Document Type : Original Article


Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA/Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA


Background and aims: Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including, but not limited to, problematic substance use. Negative urgency is also shaped by family socioeconomic position (SEP), such as parental educational attainment (PEA). This study aimed to explore sex differences regarding protective effects of PEA on children’s negative urgency in the US.

Methods: This cross-sectional study used the Adolescent Brain Cognitive Development (ABCD) study data. Baseline ABCD data included 10,535 American children in the age range of 9-10 years old. The independent variable was PEA, treated as a 5-level categorical variable. The primary outcome was negative urgency measured by the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-SS). Mixed-effects regression models were applied for data analysis.

Results: In sex-stratified regression models, high PEA was predictive of lower levels of negative urgency in female but not male children. In the overall sample, sex showed a statistically significant interaction with PEA on children’s negative urgency, indicating a stronger protective effect of high PEA for female compared to male children.

Conclusion: PEA was a more salient determinant of negative urgency in female children than male ones. Our results also showed that American boys tend to have high levels of negative urgency, which is a risk factor of drug use, at all parental education levels.


Main Subjects

1.Valencia MLC, Tran BT, Lim MK, Choi KS, Oh JK. Association between socioeconomic status and early initiation of smoking, alcohol drinking, and sexual behavior among Korean adolescents. Asia Pac J Public Health. 2019;31(5):443-53. doi: 10.1177/1010539519860732. 
2.Ahmad A, Zulaily N, Shahril MR, Syed Abdullah EFH, Ahmed A. Association between socioeconomic status and obesity among 12-year-old Malaysian adolescents. PLoS One. 2018;13(7):e0200577. doi: 10.1371/journal.pone.0200577. 
3.Merz EC, Tottenham N, Noble KG. Socioeconomic status, amygdala volume, and internalizing symptoms in children and adolescents. J Clin Child Adolesc Psychol. 2018;47(2):312-23. doi: 10.1080/15374416.2017.1326122. 
4.Ross CE, Mirowsky J. The interaction of personal and parental education on health. Soc Sci Med. 2011;72(4):591-9. doi: 10.1016/j.socscimed.2010.11.028. 
5.Poh BK, Lee ST, Yeo GS, Tang KC, Noor Afifah AR, Siti Hanisa A, et al. Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children. BMC Public Health. 2019;19(Suppl 4):541. doi: 10.1186/ s12889-019-6856-4. 
6.Karlsson O, De Neve JW, Subramanian SV. Weakening association of parental education: analysis of child health outcomes in 43 low- and middle-income countries. Int J Epidemiol. 2019;48(1):83-97. doi: 10.1093/ije/dyy158. 
7.Madhushanthi HJ, Wimalasekera SW, Goonewardena CSE, Amarasekara A, Lenora J. Socioeconomic status is a predictor of neurocognitive performance of early female adolescents. Int J Adolesc Med Health. 2018;32(6). doi: 10.1515/ ijamh-2018-0024. 
8.Christensen DL, Schieve LA, Devine O, Drews-Botsch C. Socioeconomic status, child enrichment factors, and cognitive performance among preschool-age children: results from the Follow-Up of Growth and Development Experiences study. Res Dev Disabil. 2014;35(7):1789-801. doi: 10.1016/j. ridd.2014.02.003. 
9.Bouthoorn SH, Wijtzes AI, Jaddoe VW, Hofman A, Raat H, van Lenthe FJ. Development of socioeconomic inequalities in obesity among Dutch pre-school and school-aged children. Obesity (Silver Spring). 2014;22(10):2230-7. doi: 10.1002/ oby.20843. 
10.Yelin E, Trupin L, Bunde J, Yazdany J. Poverty, neighborhoods, persistent stress, and systemic lupus erythematosus outcomes: a qualitative study of the patients’ perspective. Arthritis Care Res (Hoboken). 2019;71(3):398-405. doi: 10.1002/acr.23599. 
11.Harnett NG, Wheelock MD, Wood KH, Goodman AM, Mrug S, Elliott MN, et al. Negative life experiences contribute to racial differences in the neural response to threat. Neuroimage. 2019;202:116086. doi: 10.1016/j.neuroimage.2019.116086. 
12.Schulz AJ, Mentz G, Lachance L, Johnson J, Gaines C, Israel BA. Associations between socioeconomic status and allostatic load: effects of neighborhood poverty and tests of mediating pathways. Am J Public Health. 2012;102(9):1706-14. doi: 10.2105/ajph.2011.300412. 
