About

Craig S. Fryer is an Associate Professor in the Department of Behavioral and Community Health at the University of Maryland School of Public Health. His research utilizes mixed methods study designs to examine the sociocultural and environmental contexts of health and well-being, with a particular emphasis on community-engaged research. His work focuses on addressing racial and ethnic health inequities, especially in relation to substance use among youth and young adult populations, including tobacco and marijuana use. Dr. Fryer's collateral research expertise includes Black men’s health, racism and health, and the respectful engagement of underrepresented communities in research. He has been recognized for his contributions through awards such as the George F. Kramer Practitioner of the Year Award from the School of Public Health and the Elevate Program fellowship for teaching and learning transformation. His academic background includes a DrPH in Sociomedical Sciences from Columbia University, an MPH in Behavioral and Community Health Sciences from the University of Pittsburgh, and a BS in Clinical Nutrition from Case Western Reserve University. His research and scholarly activities aim to inform health equity and improve health outcomes among marginalized populations.

Research topics

• Medicine
• Psychology
• Social psychology
• Sociology
• Environmental health
• Marketing
• Clinical psychology
• Surgery
• Business
• Internal medicine
• Advertising
• Gender studies
• Nursing

Selected publications

• Exploring Non-Cigarette Tobacco Product Use Experience Among Foreign-Born Koreans in District of Columbia, Maryland, and Virginia

  Substance Use & Misuse · 2026-01-23

  articleSenior author

  BACKGROUND: Non-cigarette tobacco product use behavior among foreign-born Koreans in the U.S. remains understudied and is poorly captured in most national surveys. OBJECTIVES: This study explored the non-cigarette tobacco product use patterns, acculturation influences, and associated factors among foreign-born Korean young adults (aged 18-39 years) in the District of Columbia, Maryland, and Virginia. METHODS: Twenty-one participants (aged 18-39 years) in the District of Columbia, Maryland, and Virginia who currently or formerly used any non-cigarette tobacco products completed a 60-minute semi-structured in-depth interview. Individual interviews were transcribed verbatim, coded, and analyzed thematically. RESULTS: Electronic nicotine delivery system (ENDS), hookah, and IQOS were the most commonly used non-cigarette tobacco products. Participants demonstrated ambivalence toward ENDS and hookah, frequently perceiving these as less harmful than traditional cigarettes. Peer influence served as the primary driver of smoking initiation. Participants' behaviors reflected influences from both Korean and American smoking cultures, with varying impacts based on acculturation levels. Price significantly influenced purchasing decisions, with increased consumption during sales promotions and coupons availability. CONCLUSION: These findings provide meaningful insights into non-cigarette tobacco use patterns and influencing factors among foreign-born Koreans in the United States. As multiple cultural, social, and economic factors shape tobacco use in this population, culturally-tailored research and prevention interventions are needed to address established and emerging risks associated with non-cigarette tobacco products.

  PublisherDOI

• Neighborhood socioeconomic status and short-term postoperative complications following metabolic and bariatric surgery

  The American Journal of Surgery · 2026-03-25

  article
  PublisherDOI

• News coverage of the proposed menthol cigarette ban in the United States (2022–2024): a content analysis

