Caribbean blacks have lower prevalence of smoking compared to African Americans. However, the protective effect of being foreign born is short-lived as there is a positive relationship between smoking behavior and length of stay in the U.S. Using a nationally representative dataset, the goal of this research proposal is to further identify associations between migration and smoking behaviors and then assess the extent to which stress influences smoking behaviors among Caribbean Black adults in the United States.
The specific aims of this application are: 1) to investigate the relationships between migration status and history, and smoking behaviors among Caribbean Blacks;2) to evaluate the extent to which chronic stress, specifically financial and social stress, influences the associations between migration and smoking among Caribbean Blacks;and 3) to assess the extent to which ethnicity moderates the relationship between social stress and smoking among sub-groups of Blacks (Caribbean Blacks and African Americans). The proposed dissertation embodies NIH's mission of promoting research activities that """"""""extend healthy life and reduces the burdens of illness"""""""", and aligns with NCI's goal """"""""to accelerate progress in cancer prevention"""""""" and """"""""to preempt cancer at every opportunity."""""""" Investigating the social and financial factors that contribute to smoking at different stages of migration status can increase our understanding of the relationships between stress and smoking. Findings from this application can inform public health initiatives and shape tailored smoking cessation interventions. Additionally, findings from theorized differential relationships between perceived discrimination and smoking behaviors of Caribbean compared to African Americans can help guide future research and public health policies. This application will utilize cross-sectional data from the National Survey of American Life (NSAL). NSAL is a large scale study that examines the effects of social, structural, political and economic determinants of health of sub-groups of Blacks. Inverse probability statistical weights that address the multi-stage sampling design and over-sampling of minority racial and ethnic groups will be used in developing ordinary linear regression and logistic regression models. Finally, as smoking is the leading cause of cancer, findings from these analyses can inform future research on the high rates of cancer-related deaths among Blacks

Public Health Relevance

Through my doctoral studies in the Society, Human Development and Health Department at the Harvard School of Public Health, I have been exposed to numerous research topics and given an analytic """"""""toolset"""""""" to address health problems. This exposure has helped me refine my research interests, shape my career goals and form the development of this doctoral dissertation. My career goals are threefold. First, by conducting socially responsible and methodologically sound research, I seek to understand social experiences as determinants of the high cancer prevalence and mortality rates among minority and marginalized populations. Second, through clear, comprehensive and concise communication, I endeavor to increase the application of my research findings among the aforementioned communities. Third, I aspire to be a teacher to future generations of researchers. Several personal motivations and experiences underlie my career goals. My deep desire to understand the multidimensional social experiences of Black immigrants has been greatly shaped by the experiences of my family and me as immigrants to the U.S., 14 years ago. Furthermore, as a Black, female, immigrant, I have been exposed to differential treatment in various U.S. institutions, including education and healthcare, which have made me aware of my social status as a """"""""triple minority"""""""".

National Institute of Health (NIH)
National Cancer Institute (NCI)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1-RPHB-K (29))
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Bini, Alessandra M
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Harvard University
Social Sciences
Schools of Public Health
United States
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