The Relationship of Ethnicity, Socioeconomic Factors, and Overweight in US Adolescents — Add Health
In the UK, socioeconomic inequalities have increased since the s and Other dimensions of inequality, which intersect with socioeconomic status in complex The prevalence of obesity and overweight changes with age. There is no straightforward relationship between obesity and ethnicity, with a. The prevalence of overweight status among adolescents in the United States has .. The relationship of ethnicity, socioeconomic factors, and overweight in U.S. Gordon-Larsen, P.; Adair, Linda S.; & Popkin, Barry M. (). The Relationship of Ethnicity, Socioeconomic Factors, and Overweight in US Adolescents. Obesity .
The cross-sectional prevalence of overweight among the sample is shown in Table 2. The Hispanic girls had the largest proportion of overweight compared to the Asian and non-Hispanic White girls at all three time points. The probability of becoming overweight was not significantly associated with acculturation score at any of the time points for either Asian or Hispanic girls Table 3.
Figure 1 Kaplan—Meier survival curve showing probability for not becoming overweight among early adolescent girls. Cumulative survival is the probability of not becoming overweight. Table 3 Binary logistic regression model s of the relationship of acculturation score and overweight status among early adolescent Asian and Hispanic girls at three time points followed over 18 months Notes: OR, odds ratio; CI, confidence interval.
Discussion This study involved a sample of early adolescent Hispanic, non-Hispanic White, and Asian girls from multiple locations around the country. The multiple sites allowed a substantial number of Hispanic and Asian girls to participate with a variety of cultural exposures. Previous studies 13 demonstrated a protective effect of low acculturation toward a lower BMI and normal weight status among boys and girls in the 7th—12th grades.
We expected to find similar results given the diverse sample of girls and salient indicators of acculturation in our study. Despite these strengths, we were not able to duplicate the previous results.
We found no significant relationship between the acculturation variables and probability for overweight regardless of the analytical approach used. We found that Hispanic adolescent girls had a significantly lower probability of not being overweight compared to Asian or non-Hispanic White adolescent girls. This may be due to the Hispanic sample being primarily Mexican American. Previously, Gordon-Larsen et al 13 found that acculturation and overweight among Hispanic adolescent immigrants to the US from Puerto Rico, Cuba, and Mexico displayed different profiles.
The prevalence for overweight increased as generation increased in all groups except for the adolescents of Mexican origin.
[Full text] Ethnicity and acculturation: do they predict weight status in a longit | AHMT
Coinciding with these results, Popkin 23 identified Mexico as having a higher prevalence of overweight among the entire population, with the prevalence being highest in Northern Mexico, compared to other Latin American countries. This is a research question warranting further exploration.
Maturation was also examined as a potential factor, because it has been shown to differ by ethnic group 24 and menarche and it may influence overweight and obesity. However, among Hispanic children, one fourth of whom were obese Table 1the prevalence of obesity was significantly higher than in either black or white children. There was a significant inverse relationship between maternal education and obesity prevalence, but there was no significant relationship between household income and obesity or between children's food security level and obesity.
These findings on the bivariate relationship with the 3 socioeconomic indicators also held true when we used the 90th or 85th percentile as a BMI cut point.
When all 18 items on the US Household Food Security Survey Module, including the 10 adult-referenced items, were scored to establish a single measure of household food security, 37 this measure was also not significantly related to childhood obesity. Hispanics and blacks had similar levels of food security and income, but Hispanics had lower levels of maternal education than blacks Table 2.
Whites had significantly higher levels of food security, income, and education than either Hispanics or blacks. Stratified analyses Table 4 showed an inverse bivariate relationship between maternal education and child obesity in whites and Hispanics, but not in blacks. Only among blacks was the prevalence of obesity significantly higher in children who were fully food secure. In the National Health and Nutrition Examination Survey, the estimated prevalence of obesity among the two- to five-year-old non-Hispanic white, non-Hispanic black, and Mexican American children was 8.
We found no overall association between the level of food security and childhood obesity.
