Document Type : Original Article

Author

Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

Abstract

Background and aims: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups such as Blacks and Latinos than non-Latino Whites, which is due to racism and social stratification. In this study, we investigated the association between parental education and children’s sleep problems, as a proxy of sleep problems, by race.
 
Methods: This cross-sectional study included 11718 American children aged 9-10. All participants were recruited to the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education, a five-level nominal variable. The dependent variable – sleep problems, was a continuous variable. Race/ethnicity was the effect modifier. Age, sex, and marital status were the covariates. Mixed-effects regression models were used for data analysis.
 
Results: Parental education was associated with children’s sleep problems. However, there was a weaker inverse association seen in non-Latino Black and Latino families compared to non-Latino White families. This was documented by a significant statistical interaction between race and ethnicity and parental education on children’s sleep problems.
 
Conclusion: Diminished protective effect of parental education on children’s sleep problems for non- Latino Black and Latino families compared to non-Latino White families is similar to the MDRs in other domains. Worse than expected sleep may contribute to higher-than-expected health risks of middle-class Black and Latino children.

Keywords

Main Subjects

1.Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80-94. 
2.Mirowsky J, Ross CE. Education, health, and the default American lifestyle. J Health Soc Behav. 2015;56(3):297-306. doi: 10.1177/0022146515594814. 
3.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. 
4.Ross CE, Mirowsky J. Refining the association between education and health: the effects of quantity, credential, and selectivity. Demography. 1999;36(4):445-60. 
5.Williams DR, Mohammed SA, Leavell J, Collins C. Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities. Ann N Y Acad Sci. 2010;1186:69-101. doi: 10.1111/j.1749-6632.2009.05339.x. 
6.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. 
7.Chen R, Kessler RC, Sadikova E, NeMoyer A, Sampson NA, Alvarez K, et al. Racial and ethnic differences in individual-level and area-based socioeconomic status and 12-month DSM-IV mental disorders. J Psychiatr Res. 2019;119:48-59. doi: 10.1016/j.jpsychires.2019.09.006. 
8.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. 
9.Braveman PA, Cubbin C, Egerter S, Williams DR, Pamuk E. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health. 2010;100(Suppl 1):S186-96. doi: 10.2105/ajph.2009.166082. 
10.Williams DR, Priest N, Anderson NB. Understanding associations among race, socioeconomic status, and health: Patterns and prospects. Health Psychol. 2016;35(4):407-11. doi: 10.1037/hea0000242. 
11.Assari S. Distal, intermediate, and proximal mediators of racial disparities in renal disease mortality in the United States. J Nephropathol. 2016;5(1):51-9. doi: 10.15171/jnp.2016.09. 
12.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. 
13.Assari S, Mardani A, Maleki M, Boyce S, Bazargan M. Black- White Achievement Gap: Role of Race, School Urbanity, and Parental Education. Pediatric Health Med Ther. 2021 Jan 6;12:1-11. doi: 10.2147/PHMT.S238877. 
14.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. 
15.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. 
16.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. 
17.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. 
18.Assari S, Bazargan M. Being married increases life expectancy of White but not Black Americans. J Family Reprod Health. 2019;13(3):132-40. doi: 10.18502/jfrh.v13i3.2126. 
19.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. 
20.Assari S. Understanding America: unequal economic returns of years of schooling in Whites and Blacks. World J Educ Res. 2020;7(2):78-92. doi: 10.22158/wjer.v7n2p78. 
21.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. 
22.Assari S, Boyce S, Bazargan M, Caldwell CH. Mathematical performance of american youth: diminished returns of educational attainment of Asian-American parents. Educ Sci (Basel). 2020;10(2):32. 
23.Assari S, Bazargan M. Protective effects of educational attainment against cigarette smoking; diminished returns of American Indians and Alaska natives in the National Health Interview Survey. Int J Travel Med Glob Health. 2019;7(3):105- 10. doi: 10.15171/ijtmgh.2019.22. 