13.Kaufman JS, Cooper RS, McGee DL. Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race. Epidemiology. 1997;8(6):621-8. 
14.Bell CN, Sacks TK, Thomas Tobin CS, Thorpe RJ Jr. Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM Popul Health. 2020;10:100561. doi: 10.1016/j.ssmph.2020.100561. 
15.Samuel LJ, Roth DL, Schwartz BS, Thorpe RJ, Glass TA. Socioeconomic status, race/ethnicity, and diurnal cortisol trajectories in middle-aged and older adults. J Gerontol B Psychol Sci Soc Sci. 2018;73(3):468-76. doi: 10.1093/geronb/ gbw080. 
16.Fuentes M, Hart-Johnson T, Green CR. The association among neighborhood socioeconomic status, race and chronic pain in Black and White older adults. J Natl Med Assoc. 2007;99(10):1160-9. 
17.Williams DR, Costa MV, Odunlami AO, Mohammed SA. Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. J Public Health Manag Pract. 2008;14 Suppl:S8-17. doi: 10.1097/01.phh.0000338382.36695.42. 
18.Williams DR. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999;896:173-88. doi: 10.1111/j.1749-6632.1999. tb08114.x. 
19.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(7):122. doi: 10.3390/ brainsci8070122. 
20.Assari S. Family socioeconomic position at birth and school bonding at age 15; Blacks’ diminished returns. Behav Sci (Basel). 2019;9(3):26. doi: 10.3390/bs9030026. 
21.Assari S. Income and mental well-being of middle-aged and older Americans: immigrants’ diminished returns. Int J Travel Med Glob Health. 2020;8(1):37-43. doi: 10.34172/ ijtmgh.2020.06. 
22.Assari S. Socioeconomic status and current cigarette smoking status: immigrants’ diminished returns. Int J Travel Med Glob Health. 2020;8(2):66-72. doi: 10.34172/ijtmgh.2020.11. 
23.Assari S, Farokhnia M, Mistry R. Education attainment and alcohol binge drinking: diminished returns of Hispanics in Los Angeles. Behav Sci (Basel). 2019;9(1):9. doi: 10.3390/ bs9010009. 
24.Assari S. Health disparities due to diminished return among black Americans: public policy solutions. Soc Issues Policy Rev. 2018;12(1):112-45. doi: 10.1111/sipr.12042. 
25.Assari S. Unequal gain of equal resources across racial groups. Int J Health Policy Manag. 2018;7(1):1-9. doi: 10.15171/ ijhpm.2017.90. 
26.Assari S, Caldwell CH, Mincy R. Family socioeconomic status at birth and youth impulsivity at age 15; Blacks’ diminished return. Children (Basel). 2018;5(5):58. doi: 10.3390/ children5050058. 
27.Assari S, Caldwell CH, Mincy RB. Maternal educational attainment at birth promotes future self-rated health of White but not Black youth: a 15-year cohort of a national sample. J Clin Med. 2018;7(5):93. doi: 10.3390/jcm7050093. 
28.Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks’ diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. J Urban Health. 2018;95(1):21-35. doi: 10.1007/s11524-017-0217-3. 
29.Assari S, Mistry R. Diminished return of employment on ever smoking among Hispanic Whites in Los Angeles. Health Equity. 2019;3(1):138-44. doi: 10.1089/heq.2018.0070. 
30.Assari S. Socioeconomic determinants of systolic blood pressure; minorities’ diminished returns. J Health Econ Dev. 2019;1(1):1-11. 
31.Assari S. Socioeconomic status and self-rated oral health; diminished return among Hispanic Whites. Dent J (Basel). 2018;6(2):11. doi: 10.3390/dj6020011. 
32.Assari S. Education attainment and obesity: differential returns based on sexual orientation. Behav Sci (Basel). 2019;9(2):16. doi: 10.3390/bs9020016. 
33.Assari S, Boyce S, Bazargan M, Caldwell CH, Zimmerman MA. Place-based diminished returns of parental educational attainment on school performance of non-Hispanic White youth. Front Educ (Lausanne). 2020;5:30. doi: 10.3389/ feduc.2020.00030. 
34.Assari S, Moghani Lankarani M. Stressful life events and risk of depression 25 years later: race and gender differences. Front Public Health. 2016;4:49. doi: 10.3389/fpubh.2016.00049. 
35.Assari S, Caldwell CH, Zimmerman MA. Sex differences in the association between testosterone and violent behaviors. Trauma Mon. 2014;19(3):e18040. doi: 10.5812/traumamon.18040. 
