Elsevier

Social Science & Medicine

Volume 148, January 2016, Pages 79-92
Social Science & Medicine

A discrete-time analysis of the effects of more prolonged exposure to neighborhood poverty on the risk of smoking initiation by age 25

https://doi.org/10.1016/j.socscimed.2015.11.027Get rights and content

Highlights

  • Examines neighborhood poverty exposure duration and age at smoking onset by race.

  • Neighborhood selection bias addressed using inverse-probability-of-treatment weights.

  • Nonwhites more likely to experience persistent neighborhood poverty than whites.

  • Prolonged neighborhood poverty linked to smoking onset among whites, not nonwhites.

  • Neighborhoods matter, but differentially by exposure duration and race.

Abstract

Evidence suggests that individuals who initiate smoking at younger ages are at increased risk for future tobacco dependence and continued use as well as for numerous smoking-attributable health problems. Identifying individual, household, and to a far lesser extent, contextual factors that predict early cigarette use has garnered considerable attention over the last several decades. However, the majority of scholarship in this area has been cross-sectional or conducted over relatively short windows of observation. Few studies have investigated the effects of more prolonged exposure to smoking-related risk factors, particularly neighborhood characteristics, from childhood through early adulthood. Using the 1970–2011 waves of the Panel Study of Income Dynamics merged with census data on respondents' neighborhoods, this study estimates a series of race-specific discrete-time marginal structural logit models for the risk of smoking initiation as a function of neighborhood poverty, as well as individual and household characteristics, from ages four through 25. Neighborhood selection bias is addressed using inverse-probability-of-treatment weights. Results indicate that more prolonged exposure to high (>20%) as opposed to low (<10%) poverty neighborhoods is associated with an increased risk of smoking onset by age 25, although consistent with prior literature, this effect is only evident among white and not nonwhite youth and young adults.

Section snippets

Theoretical background

Research examining the health effects of neighborhood characteristics, particularly concentrated poverty and other forms of socioeconomic disadvantage, has surged in recent decades. Numerous studies have linked adverse residential conditions to premature death (Doubeni et al., 2012), poor self-rated health (Tomey et al., 2013, Yen and Kaplan, 1999), depression and other mental health problems (Ahern and Galea, 2011, Beard et al., 2009, Cutrona et al., 2006, Gapen et al., 2011), health-risk

Data and methods

Data for this study are drawn from the 1970 to 2011 waves of the Panel Study of Income Dynamics (PSID), produced and distributed by the University of Michigan's Institute for Social Research and funded by the National Institutes of Health and the National Science Foundation. The PSID is a large, longitudinal survey of US residents and their families conducted annually between 1968 and 1997 and every two years thereafter. The PSID has several strengths that make it particularly well-suited to

Sample characteristics

Table 1, Table 2 display descriptive statistics for the time-invariant and time-varying sample characteristics, respectively, among nonwhite and white respondents. As shown, there are considerable racial differences across most variables of interest. For example, nonwhite respondents – approximately 95 percent of whom are African American – are over six times as likely to be born to an unmarried mother, more than twice as likely to be low birthweight, and about three times as likely at age four

Discussion and conclusions

This study examined the effects of more prolonged exposure to neighborhoods characterized by varying levels of poverty on the risk of smoking initiation by age 25 utilizing the 1970 to 2011 waves of the PSID merged with census data on respondents' neighborhoods. Two primary conclusions emerge from this investigation. First, the overall risk of early smoking initiation is lower among nonwhite compared to white youth and young adults despite higher rates of exposure to adverse socioeconomic

Acknowledgments

This research was supported in part by a Shanahan Endowment Fellowship and a Eunice Kennedy Shriver National Institute of Child Health and Human Development training grant, T32 HD007543, to the Center for Studies in Demography and Ecology at the University of Washington. The data used in this study was collected with the support of the National Institutes of Health under grant number R01 HD069609 and the National Science Foundation under award number 1157698. The funders had no role in study

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