ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2024
The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The association between macro-level structural discrimination and alcohol outcomes: A systematic review.Social science & medicine (1982) · 2025Pooled it
- The Role of Physical Activity on Quality of Life Among Breast Cancer Survivors in the Black Women's Health Study.Journal of racial and ethnic health disparities · 2026Article
- Structural stressors, neurocognition in reward-related decision making and substance use risk in Puerto Rican early adolescents at two sites: study design.Frontiers in public health · 2026Observational
- Residential segregation, housing cost, and smoking behaviors in Black Americans.Social science & medicine (1982) · 2025Article
- Electronic and Conventional Cigarette Use and Academic Achievement Among Predominantly Low-Income Black High School Students.Children (Basel, Switzerland) · 2025Article
- Examining the Relationship Between Racial, Ethnic, and Economic Residential Segregation and Cigarette Smoking Among a Nationally Representative Sample of Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Social Risks and Nonadherence to Recommended Cancer Screening Among US Adults.JAMA network open · 2025Article
- Area-Level Social Determinants of Alcohol-Related Mortality: Knowledge Gaps and Implications for Community Health.Alcohol research : current reviews · 2024Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundStructural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans.
methodsAn existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates.
resultsResults indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status.
conclusionsResults suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans. IMPACT: Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.
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