36.Assari S, Caldwell CH. Gender and ethnic differences in the association between obesity and depression among Black adolescents. J Racial Ethn Health Disparities. 2015;2(4):481- 93. doi: 10.1007/s40615-015-0096-9. 
37.Assari S, Moghani Lankarani M, Malekahmadi MR, Caldwell CH, Zimmerman M. Baseline religion involvement predicts subsequent salivary cortisol levels among male but not female Black youth. Int J Endocrinol Metab. 2015;13(4):e31790. doi: 10.5812/ijem.31790. 
38.Assari S, Moghani Lankarani M. Association between stressful life events and depression; intersection of race and gender. J Racial Ethn Health Disparities. 2016;3(2):349-56. doi: 10.1007/s40615-015-0160-5. 
39.Assari S, Moghani Lankarani M, Caldwell CH, Zimmerman M. Anxiety symptoms during adolescence predicts salivary cortisol in early adulthood among Blacks; sex differences. Int J Endocrinol Metab. 2015;13(4):e18041. doi: 10.5812/ ijem.18041. 
40.Assari S, Caldwell CH, Bazargan M. Association between parental educational attainment and youth outcomes and role of race/ethnicity. JAMA Netw Open. 2019;2(11):e1916018. doi: 10.1001/jamanetworkopen.2019.16018. 
41.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(4):763. doi: 10.3390/ijerph15040763. 
42.Assari S, Mistry R, Caldwell CH, 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. doi: 10.2147/ahmt.s238441. 
43.Assari S. Parental educational attainment and mental well-being of college students; diminished returns of Blacks. Brain Sci. 2018;8(11):193. doi: 10.3390/brainsci8110193. 
44.Assari S. Blacks’ diminished return of education attainment on subjective health; mediating effect of income. Brain Sci. 2018;8(9):176. doi: 10.3390/brainsci8090176. 
45.Assari S, Caldwell CH, Zimmerman MA. Family structure and subsequent anxiety symptoms; minorities’ diminished return. Brain Sci. 2018;8(6):97. doi: 10.3390/brainsci8060097. 
46.Assari S, Hani N. Household income and children’s unmet dental care need; Blacks’ diminished return. Dent J (Basel). 2018;6(2):17. doi: 10.3390/dj6020017. 
47.Wierenga LM, Sexton JA, Laake P, Giedd JN, Tamnes CK. A key characteristic of sex differences in the developing brain: greater variability in brain structure of boys than girls. Cereb Cortex. 2018;28(8):2741-51. doi: 10.1093/cercor/bhx154. 
48.Javanbakht A, Kim P, Swain JE, Evans GW, Phan KL, Liberzon I. Sex-specific effects of childhood poverty on neurocircuitry of processing of emotional cues: a neuroimaging study. Behav Sci (Basel). 2016;6(4):28. doi: 10.3390/bs6040028. 
49.Kim DJ, Davis EP, Sandman CA, Glynn L, Sporns O, O’Donnell BF, et al. Childhood poverty and the organization of structural brain connectome. NeuroImage. 2019;184:409-16. doi: 10.1016/j.neuroimage.2018.09.041. 
50.Whittle S, Lichter R, Dennison M, Vijayakumar N, Schwartz O, Byrne ML, et al. Structural brain development and depression onset during adolescence: a prospective longitudinal study. Am J Psychiatry. 2014;171(5):564-71. doi: 10.1176/appi. ajp.2013.13070920. 
51.McDermott CL, Seidlitz J, Nadig A, Liu S, Clasen LS, Blumenthal JD, et al. Longitudinally mapping childhood socioeconomic status associations with cortical and subcortical morphology. J Neurosci. 2019;39(8):1365-73. doi: 10.1523/jneurosci.1808-18.2018. 
52.Assari S, Caldwell CH. High risk of depression in high-income African American boys. J Racial Ethn Health Disparities. 2018;5(4):808-19. doi: 10.1007/s40615-017-0426-1. 
53.Assari S, Gibbons FX, Simons R. Depression among Black youth; interaction of class and place. Brain Sci. 2018;8(6):108. doi: 10.3390/brainsci8060108. 
54.Littlefield AK, Stevens AK, Ellingson JM, King KM, Jackson KM. Changes in negative urgency, positive urgency, and sensation seeking across adolescence. Pers Individ Dif. 2016;90:332-7. doi: 10.1016/j.paid.2015.11.024. 
