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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Keiichi Hayashi, MD, MPH, MSc, Department of Health and Social Behavior, Harvard University, 677 Hungtington Av., Boston, MA 02115, 617-536-4980, khayashi@hsph.harvard.edu
Social determinants of when young people try cigarette smoking for the first time were analyzed by discrete-time multilevel hazard analysis. Data from the National Longitudinal Survey of Youth were analyzed. The dependent variable is whether or not he or she tried to smoke cigarette and if yes, when was that. The independent variable of interest is state-level income inequality measured by Gini coefficient at household level. I employed a multilevel analysis that controls for both individual factors and state-level covariates simultaneously. Females are at lower hazard rate ratio (0.80 95%CI 0.77-0.84). Hispanics and Blacks are both at lower hazard rate ratio of 0.68 (95%CI 0.64-.72) and 0.71 (95%CI 0.67-0.74) respectively. Income has marginal effect compared to years of schooling completed. After controlling for individual major determinants, state-level income inequality does not seem significant. However, after 18 years old, those in high Gini states are 1.44 times higher at risk compared to those in middle Gini states holding other factors constant, even though before age 16 there is no significant effect of state-level income inequality. These results are consistent with my previous work (submitted to socialist caucus), which showed state-level income inequality is a moderate determinant of adult smoking initiation after controlling for major individual factors. The results back up the hypothesis that income inequality harms individual health partly via health behavior through psychosocial pathway.
Learning Objectives:
Keywords: Tobacco, Adolescents
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.