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Bell LN, Singleton CR, Bell CN. Household Composition, Income, and Fast-Food Consumption among Black Women and Men. J Racial Ethn Health Disparities 2024; 11:2318-2328. [PMID: 37507635 DOI: 10.1007/s40615-023-01699-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023]
Abstract
Black adults are more likely to consume meals from fast-food restaurants than other racial/ethnic groups with implications for disparities in dietary quality and obesity outcomes. Family and economic characteristics are associated with fast-food consumption. The aim of this study was to determine the association between household composition, income, and fast-food consumption among Black women and men. A cross-sectional, secondary analysis of nationally representative data from the 2011-2018 National Health and Nutrition Examination Survey using multiplicative interaction terms and negative binomial regressions were used to assess whether household income moderated associations between number of children or older adults in the household and number of weekly fast-food meals consumed. Household composition was not associated with fast-food consumption among Black women overall. Yet, demonstrated by a significant interaction (incidence rate ratio (IRR) = 3.41, 95% confidence interval (CI) = 1.59-7.32), Black women with higher household income (≥ $75,000) and multiple young children consumed more fast-food compared to women with no children in the household. In contrast, Black men with one school-aged child in the home consumed fewer weekly fast-food meals than men with no school-aged children in the home (IRR = 0.69, 95% CI = 0.51-0.93). A significant interaction between number of older adults in the household and household income ≥ $75,000 (IRR = 3.56, 95% CI = 1.59-8.01) indicated that Black men with lower incomes and at least one older adult in the household consumed fewer weekly fast-food meals. These findings demonstrate that household composition and household income interact on fast-food consumption among Black women and men. Future studies should interrogate these differences, while programs and policies can be informed by the results of this study.
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Affiliation(s)
- Lauren N Bell
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA.
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2
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Al Hennawi H, Zohaib M, Khan MK, Ahmed F, Mathbout OF, Alkhachem A, Ahmed UA. Temporal Trends in Obesity-Related Mortality Rates: An Analysis of Gender, Race/Ethnicity, and Geographic Disparities in the United States. Curr Probl Cardiol 2024; 49:102108. [PMID: 37778431 DOI: 10.1016/j.cpcardiol.2023.102108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
Obesity is a global public health concern linked to premature death and an increased burden of noncommunicable diseases. This study aims to assess obesity-related mortality rates and temporal trends in the United States. We investigate variations by gender, ethnicity, and state-level demographics using data from the Centers for Disease Control and Prevention WONDER database spanning 1999 to 2021. We identified 124,076 obesity-related deaths, with a mean age-adjusted mortality rate (AAMR) of 2.7 per 100,000 population. AAMRs increased over time, with the highest rises observed in non-Hispanic Black/African American and American Indian/Alaska Native populations, and among males. Certain states showed higher AAMRs. These findings underscore racial disparities in obesity-related mortality and the need for further research to address these disparities.
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Affiliation(s)
| | | | | | - Fasih Ahmed
- Dow University of Health Sciences, Karachi, Pakistan
| | - Omar F Mathbout
- Los Angeles Community College District, Los Angeles, CA, United States
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3
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Baxter SLK, Zare H, Thorpe RJ. Race Disparities in Hypertension Prevalence Among Older Men. Int J Aging Hum Dev 2024; 98:10-26. [PMID: 37150878 DOI: 10.1177/00914150231172119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for hypertension. Modified Poisson models estimated prevalence ratios (PRs) and 95% confidence intervals (CI) for race and age group associations with hypertension. The prevalence of hypertension was 38% overall and 46% of the men were aged 50 and older. Analyses that focused on older men (50 years of age or older) found that non-Hispanic Black men had a higher prevalence of hypertension (PR = 1.28, 95% CI: 1.19 - 1.37) compared to non-Hispanic White men. We suggest future research utilize life course perspectives to better identify which cumulative experiences impact hypertension disparities.