55.Cyders MA, Zapolski TC, Combs JL, Settles RF, Fillmore MT, Smith GT. Experimental effect of positive urgency on negative outcomes from risk taking and on increased alcohol consumption. Psychol Addict Behav. 2010;24(3):367-75. doi: 10.1037/a0019494. 
56.Racine SE, Keel PK, Burt SA, Sisk CL, Neale M, Boker S, et al. Exploring the relationship between negative urgency and dysregulated eating: etiologic associations and the role of negative affect. J Abnorm Psychol. 2013;122(2):433-44. doi: 10.1037/a0031250. 
57.Halcomb M, Argyriou E, Cyders MA. Integrating preclinical and clinical models of negative urgency. Front Psychiatry. 2019;10:324. doi: 10.3389/fpsyt.2019.00324. 
58.Wang H, Wen B, Cheng J, Li H. Brain structural differences between normal and obese adults and their links with lack of perseverance, negative urgency, and sensation seeking. Sci Rep. 2017;7:40595. doi: 10.1038/srep40595. 
59.Wang FL, Chassin L. Negative urgency mediates the relation between genetically-influenced serotonin functioning and alcohol problems. Clin Psychol Sci. 2018;6(1):106-22. doi: 10.1177/2167702617733817. 
60.Albein-Urios N, Martinez-Gonzalez JM, Lozano Ó, Moreno- López L, Soriano-Mas C, Verdejo-Garcia A. Negative urgency, disinhibition and reduced temporal pole gray matter characterize the comorbidity of cocaine dependence and personality disorders. Drug Alcohol Depend. 2013;132(1- 2):231-7. doi: 10.1016/j.drugalcdep.2013.02.008. 
61.Aloi M, Rania M, Carbone EA, Calabrò G, Caroleo M, Carcione A, et al. The role of self-monitoring metacognition sub-function and negative urgency related to binge severity. Eur Eat Disord Rev. 2020;28(5):580-6. doi: 10.1002/erv.2742. 
62.Verdejo-García A, Lozano O, Moya M, Alcázar MA, Pérez- García M. Psychometric properties of a Spanish version of the UPPS-P impulsive behavior scale: reliability, validity and association with trait and cognitive impulsivity. J Pers Assess. 2010;92(1):70-7. doi: 10.1080/00223890903382369. 
63.Mason TB, Dunton GF, Gearhardt AN, Leventhal AM. Emotional disorder symptoms, anhedonia, and negative urgency as predictors of hedonic hunger in adolescents. Eat Behav. 2020;36:101343. doi: 10.1016/j.eatbeh.2019.101343. 
64.Racine SE, Burt SA, Keel PK, Sisk CL, Neale MC, Boker S, et al. Examining associations between negative urgency and key components of objective binge episodes. Int J Eat Disord. 2015;48(5):527-31. doi: 10.1002/eat.22412. 
65Puhalla AA, Ammerman BA, Uyeji LL, Berman ME, McCloskey MS. Negative urgency and reward/punishment sensitivity in intermittent explosive disorder. J Affect Disord. 2016;201:8- 14. doi: 10.1016/j.jad.2016.04.045. 
66.Bardo MT, Weiss VG, Rebec GV. Using preclinical models to understand the neural basis of negative urgency. In: Sangha S, Foti D, ed. Neurobiology of Abnormal Emotion and Motivated Behaviors. Academic Press; 2018. p. 2-20. doi: 10.1016/ b978-0-12-813693-5.00001-0. 
67.NIH’s Adolescent Brain Cognitive Development (ABCD) Study. Alcohol Res. 2018;39(1):97. 
68.Casey BJ, Cannonier T, Conley MI, Cohen AO, Barch DM, Heitzeg MM, et al. The adolescent brain cognitive development (ABCD) study: imaging acquisition across 21 sites. Dev Cogn Neurosci. 2018;32:43-54. doi: 10.1016/j.dcn.2018.03.001. 
69.Karcher NR, O’Brien KJ, Kandala S, Barch DM. Resting-state functional connectivity and psychotic-like experiences in childhood: results from the adolescent brain cognitive development study. Biol Psychiatry. 2019;86(1):7-15. doi: 10.1016/j.biopsych.2019.01.013. 
70.Lisdahl KM, Sher KJ, Conway KP, Gonzalez R, Feldstein Ewing SW, Nixon SJ, et al. Adolescent brain cognitive development (ABCD) study: overview of substance use assessment methods. Dev Cogn Neurosci. 2018;32:80-96. doi: 10.1016/j. dcn.2018.02.007. 