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This finding is consistent with those of several other studies, 26 - 31 despite the differences between them in the age of the children studied, the specific measure of food security, and the cut point for obesity or overweight. In these studies, an inverse relationship between socioeconomic status and obesity was seen primarily in white children but not in nonwhite children, a finding that was particularly true among females. The findings are not meant to apply to all US 3-year-old children, especially those living outside large cities.
Overall, the sample contained a broad range of household income and maternal education levels, but when our analyses were stratified by race, some sample sizes were small. The study involved only half the original birth cohort. We cannot determine how these differences might have influenced our findings about the relationship between childhood obesity and the socioeconomic factors we examined. For example, it is possible that the Hispanic children who had anthropometric measurements were less likely to be obese than the Hispanic children who did not have these measurements.
Socioeconomic status is a complex construct that is only partly captured by the indicators we studied. Income was not measured at the same time as maternal education and food security. Furthermore, among those at the lower end of the income distribution, actual income levels may fluctuate greatly. Income also does not reflect wealth or the possession of assets, economic or social, which may be more strongly associated with childhood obesity.
Despite these limitations in measuring income, we found no association between childhood obesity and food insecurity, a specific form of material deprivation that might influence diet quality and thereby obesity. We found no evidence that this disparity was related to household income, maternal education, or children's food security. This suggests that other unidentified factors, including genes conferring susceptibility to obesity, are the more likely explanation.
Thus far, studies in young children have failed to identify possible environmental or behavioral factors to explain this disparity, but measuring such factors in young children is challenging. In this cohort, we have previously shown that perceived neighborhood safety, outdoor play time, and television viewing are all unrelated to childhood obesity, 43 and further analyses Hillary L. A greater understanding of factors associated with overweight will provide a rational basis for the design and implementation of interventions to prevent obesity among U.
Methods Survey design and study sample The survey focused on public health topics such as medical history, lifestyle practices, health insurance coverage, and access to health care services. CHIS was administered through a 2-stage, geographically stratified random-digit—dialing telephone survey of California households designed to generate reliable estimates for the entire state From August through Februarya total of 54, people were interviewed from 42, randomly selected households in every county; interviewees were adolescents aged 12—17 years We analyzed the CHIS adolescent data public release file Outcome and independent variables During the telephone interview, adolescents reported their height and weight.
We calculated BMI as a measure of adolescent adiposity We chose independent variables on the basis of previous research and their statistical relationship with dependent variables.
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- The Relationship of Ethnicity, Socioeconomic Factors, and Overweight in US Adolescents
- Health inequalities
We classified family income according to the U. We grouped income as a dichotomous variable as follows: We created a new variable that accounted for all 3 of the above questions by assigning 0 to respondents who ate 5 servings of fruits and vegetables and 1 to respondents who did not. To this value we added the number of times respondents reported consuming fast food or soda and sweetened drinks.
The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents.
Thus, respondents with bad dietary habits would have a higher numerical score than would respondents with good dietary habits. All regression analyses were conducted separately for boys and girls. All models were weighted to allow generalization of the results to the civilian, noninstitutionalized population of California, and standard errors were corrected for survey design effects of multiple stages of cluster sampling.
Independent variables were chosen on the basis of previous research findings and their statistical relationships with the dependent variables. We tested colinearity by examining the variance inflation factor. No colinearity was detected because none of the variance inflation factors were greater than Analyses included tests of 2-way interaction terms in regression equations. Back to top Results The adolescent respondents Table 1 represent an estimated 3, adolescents in California.
Approximately half of the respondents were boys. Mean age of respondents was Most had a park or playground within walking distance of home. Older adolescents in high school were less likely than younger adolescents in middle school to be AROW.
Boys whose parents had less than a high school diploma or some college education were also more likely to be AROW than were adolescents whose parents had college degrees. Boys who had lived in the United States for 10 or more years or who were born in the United States were more likely to be AROW than were boys who had resided in the United States for fewer than 10 years.