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Affiliation(s)
- Samuel L K Baxter
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Business, University of Maryland Global Campus (UMGC), Baltimore, MD, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Baltimore, MD, USA
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4
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Zare H, Aazami A, Shalby N, Gilmore DR, Thorpe RJ. Measuring Racial Differences in Obesity Risk Factors in Non-Hispanic Black and White Men Aged 20 Years or Older. Am J Mens Health 2023; 17:15579883231205845. [PMID: 37978812 PMCID: PMC10657537 DOI: 10.1177/15579883231205845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 11/19/2023] Open
Abstract
Obesity prevalence in the United States has increased drastically in the last two decades. Racial differences in obesity have emerged with the increase in obesity, with temporal trends because of individual, socioeconomic, and environmental factors, eating behaviors, lack of exercise, etc., raising questions about understanding the mechanisms driving these racial differences in the prevalence of obesity among non-Hispanic Black (NHB) and non-Hispanic White (NHW) men. Although many studies have measured obesity using body mass index (BMI), little is known about waist circumference (WC). This study examines variations in obesity among NHW and NHB using BMI and WC. We used National Health and Nutrition Examination Surveys (1999-2016) with a sample of 9,000 NHW and 3,913 NHB men aged 20 years or older. To estimate the association between the prevalence of obesity (BMI ≥30) and race, we applied modified Poisson regression; to explore and decompose racial differences, we used Oaxaca-Blinder decomposition (OBD). We found that NHW had higher abdominal obesity (WC ≥102) than NHB, but NHB were more likely to be obese (BMI ≥30) during most years, with some fluctuations. Modified Poisson regression showed that NHB had a higher prevalence of obesity (prevalence ratio [PR]: 1.11, 95% confidence interval [CI] = [1.04, 1.18]) but lower abdominal obesity (PR: 0.845; 95% CI = [0.801, 0.892]) than NHW. OBD showed that age, access to health care, smoking, and drinking contributed to the differences in abdominal obesity. The study identifies a significant increase in obesity among men over the last two decades; generalized obesity (based on BMI) was more problematic for NHB men, but abdominal obesity was more problematic for NHW men.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- The School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, USA
| | - Aida Aazami
- The University of Texas at Dallas, Dallas, TX, USA
| | - Noran Shalby
- Public Health Studies in the Johns Hopkins Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle R. Gilmore
- Trachtenberg School of Public Policy & Administration, George Washington University, Washington, DC, USA
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J. Thorpe
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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5
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Smith GS, Archibald P, Thorpe RJ. Race and obesity disparities among adults living in gentrifying neighborhoods. J Racial Ethn Health Disparities 2023; 10:93-99. [PMID: 35083727 DOI: 10.1007/s40615-021-01199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 02/03/2023]
Abstract
There is a paucity of research seeking to understand race disparities in obesity among individuals living in a gentrifying neighborhood. American Community Survey data were used to identify gentrifying neighborhoods. In a cross-sectional analysis, these data were then linked to the 2014 Medical Expenditure Panel Survey, yielding an analytic sample of 887 Black and White adults. Obesity was based on body mass index ≥ 30 kg/m2. After controlling for potential confounders, Black adults living in gentrifying neighborhoods had a higher prevalence of obesity (PR: 1.39; 95% CI: 1.03, 1.88) than White adults living in gentrifying neighborhoods. Gentrification may have no impact on reducing Black-White obesity disparities in the US.
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Affiliation(s)
- G S Smith
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - P Archibald
- Department of Social Work, College of Staten Island-City University of New York School of Health Science, Staten Island, NY, USA
| | - R J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Program for Research On Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hudson D, Collins-Anderson A, Hutson W. Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1660. [PMID: 36767028 PMCID: PMC9914282 DOI: 10.3390/ijerph20031660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 06/18/2023]
Abstract
Evidence from previous research indicates that while socioeconomic status (SES) narrows Black-White health inequities, these inequities do not completely disappear, and in some cases, worsen. Why do Black-White health inequities persist, even when controlling for SES? It is critical to examine how perceptions of unfair treatment, especially those that are nuanced and subtle, affect the mental health of Black Americans with greater levels of SES. This study, using a new sample composed exclusively of college-educated Black Americans, investigated whether experiences related to racism were associated with poorer mental health. Qualtrics provided the sample from their nationwide panelists that met the research criteria. Inclusion criteria included the following: (1) self-identified as Black or African American; (2) at least 24 years old; (3) completed a 4-year college degree or higher. The findings from this study indicated that the effects of unfair treatment are significantly associated with poorer mental health. These findings highlight the insidious nature of contemporary racism as the everyday experiences of unfair treatment have a tremendous effect on depressive symptoms among this sample of college-educated Black Americans. Efforts to simply improve SES among historically marginalized groups will not bring about health equity. Findings from this study indicate that there are mental health costs associated with upward social mobility. It is likely that these costs, particularly the experience of everyday unfair treatment, likely diminish the social, economic and health returns on the human capital.