  Nicotine & Tobacco Research · 2026-02-17

  article

  Abstract Introduction In April 2022, the US Food and Drug Administration announced a proposed ban on menthol cigarettes, a historic policy to improve public health. This study aimed to identify arguments used to position the ban in relevant news sources to determine how messages were framed and inform future educational and policy efforts. Methods Online news databases were searched for articles about the ban published between April 2022 and April 2024 in the top 25 circulating newspapers in the United State, one online-only news source (CNN), three national news wires (AP, Reuters, UPI), and one press release wire. Unique articles (n = 122) were coded for pro- and anti-ban arguments and their sources. Results Supporting arguments referred to public health benefits (75% of all articles), health equity issues (66%), and targeted marketing of tobacco products in Black communities (61%). Most articles also noted youth prevalence (65%) and that menthol qualities facilitate use (57%). Fewer articles (34%) mentioned that ban enforcement would not be against individuals. Anti-ban arguments related to concerns about increased criminalization in Black communities (54%), and 20% referred to the ban as discriminatory. Arguments on both sides were attributed to Black organizations, leaders, and advocates (pro-48%; anti-26%). Conclusions This study identified gaps in news coverage related to the ban’s rationale, enforcement plans, and industry-funding of anti-ban advocacy efforts, finding that coverage often framed the ban as a debated issue, particularly with implications for Black individuals and communities. Messaging on these topics may build public and political support for menthol cigarette policies. Implications Our findings suggest that message amplification about the rationale for menthol cigarette policies, enforcement plans, and tobacco company involvement in shaping the anti-ban narrative may be beneficial in any potential future messaging around menthol cigarette policies, along with anticipating and acknowledging concerns about criminalization in Black communities. Further, there is an opportunity to highlight public support for policies that reduce menthol cigarette use. Examining how tobacco control policy debates unfold in the media can help inform future actions to educate constituents and lawmakers about these policies.

  PublisherDOI

• Neighborhood Socioeconomic Status and Healthcare Quality Measures Following Bariatric Surgery in Maryland

  medRxiv · 2025-09-22

  preprintOpen access

  Abstract Introduction Bariatric surgery is the most effective treatment for severe obesity, yet significant socioeconomic disparities in access and outcomes persist, especially in disadvantaged communities. Neighborhood socioeconomic status (nSES) influences healthcare utilization, complication rates, and recovery, but its impact within state-specific reimbursement models remains understudied. Objective This study examines whether nSES, measured by the Distressed Communities Index (DCI), is independently associated with prolonged hospital stays and higher readmission rates after bariatric surgery. It also evaluates the interaction between race/ethnicity and nSES, to assess disparities in post-surgical outcomes. Methodology A retrospective cohort study was conducted using Maryland State Inpatient Databases (SID) from 2018 to 2020. The study population included all adult patients who underwent bariatric surgery, identified using ICD-10 procedure codes. The primary explanatory variable was nSES, operationalized using DCI quintiles, linked to patient ZIP codes. The primary outcomes were hospital length of stay (continuous variable) and readmission (binary variable: Yes/No). Multivariate linear regression (for hospital stay) and logistic regression (for readmission) were performed, adjusting for demographic factors (age, sex, race/ethnicity), clinical characteristics (preexisting comorbidities using the Charlson Comorbidity Index (CCI) and, obesity class), and socioeconomic indicators (insurance type) and Geographic classification. Interaction terms were included to evaluate whether race/ethnicity modified the association between nSES and these outcomes. Result Among 10,784 bariatric surgery recipients, the majority were Black (48.3%), female (83.1%), with a mean age of 44.1 ± 11.6 years. Length of stay did not differ significantly by DCI Quintiles; patients in distressed areas had similar odds of prolonged hospitalization compared to those in prosperous areas (β = 0.045; 95% CI: –0.111 to 0.201; p = 0.575). Readmission risk was higher in distressed neighborhoods (OR = 1.64; 95% CI: 0.76–3.54; p = 0.207), though not statistically significant. No interaction was observed between nSES and race/ethnicity. Conclusion Residents of disadvantaged neighborhoods showed a non-significant trend toward higher readmission without increased hospital stay. Findings underscore the need to enhance post-discharge care for socioeconomically vulnerable populations.