71.Luciana M, Bjork JM, Nagel BJ, Barch DM, Gonzalez R, Nixon SJ, et al. Adolescent neurocognitive development and impacts of substance use: overview of the adolescent brain cognitive development (ABCD) baseline neurocognition battery. Dev Cogn Neurosci. 2018;32:67-79. doi: 10.1016/j. dcn.2018.02.006. 
72.Auchter AM, Hernandez Mejia M, Heyser CJ, Shilling PD, Jernigan TL, Brown SA, et al. A description of the ABCD organizational structure and communication framework. Dev Cogn Neurosci. 2018;32:8-15. doi: 10.1016/j. dcn.2018.04.003. 
73.Asaad SK, Bjarkam CR. The Aalborg Bolt-Connected Drain (ABCD) study: a prospective comparison of tunnelled and bolt-connected external ventricular drains. Acta Neurochir (Wien). 2019;161(1):33-9. doi: 10.1007/s00701-018-3737-z. 
74.ABCD. ABCD Protocl Brocure - Baseline. 
75.Feldstein Ewing SW, Chang L, Cottler LB, Tapert SF, Dowling GJ, Brown SA. Approaching retention within the ABCD study. Dev Cogn Neurosci. 2018;32:130-7. doi: 10.1016/j. dcn.2017.11.004. 
76.Werneck AO, Agostinete RR, Cayres SU, Urban JB, Wigna A, Chagas LGM, et al. Association between cluster of lifestyle behaviors and HOMA-IR among adolescents: ABCD growth study. Medicina (Kaunas). 2018;54(6):96. doi: 10.3390/ medicina54060096. 
77.Fine JD, Moreau AL, Karcher NR, Agrawal A, Rogers CE, Barch DM, et al. Association of prenatal cannabis exposure with psychosis proneness among children in the adolescent brain cognitive development (ABCD) study. JAMA Psychiatry. 2019;76(7):762-4. doi: 10.1001/jamapsychiatry.2019.0076. 
78.Dick AS, Garcia NL, Pruden SM, Thompson WK, Hawes SW, Sutherland MT, et al. Author Correction: No evidence for a bilingual executive function advantage in the ABCD study. Nat Hum Behav. 2019;3(10):1124. doi: 10.1038/s41562-019- 0756-6. 
79.Dick AS, Garcia NL, Pruden SM, Thompson WK, Hawes SW, Sutherland MT, et al. Author Correction: No evidence for a bilingual executive function advantage in the nationally representative ABCD study. Nat Hum Behav. 2019;3(9):999. doi: 10.1038/s41562-019-0709-0. 
80.Michelini G, Barch DM, Tian Y, Watson D, Klein DN, Kotov R. Delineating and validating higher-order dimensions of psychopathology in the Adolescent Brain Cognitive Development (ABCD) study. Transl Psychiatry. 2019;9(1):261. doi: 10.1038/s41398-019-0593-4. 
81.Gray JC, Schvey NA, Tanofsky-Kraff M. Demographic, psychological, behavioral, and cognitive correlates of BMI in youth: findings from the Adolescent Brain Cognitive Development (ABCD) study. Psychol Med. 2020;50(9):1539- 47. doi: 10.1017/s0033291719001545. 
82.Beauchaine TP. Family history of depression and child striatal volumes in the ABCD study: promise and perils of neuroimaging research with large samples. J Am Acad Child Adolesc Psychiatry. 2020;59(10):1133-4. doi: 10.1016/j. jaac.2020.01.002. 
83.Buscemi S, Corleo D, Vasto S, Buscemi C, Massenti MF, Nuzzo D, et al. Factors associated with circulating concentrations of irisin in the general population cohort of the ABCD study. Int J Obes (Lond). 2018;42(3):398-404. doi: 10.1038/ijo.2017.255. 
84.Exupério IN, Agostinete RR, Werneck AO, Maillane-Vanegas S, Luiz-de-Marco R, Mesquita EDL, et al. Impact of artistic gymnastics on bone formation marker, density and geometry in female adolescents: ABCD-growth study. J Bone Metab. 2019;26(2):75-82. doi: 10.11005/jbm.2019.26.2.75. 
85.Lynch KR, Anokye NK, Vlachopoulos D, Barbieri FA, Turi- Lynch BC, Codogno JS, et al. Impact of sports participation on incidence of bone traumatic fractures and health-care costs among adolescents: ABCD-growth study. Phys Sportsmed. 2020;48(3):298-303. doi: 10.1080/00913847.2019.1685859. 