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Mahmood N, Sanchez-Vaznaugh EV, Matsuzaki M, Sánchez BN. Racial/ethnic disparities in childhood obesity: The role of school segregation. Obesity (Silver Spring) 2022; 30:1116-1125. [PMID: 35470976 PMCID: PMC9097556 DOI: 10.1002/oby.23416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/29/2021] [Accepted: 02/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Recent studies have observed that racial or ethnic adult health disparities revealed in national data dissipate in racially integrated communities, supporting the theory that "place, not race" shapes the nature and magnitude of racial/ethnic health disparities. This study tested this theory among children. METHODS In 2020, the racial/ethnic childhood obesity disparities within integrated schools and between segregated schools were estimated using statewide cross-sectional data collected in 2019 on fifth, seventh, and ninth grade students from California public schools. RESULTS School segregation accounted for a large part of the obesity disparities between White children and children of color (Latino, Black, and Filipino children). In racially integrated schools, obesity disparities were much smaller than those in statewide data, whereas racial or ethnic childhood obesity disparities were larger when comparing children in majority-White schools with those attending schools with a majority enrollment of children of color, except for Asian children, who generally had lower obesity rates than their White peers. CONCLUSIONS School-level racial segregation is a salient contributor to racial/ethnic childhood obesity disparities. Reducing obesity disparities may be particularly effective if place-level interventions target socioeconomically disadvantaged integrated schools and segregated schools attended primarily by children of color.
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Affiliation(s)
- Nuha Mahmood
- The University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Mika Matsuzaki
- Johns Hopkins University School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Brisa N Sánchez
- Drexel University Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Sistrunk C, Tolbert N, Sanchez-Pino MD, Erhunmwunsee L, Wright N, Jones V, Hyslop T, Miranda-Carboni G, Dietze EC, Martinez E, George S, Ochoa AC, Winn RA, Seewaldt VL. Impact of Federal, State, and Local Housing Policies on Disparities in Cardiovascular Disease in Black/African American Men and Women: From Policy to Pathways to Biology. Front Cardiovasc Med 2022; 9:756734. [PMID: 35509276 PMCID: PMC9058117 DOI: 10.3389/fcvm.2022.756734] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/11/2022] [Indexed: 12/29/2022] Open
Abstract
Racist and discriminatory federal, state, and local housing policies significantly contribute to disparities in cardiovascular disease incidence and mortality for individuals that self-identify as Black or African American. Here we highlight three key housing policies - "redlining," zoning, and the construction of highways - which have wrought a powerful, sustained, and destructive impact on cardiovascular health in Black/African American communities. Redlining and highway construction policies have restricted access to quality health care, increased exposure to carcinogens such as PM2.5, and increased exposure to extreme heat. At the root of these policy decisions are longstanding, toxic societal factors including racism, segregation, and discrimination, which also serve to perpetuate racial inequities in cardiovascular health. Here, we review these societal and structural factors and then link them with biological processes such as telomere shortening, allostatic load, oxidative stress, and tissue inflammation. Lastly, we focus on the impact of inflammation on the immune system and the molecular mechanisms by which the inflamed immune microenvironment promotes the formation of atherosclerotic plaques. We propose that racial residential segregation and discrimination increases tissue inflammation and cytokine production, resulting in dysregulated immune signaling, which promotes plaque formation and cardiovascular disease. This framework has the power to link structural racism not only to cardiovascular disease, but also to cancer.