  PublisherOA PDFDOI

• Bridging the gap: Understanding Latino willingness to participate in public health and clinical trials research across diverse subgroups

  Contemporary Clinical Trials Communications · 2025-02-03 · 5 citations

  articleOpen access

  Background: Latino sub-groups remains limited. The purpose of this study was to investigate how knowledge, awareness and willingness to participate in research differs between US- born and immigrant Latinos. Methods: We conducted a population-based household telephone survey with Latino adults (N = 1264), with 68 % Mexican/Mexican American, 11 % Central/South American, 8 % Puerto Rican and the remaining 13 % self-identified as "Other". The "Building Trust Survey," included valid standardized instruments designed to assess knowledge of research, human subjects' protections, previous participation in research, immigrant status (nativity), length of time in the US, and country of origin. Results: The study found that Latinos who immigrated to the US as teens or young adults were more willing to participate in medical research than those born in the US. Willingness to "take" something in a study varied by Latino subgroup, immigration age, gender, and age. Analysis highlighted that Mexican/Mexican Americans (76 %) and Central/South Americans (74 %) indicated a willingness to participate in research but also were less likely to have been "Asked" to participate in research (9 % and 6 % respectively) compared to the other subgroups (p < .05). Conclusions: Insights from this study will inform the development of culturally tailored interventions aimed at successfully recruiting and retaining Latino populations in public health and clinical trials research, thereby contributing to more equitable and representative health outcomes.

  PublisherDOI

• Unpacking the complexities in racial and ethnic discrimination and tobacco use and cannabis co-use behaviors among young adults in the U.S.

  Addictive Behaviors Reports · 2025-02-28 · 2 citations

  articleOpen access

  • 16.3% of young adults (YA) used little cigars and cigarillos (LCCs). • YA exposed to recent LCC marketing had 2.36 times the odds using LCCs as blunts. • Racial and ethnic discrimination (RED) was associated with greater odds of LCC use. • Non-Hispanic Black YA who used problem-focused coping had greater odds blunt use. • Hispanic YA who used emotion-focused coping had greater odds of blunt use. There is a general paucity of research describing the relationship between racial and ethnic discrimination (RED) and coping strategies on use of little filtered cigars and cigarillos (LCCs) across racial and ethnic identities. This research sought to unravel some of the complex, multilayered experiences of RED and subsequent coping strategies to examine the impact on LCC use. Data come from a cross-sectional survey conducted among a nationally representative sample of U.S. young adults (n = 1,178) in May 2022. Respondents were asked about their exposure to LCC marketing (systemic RED), interpersonal experiences of RED, coping strategies, and use of LCCs as-sold (tobacco only) or as a blunt (with marijuana). Multivariable logistic regression was used to examine odds of LCC use examining systemic and interpersonal RED and the relationship between emotion-focused and problem-focused coping strategies among those who have experienced RED. Exposure to systemic RED was associated with increased odds of blunt use. Interpersonal experiences of RED were associated with increased odds of LCC use as-sold and as blunts. Among those who experienced any RED, the impact of problem-focused and emotion-focused coping was differential across racial and ethnic identities in the impact on LCC use modality. Systemic and interpersonal RED are independently associated with LCC use. There are considerable differences in how young adults cope with RED which necessitates additional research to further elucidate the complex pathways between RED and product use to more effectively inform strategies to address the undeniable racial and ethnic inequities in tobacco-related health outcomes.

  PublisherDOI

• Variation of metabolic and bariatric surgery utilization by neighborhood socioeconomic status in Maryland

