time, so we used generalized estimating equations (GEE) to analyze data. Depression was found to increase heavy drinking uniformly. Empirical evidence confirmed that in the strain–heavy drinking relationship, depression plays a minor mediating role. Gender moderated heavy drinking’s associations. Specifically, bullying in childhood raised risk for female respondents. The current strain was associated with a higher risk of heavy drinking among male respondents. Childhood victimization, as well as current life stress, play an important role in depression and heavy drinking. Future research should focus on the development of specific, targeted care to reduce heavy drinking’s harm and promote equity among Americans. Full article
(This article belongs to the Special Issue Disparities in Health-Risk Behaviors and Health)
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