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Affiliation(s)
| | - Nora Tolbert
- Department of Cardiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Maria Dulfary Sanchez-Pino
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University, Baton Rouge, LA, United States
| | | | - Nikita Wright
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Veronica Jones
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Terry Hyslop
- Department of Biochemistry, Duke University, Durham, NC, United States
| | | | - Eric C. Dietze
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ernest Martinez
- Department of Biostatistics and Bioinformatics, University of California, Riverside, Riverside, CA, United States
| | - Sophia George
- Sylvester Comprehensive Cancer Center, Miami, FL, United States
| | - Augusto C. Ochoa
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University, Baton Rouge, LA, United States
| | - Robert A. Winn
- VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States
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9
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Responding to Health Disparities in Behavioral Weight Loss Interventions and COVID-19 in Black Adults: Recommendations for Health Equity. J Racial Ethn Health Disparities 2022; 9:739-747. [PMID: 35192179 PMCID: PMC8862701 DOI: 10.1007/s40615-022-01269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022]
Abstract
COVID-19 has disproportionately impacted Black adults with high prevalence and mortality rates. Obesity is a central factor in the severity of COVID-19 and related treatment. Behavioral weight loss interventions are an efficacious treatment for obesity, but consistently, Black men and women are minimally represented, and weight loss outcomes are less than clinically significant thresholds. This commentary draws parallels between COVID-19 racial disparities, disparate obesity rates, weight loss treatment outcomes, and underlying systemic racial context. This paper also indicates paths forward to address racialized societal norms in obesity treatment to advance health equity in obesity and reduce acute disease vulnerability. Recommendations for behavioral medicine practice and policy include (1) expanding the research lens to prioritize Black scholars and institutions to generate innovative research questions, (2) creating trustworthy relationships with Black community members to bolster recruitment and retention, (3) employing qualitative methods to facilitate better intervention design and uncover influences of racialized social context, (4) centering Black adults in weight loss interventions, and (5) using multilevel approaches that integrate policy into interventions. Moving forward, this commentary aims to make plain the multilayered form and function of racism, its impact on COVID-19 and obesity, and offer pathways to improve behavioral weight loss interventions that can produce more equitable outcomes.
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Fabius CD, Parker LJ, Thorpe RJ. The Influence of Race and Gender on Receiving Assistance with Daily Activities among Older Americans. Innov Aging 2021; 6:igab060. [PMID: 35233471 PMCID: PMC8874838 DOI: 10.1093/geroni/igab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background and Objectives Nearly 8.2 million community-dwelling, older Medicare beneficiaries receive support from long-term services and supports (LTSS) with routine daily activities. Prior work demonstrates disability-related disparities; however, it is unclear whether these patterns persist among LTSS recipients and across specific sets of activities. We examine race and gender differences in receiving help with self-care (e.g., eating), mobility (e.g., getting around the house), and household (e.g., shopping) activities in a nationally representative sample of community-dwelling Medicare beneficiaries receiving LTSS. Research Design and Methods Cross-sectional analysis of 1,808 White and Black older adults receiving assistance with routine daily activities in the 2015 National Health and Aging Trends Study. Bivariate statistics were used to describe the sample and provide comparisons of characteristics by race and gender. Logistic regression models examined race and gender differences in receiving assistance with self-care, mobility, and household activities after adjusting for sociodemographic and health characteristics. Results Race and gender differences were observed across all sociodemographic and health characteristics, as well as for all forms of assistance. Relative to White men, Black men had lower odds of receiving help with self-care activities. White and black women had higher odds and Black men had lower odds of getting help with mobility activities than White men. Black men and White and Black women all had higher odds of receiving assistance with household tasks compared to White men. Discussion and Implications Our findings indicate that, despite prior evidence of disability-related disparities, the receipt of help with self-care, mobility, and household activities varies by race and gender. Findings reveal several target areas for future research. Future work should examine the role of cultural and social preferences for care, as well as the appropriateness of help, as evidenced by health service use and changes in quality of life.