  PLoS ONE · 2025-11-10 · 1 citations

  articleOpen accessCorresponding

  IMPORTANCE: Metabolic and Bariatric Surgery (MBS) is a proven treatment for severe obesity, yet disparities in its utilization persist, particularly among socioeconomically disadvantaged populations. OBJECTIVE: To evaluate the association between neighborhood socioeconomic status (nSES) and MBS utilization in Maryland and assess whether this relationship varies by race and ethnicity. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study using the Maryland State Inpatient Database (2018-2020), linked with the Distressed Communities Index (DCI). The study included adults aged ≥18 years with body mass index (BMI) ≥35 kg/m² who were eligible for MBS. Race/ethnicity was self-reported and categorized as non-Hispanic White, non-Hispanic Black, Hispanic, or Other. MAIN OUTCOMES AND MEASURES: The primary outcome was receipt of MBS. The primary exposure was nSES, measured using DCI quintiles (prosperous, comfortable, mid-tier, at-risk, and distressed). Multivariable logistic regression models estimated the adjusted odds of undergoing surgery, accounting for age, sex, race/ethnicity, insurance, comorbidities, obesity class, and urbanicity. Interaction terms tested effect modification by race. RESULTS: Of 169,026 eligible individuals, 11,963 (7.1%) received MBS. Most recipients were female (82.6%), with nearly equal representation of Black (46.9%) and White (46.1%) patients. A socioeconomic gradient in utilization was evident: individuals from distressed neighborhoods had 30% lower odds of receiving surgery (OR, 0.70; 95% CI, 0.64-0.76) compared to those in prosperous areas. Odds were similarly reduced for mid-tier (OR, 0.74; 95% CI, 0.70-0.79), at-risk (OR, 0.89; 95% CI, 0.83-0.96), and comfortable (OR, 0.89; 95% CI, 0.84-0.95) neighborhoods. Race moderated this association: across all DCI quintiles, Black individuals were more likely than White individuals to undergo surgery, with marginal effects increasing from 0.90% in prosperous to 2.10% in distressed areas. CONCLUSIONS AND RELEVANCE: MBS remains underutilized among eligible patients, especially those in socioeconomically disadvantaged neighborhoods. However, utilization patterns differ by race, with higher odds among Black individuals across all neighborhood strata. These findings highlight the need for targeted interventions to improve equity in obesity treatment access.

  PublisherDOI

• Neighborhood Socioeconomic Status and Short-Term Postoperative Complications Following Bariatric Surgery

  medRxiv · 2025-09-18

  preprintOpen access

  Abstract Background Obesity is a significant public health concern, affecting over 41.9% of adults in the United States and contributing to increased risk of chronic conditions and premature mortality. Bariatric surgery is the most effective long-term intervention for severe obesity, offering sustained weight loss and improved metabolic outcomes. However, socioeconomic disparities persist in both the utilization and postoperative outcomes of bariatric surgery, particularly among those who live in socioeconomically disadvantaged neighborhoods. Objective This study evaluates the impact of neighborhood socioeconomic status (nSES), as measured by the Distressed Communities Index (DCI), on short-term postoperative complications following bariatric surgery. Additionally, we investigate whether race/ethnicity moderates this association. Methods We conducted a retrospective cohort study using data from the Maryland State Inpatient Database (SID) from 2018 to 2020. The study population included adult patients (≥18 years) who underwent bariatric surgery during the study period. The primary outcome was the occurrence of short-term postoperative complications (e.g. gastrointestinal leaks, gastrointestinal bleeding and venous thromboembolism) categorized using a composite complication variable defined as no complications or one or more complication. The primary independent variable was nSES, classified into five categories based on the DCI (prosperous, comfortable, mid-tier, at-risk, and distressed). Multivariable ordinal logistic regression models were used to assess the association between nSES and the occurrence of one or more complication post-surgery, adjusting for demographic, clinical, and socioeconomic and geographic covariates. We tested whether race/ethnicity modified the association between nSES and the selected outcomes. Results Among 10,784 patients who underwent bariatric surgery in the study period, 94.7% had no postoperative complications, 5.3% experienced one or more complications. The most common complications were venous thromboembolism (2.2%) and gastrointestinal leaks (0.9%). Multivariable analyses revealed no statistically significant association between nSES and the occurrence of short-term postoperative complications. Additionally, race/ethnicity did not significantly moderate this relationship. Conclusions This study found no significant association between neighborhood socioeconomic disadvantages and the occurrence of short-term postoperative complications following bariatric surgery.