24.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. 
25.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. 
26.Assari S, Caldwell CH. Family income at birth and risk of attention deficit hyperactivity disorder at age 15: racial differences. Children (Basel). 2019;6(1):10. doi: 10.3390/ children6010010. 
27.Assari S, Boyce S, Bazargan M, Caldwell CH, Mincy R. Maternal education at birth and youth breakfast consumption at age 15: Blacks’ diminished returns. J (Basel). 2020;3(3):313- 23. doi: 10.3390/j3030024. 
28.Assari S. Educational attainment and exercise frequency in American women; Blacks’ diminished returns. Womens Health Bull. 2019;6(3):e87413. doi: 10.5812/whb.87413. 
29.Assari S, Boyce S, Bazargan M, Mincy R, Caldwell CH. Unequal protective effects of parental educational attainment on the body mass index of Black and White youth. Int J Environ Res Public Health. 2019;16(19):3641. doi: 10.3390/ ijerph16193641. 
30.Assari S, Nikahd A, Malekahmadi MR, Moghani Lankarani M, Zamanian H. Race by gender group differences in the protective effects of socioeconomic factors against sustained health problems across five domains. J Racial Ethn Health Disparities. 2017;4(5):884-94. doi: 10.1007/s40615-016- 0291-3. 
31. NIH’s Adolescent Brain Cognitive Development (ABCD) study. Alcohol Res. 2018;39(1):97. 
32. 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. 
33. 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. 
34. 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. 
35. 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. 
36. 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. 
37. 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. 
38. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251-61. doi: 10.1111/j.1365- 2869.1996.00251.x. 
39. Assari S, Boyce S, Bazargan M, Caldwell CH. African Americans’ diminished returns of parental education on adolescents’ depression and suicide in the Adolescent Brain Cognitive Development (ABCD) study. Eur J Investig Health Psychol Educ. 2020;10(2):656-68. doi: 10.3390/ ejihpe10020048. 
40. Assari S, Boyce S, Akhlaghipour G, Bazargan M, Caldwell CH. Reward responsiveness in the Adolescent Brain Cognitive Development (ABCD) study: African Americans’ diminished returns of parental education. Brain Sci. 2020;10(6). doi: 10.3390/brainsci10060391. 
41. Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. African American children’s diminished returns of subjective family socioeconomic status on fun seeking. Children (Basel). 2020;7(7):75. doi: 10.3390/children7070075. 
42. Assari S. Youth social, emotional, and behavioral problems in the ABCD study: minorities’ diminished returns of family income. J Econ Public Financ. 2020;6(4):1-19. doi: 10.22158/ jepf.v6n4p1. 
43. Assari S, Boyce S, Caldwell CH, Bazargan M. Minorities’ diminished returns of parental educational attainment on adolescents’ social, emotional, and behavioral problems. Children (Basel). 2020;7(5):49. doi: 10.3390/children7050049. 
44. Assari S, Boyce S, Bazargan M. Subjective socioeconomic status and children’s amygdala volume: minorities’ diminish returns. NeuroSci. 2020;1(2):59-74. doi: 10.3390/ neurosci1020006. 
45. Assari S, Boyce S, Saqib M, Bazargan M, Caldwell CH. Parental Education and Left Lateral Orbitofrontal Cortical Activity during N-Back Task: An fMRI Study of American Adolescents. Brain Sci. 2021 Mar 22;11(3):401. doi: 10.3390/ brainsci11030401. 
46. Assari S, Boyce S, Bazargan M. Subjective family socioeconomic status and adolescents’ attention: Blacks’ diminished returns. Children (Basel). 2020;7(8):80. doi: 10.3390/children7080080. 
47. Assari S. Education attainment and obesity: differential returns based on sexual orientation. Behav Sci (Basel). 2019;9(2):16. doi: 10.3390/bs9020016. 
48. 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. 
49. Assari S. Family income reduces risk of obesity for White but not Black children. Children (Basel). 2018;5(6):73. doi: 10.3390/children5060073. 
50. Hudson DL, Bullard KM, Neighbors HW, Geronimus AT, Yang J, Jackson JS. Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men? J Mens Health. 2012;9(2):127- 36. doi: 10.1016/j.jomh.2012.03.006. 
51. Hudson DL, Puterman E, Bibbins-Domingo K, Matthews KA, Adler NE. Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health. Soc Sci Med. 2013;97:7-14. doi: 10.1016/j. socscimed.2013.07.031. 
