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What drives us apart?: Decomposing intersectional inequalities in cigarette smoking by education and sexual orientation among U.S. adults
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
2019 (Engelska)Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 18, artikel-id 109Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Socio-economic and sexual orientation inequalities in cigarette smoking are well-documented; however, there is a lack of research examining the social processes driving these complex inequalities. Using an intersectional framework, the current study examines key processes contributing to inequalities in smoking between four intersectional groups by education and sexual orientation.

Methods: The sample (28,362 adults) was obtained from Wave 2 (2014–2015) of the Population Assessment of Tobacco and Health (PATH) Study. Four intersectional positions were created by education (high- and low-education) and sexual orientation (heterosexual or lesbian, gay, bisexual, or queer/questioning (LGBQ). The joint inequality, the referent socio-economic inequality, and the referent sexual orientation inequality in smoking were decomposed by demographic, material, tobacco marketing-related, and psychosocial factors using non-linear Oaxaca decomposition.

Results: Material conditions made the largest contribution to the joint inequality (9.8 percentage points (p.p.), 140.9%), referent socio-economic inequality (10.01 p.p., 128.4%), and referent sexual orientation inequality (4.91 p.p., 59.8%), driven by annual household income. Psychosocial factors made the second largest contributions to the joint inequality (2.12 p.p., 30.3%), referent socio-economic inequality (2.23 p.p., 28.9%), and referent sexual orientation inequality (1.68 p.p., 20.5%). Referent sexual orientation inequality was also explained by marital status (20.3%) and targeted tobacco marketing (11.3%).

Conclusion: The study highlights the pervasive role of material conditions in inequalities in cigarette smoking across multiple dimensions of advantage and disadvantage. This points to the importance of addressing material disadvantage to reduce combined socioeconomic and sexual orientation inequalities in cigarette smoking.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2019. Vol. 18, artikel-id 109
Nyckelord [en]
Sexual and Gender minorities, Education, Cigarette smoking, Intersectionality, Health inequality, Blinder-Oaxaca decomposition
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-161895DOI: 10.1186/s12939-019-1015-1ISI: 000475907200001PubMedID: 31315627OAI: oai:DiVA.org:umu-161895DiVA, id: diva2:1341342
Tillgänglig från: 2019-08-08 Skapad: 2019-08-08 Senast uppdaterad: 2019-08-08Bibliografiskt granskad

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Gustafsson, Per E.

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Amroussia, NadaGustafsson, Per E.
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International Journal for Equity in Health
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

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