  PublisherOA PDFDOI

• Variation of Bariatric Surgery Utilization by Neighborhood Socioeconomic Status in Maryland

  medRxiv · 2025-08-01

  preprintOpen access

  Abstract Importance Bariatric surgery is a proven treatment for severe obesity, yet disparities in its utilization persist, particularly among socioeconomically disadvantaged populations. Objective To evaluate the association between neighborhood socioeconomic status (nSES) and bariatric surgery utilization in Maryland and assess whether this relationship varies by race and ethnicity. Design, Setting, and Participants A cross-sectional, population-based study using the Maryland State Inpatient Database (2018–2020), linked with the Distressed Communities Index (DCI). The study included adults aged ≥18 years with body mass index (BMI) ≥35 kg/m² who were eligible for bariatric surgery. Race/ethnicity was self-reported and categorized as non-Hispanic White, non-Hispanic Black, Hispanic, or Other. Main Outcomes and Measures The primary outcome was receipt of bariatric surgery. The primary exposure was nSES, measured using DCI quintiles (prosperous, comfortable, mid-tier, at-risk, and distressed). Multivariable logistic regression models estimated the adjusted odds of undergoing surgery, accounting for age, sex, race/ethnicity, insurance, comorbidities, obesity class, and urbanicity. Interaction terms tested effect modification by race. Results Of 169,026 eligible individuals, 11,963 (7.1%) received bariatric surgery. Most recipients were female (82.6%), with nearly equal representation of Black (46.9%) and White (46.1%) patients. A socioeconomic gradient in utilization was evident: individuals from distressed neighborhoods had 30% lower odds of receiving surgery (OR, 0.70; 95% CI, 0.64– 0.76) compared to those in prosperous areas. Odds were similarly reduced for mid-tier (OR, 0.74; 95% CI, 0.70–0.79), at-risk (OR, 0.89; 95% CI, 0.83–0.96), and comfortable (OR, 0.89; 95% CI, 0.84–0.95) neighborhoods. Race moderated this association: across all DCI quintiles, Black individuals were more likely than White individuals to undergo surgery, with marginal effects increasing from 0.90% in prosperous to 2.10% in distressed areas. Conclusions and Relevance Bariatric surgery remains underutilized among eligible patients, especially those in socioeconomically disadvantaged neighborhoods. However, utilization patterns differ by race, with higher odds among Black individuals across all neighborhood strata. These findings highlight the need for targeted interventions to improve equity in obesity treatment access.

  PublisherOA PDFDOI

• Youth Acquisition and Situational Use of Cigars, Cigarillos, and Little Cigars: A Cross-sectional Study

  UNC Libraries · 2024-07-25 · 1 citations

  articleOpen access
  PublisherDOI

Recent grants

• Correlates of Nicotine Dependence among Urban African American Youth

  NIH · $633k · 2010–2016

Frequent coauthors

• Mary A. Garza

  California State University, Fresno

  16 shared

• Kymberle L. Sterling

  Rutgers Health

  13 shared

• Stephen B. Thomas

  Lindsay Unified School District

  13 shared

• James Butler

  University of Cape Town

  12 shared

• William G. Shadel

  RAND Corporation

  11 shared

• Sandra Crouse Quinn

  10 shared

• Shannah Tharp-Taylor

  RAND Corporation

  8 shared

• Douglas D. Gunzler

  Case Western Reserve University

  7 shared

Education

• DrPH, Sociomedical Sciences

  Columbia University

  2006

• MPH, Behavioral and Community Health Sciences

  University of Pittsburgh

  1997

• BS, Nutrition

  Case Western Reserve University

  1992

Awards & honors

• George F. Kramer Practitioner of the Year Award, School of P…
• Scholar, Inaugural ADVANCE Program for Inclusion Excellence,…
• Attendee, Robert Wood Johnson Foundation, New Connections Sy…
• Health Disparities Scholar, National Institute on Minority H…