86.Dick AS, Garcia NL, Pruden SM, Thompson WK, Hawes SW, Sutherland MT, et al. No evidence for a bilingual executive function advantage in the nationally representative ABCD study. Nat Hum Behav. 2019;3(7):692-701. doi: 10.1038/ s41562-019-0609-3. 
87.Hoffman EA, Howlett KD, Breslin F, Dowling GJ. Outreach and innovation: communication strategies for the ABCD study. Dev Cogn Neurosci. 2018;32:138-42. doi: 10.1016/j. dcn.2018.04.001. 
88.Garavan H, Bartsch H, Conway K, Decastro A, Goldstein RZ, Heeringa S, et al. Recruiting the ABCD sample: design considerations and procedures. Dev Cogn Neurosci. 2018;32:16-22. doi: 10.1016/j.dcn.2018.04.004. 
89.Lynam DR, Smith GT, Whiteside SP, Cyders MA. The UPPS-P: Assessing Five Personality Pathways to Impulsive Behavior. West Lafayette, IN: Purdue University; 2006. 
90.Gur RE, Gur RC. Sex differences in brain and behavior in adolescence: findings from the Philadelphia Neurodevelopmental Cohort. Neurosci Biobehav Rev. 2016;70:159-70. doi: 10.1016/j.neubiorev.2016.07.035.
91.Fagot BI. Parenting boys and girls. In: Bornstein MH, ed. Handbook of Parenting. Vol 1. Children and Parenting. Lawrence Erlbaum Associates, Inc; 1995. p. 163-83. 
92.Carlo G, Raffaelli M, Laible DJ, Meyer KA. Why are girls less physically aggressive than boys? personality and parenting mediators of physical aggression. Sex Roles. 1999;40(9):711- 29. doi: 10.1023/A:1018856601513. 
93.Khooshabi K, Ameneh-Forouzan S, Ghassabian A, Assari S. Is there a gender difference in associates of adolescents’ lifetime illicit drug use in Tehran, Iran? Arch Med Sci. 2010;6(3):399- 406. doi: 10.5114/aoms.2010.14263. 
94.Frost L. Doing bodies differently? gender, youth, appearance and damage. J Youth Stud. 2003;6(1):53-70. doi: 10.1080/1367626032000068163. 
95.Matud MP. Gender differences in stress and coping styles. Pers Individ Dif. 2004;37(7):1401-15. doi: 10.1016/j. paid.2004.01.010. 
96.Gagné T, Veenstra G. Inequalities in hypertension and diabetes in Canada: intersections between racial identity, gender, and income. Ethn Dis. 2017;27(4):371-8. doi: 10.18865/ ed.27.4.371. 
97.McDonough P, Williams DR, House JS, Duncan GJ. Gender and the socioeconomic gradient in mortality. J Health Soc Behav. 1999;40(1):17-31. 
98.Hammarström A. Health consequences of youth unemployment--review from a gender perspective. Soc Sci Med. 1994;38(5):699-709. doi: 10.1016/0277- 9536(94)90460-x. 
99.Waldron I. Effects of labor force participation on sex differences in mortality and morbidity. In: Frankenhaeuser M, Lundberg U, Chesney M, eds. Women, Work, and Health. Boston, MA: Springer; 1991. p. 17-38. doi: 10.1007/978-1-4615-3712-0_2. 
100.Garcy AM, Vågerö D. The length of unemployment predicts mortality, differently in men and women, and by cause of death: a six year mortality follow-up of the Swedish 1992-1996 recession. Soc Sci Med. 2012;74(12):1911-20. doi: 10.1016/j. socscimed.2012.01.034. 
101.Assari S. Life expectancy gain due to employment status depends on race, gender, education, and their intersections. J Racial Ethn Health Disparities. 2018;5(2):375-86. doi: 10.1007/s40615-017-0381-x. 
102.Bowden M, Bartkowski J, Xu X, Lewis R Jr. Parental occupation and the gender math gap: examining the social reproduction of academic advantage among elementary and middle school students. Soc Sci. 2017;7(1):6. doi: 10.3390/socsci7010006. 
103.Chetty R, Hendren N, Kline P, Saez E. Where is the land of opportunity? the geography of intergenerational mobility in the United States. Q J Econ. 2014;129(4):1553-623. doi: 10.1093/ qje/qju022.