52. Hudson DL, Neighbors HW, Geronimus AT, Jackson JS. Racial discrimination, John Henryism, and depression among African Americans. J Black Psychol. 2016;42(3):221-43. doi: 10.1177/0095798414567757. 
53. 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. 
54. Assari S. Socioeconomic determinants of systolic blood pressure; minorities’ diminished returns. J Health Econ Dev. 2019;1(1):1-11. 
55. 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. 
56. Assari S, Moghani Lankarani M. Education and alcohol consumption among older Americans; Black-White differences. Front Public Health. 2016;4:67. doi: 10.3389/ fpubh.2016.00067. 
57. Assari S, Bazargan M. Unequal associations between educational attainment and occupational stress across racial and ethnic groups. Int J Environ Res Public Health. 2019;16(19):3539. doi: 10.3390/ijerph16193539. 
58. Assari S. Race, intergenerational social mobility and stressful life events. Behav Sci (Basel). 2018;8(10):86. doi: 10.3390/ bs8100086. 
59. Assari S. Family socioeconomic status and exposure to childhood trauma: racial differences. Children (Basel). 2020;7(6):57. doi: 10.3390/children7060057. 
60. Assari S. Parental education and spanking of American children: Blacks’ diminished returns. World J Educ Res. 2020;7(3):19-44. doi: 10.22158/wjer.v7n3p19. 
61. 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. 
62. Assari S. College graduation and wealth accumulation: Blacks’ diminished returns. World J Educ Res. 2020;7(3):1-18. doi: 10.22158/wjer.v7n3p1. 
63. Akin JS, Garfinkel I. Economic Returns to Education Quality: An Empirical Analysis for Whites, Blacks, Poor Whites, and Poor Blacks. Madison: Institute for Research on Poverty, University of Wisconsin-Madison; 1974. 
64. Bartik TJ, Hershbein BJ. Degrees of Poverty: The Relationship Between Family Income Background and the Returns to Education. Kalamazoo, MI: W.E. Upjohn Institute for Employment Research; 2018. doi: 10.17848/wp18-284. 
65. Bowden M, Bartkowski JP, 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. 
66. 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. 
67. 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. 
68. Assari S, Moghani Lankarani M, Caldwell CH. Does Discrimination explain high risk of depression among high-income African American men? Behav Sci (Basel). 2018;8(4):40. doi: 10.3390/bs8040040. 
69. Assari S, Preiser B, Lankarani MM, Caldwell CH. Subjective socioeconomic status moderates the association between discrimination and depression in African American youth. Brain Sci. 2018;8(4):71. doi: 10.3390/brainsci8040071. 
70. 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. 
71. Hudson DL, Neighbors HW, Geronimus AT, Jackson JS. The relationship between socioeconomic position and depression among a US nationally representative sample of African Americans. Soc Psychiatry Psychiatr Epidemiol. 2012;47(3):373-81. doi: 10.1007/s00127-011-0348-x. 
72. Hudson D, Sacks T, Irani K, Asher A. The price of the ticket: health costs of upward mobility among African Americans. Int J Environ Res Public Health. 2020;17(4):1179. doi: 10.3390/ ijerph17041179. 
73. Graven S. Sleep and brain development. Clin Perinatol. 2006;33(3):693-706. doi: 10.1016/j.clp.2006.06.009. 
74. Assari S. Parental education on youth inhibitory control in the Adolescent Brain Cognitive Development (ABCD) study: Blacks’ diminished returns. Brain Sci. 2020;10(5):312. doi: 10.3390/brainsci10050312. 
75. Assari S, Bazargan M, Chalian M. The unequal effect of income on risk of overweight/obesity of Whites and Blacks with knee osteoarthritis: the osteoarthritis initiative. J Racial Ethn Health Disparities. 2020;7(4):776-84. doi: 10.1007/s40615-020- 00719-5. 
76. 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. 
77. Farmer MM, Ferraro KF. Are racial disparities in health conditional on socioeconomic status? Soc Sci Med. 2005;60(1):191-204. doi: 10.1016/j.socscimed.2004.04.026. 
78. Sherman-Wilkins KJ, Thierry AD. Education as the great equalizer? racial and ethnic differences in the effect of education on cognitive impairment in later life. Geriatrics (Basel). 2019;4(3):51. doi: 10.3390/geriatrics4030051. 
79. Colen CG, Ramey DM, Cooksey EC, Williams DR. Racial disparities in health among nonpoor African Americans and Hispanics: the role of acute and chronic discrimination. Soc Sci Med. 2018;199:167-80. doi: 10.1016/j. socscimed.2017.04.051.