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Affiliation(s)
- Chanee D Fabius
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lauren J Parker
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Roland J Thorpe
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Zare H, Gilmore DR, Creighton C, Azadi M, Gaskin DJ, Thorpe RJ. How Income Inequality and Race/Ethnicity Drive Obesity in U.S. Adults: 1999-2016. Healthcare (Basel) 2021; 9:1442. [PMID: 34828490 PMCID: PMC8618490 DOI: 10.3390/healthcare9111442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/13/2021] [Accepted: 10/23/2021] [Indexed: 02/08/2023] Open
Abstract
Obesity is a major public health problem both globally and within the U.S. It varies by multiple factors, including but not limited to income and sex. After controlling for potential covariates, there is little evidence to determine the association between income and obesity and how obesity may be moderated by sex and family income. We examined the association between income and obesity in U.S. adults aged 20 years and older, and tested whether this relationship differs by race or ethnicity groups. For this analysis, we used data from the 1999-2016 National Health and Nutrition Examination Surveys (NHANES). Obesity was determined using Body Mass Index ≥ 30 kg/m2; the Gini coefficient (GC) was calculated to measure income inequality using the Poverty Income Ratio (PIR). We categorized the PIR into five quintiles to examine the relationship between income inequality and obesity. For the first set of analyses, we used a modified Poisson regression in a sample of 36,665 adults, with an almost equal number of men and women (women's ratio was 50.6%), including 17,303 white non-Hispanics (WNH), 7475 black non-Hispanics (BNHs), and 6281 Mexican Americans. The models included age, racial/ethnic groups, marital status, education, health behaviors (smoking and drinking status and physical activities), health insurance coverage, self-reported health, and household structure (live alone and size of household). Adjusting for potential confounders, our findings showed that the association between PIR and obesity was positive and significant more frequently among WNH and BNH in middle and top PIR quintiles than among lower-PIR quintiles; this association was not significant in Mexican Americans (MAs). Results of GC in obese women showed that in comparison with WNHs (GC: 0.34, S.E.: 0.002), BNHs (GC: 0.38, S.E.: 0.004) and MAs (GC: 0.41, S.E.: 0.006) experienced higher income inequality, and that BNH obese men experienced the highest income inequality (GC: 0.45, S.E.: 0.011). The association between PIR and obesity was significant among WNHs and BNHs men in the 3rd, 4th and 5th PIR quintiles. The same association was not found for women. In treating obesity, policymakers should consider not only race/ethnicity and sex, but also strategies to reduce inequality in income.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Global Health Services and Administration, University of Maryland Global Campus (UMGC), Largo, MD 20774, USA
| | - Danielle R Gilmore
- Trachtenberg School of Public Policy and Administration, George Washington University, Washington, DC 20052, USA
| | - Ciana Creighton
- Office of the Deputy Mayor for Health and Human Services, DC Government, Washington, DC 20004, USA
| | - Mojgan Azadi
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
- Health Services Management, University of Maryland Global Campus (UMGC), Adelphi, MD 20774, USA
| | - Darrell J Gaskin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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12
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Ciciurkaite G. Race/ethnicity, gender and the SES gradient in BMI: The diminishing returns of SES for racial/ethnic minorities. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1754-1773. [PMID: 33884635 DOI: 10.1111/1467-9566.13267] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/23/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
Using the 2013-2016 data from the National Health and Nutrition Examination Survey (NHANES), this study uses the case of obesity to examine whether and to what extent racial and ethnic minorities experience fewer benefits from higher SES relative to their white counterparts. Study results provide support for the diminishing returns in health hypothesis and add an intersectional dimension to this perspective by uncovering stark gendered racial/ethnic disparities in BMI. Specifically, research findings demonstrate that higher income and education is associated with lower BMI among white but not black or Mexican American adults. The most substantial decrease in BMI associated with increase in individual-level SES was observed among white women. Taken together, empirical evidence from this study underscores difficulty in overcoming adverse health effects of lower ascribed status (i.e. gender or race/ethnicity) even with attainment of higher achieved social status (i.e. educational attainment or income) and offers promising avenues for future research on identifying complex hierarchies that shape population health outcomes.
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Affiliation(s)
- Gabriele Ciciurkaite
- Department of Sociology, Social Work and Anthropology, Utah State University, Utah, USA
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13
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Bell CN, Thomas Tobin CS, Robles B, Spears EC, Thorpe RJ. Familial Financial Assistance and Body Mass Index in Black College Graduates. J Racial Ethn Health Disparities 2021; 9:1850-1860. [PMID: 34363186 DOI: 10.1007/s40615-021-01122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022]
Abstract
Racial disparities in obesity are larger between Black and White college graduates compared to disparities among those who did not complete high school. A possible explanation is that Black adults with higher socioeconomic status (SES) experience unique obesogenic determinants. Black adults who have completed a 4-year college degree can report "uplift stress" from providing financial assistance to family members. The aim of this study is to determine whether the association between familial financial assistance and body mass index (BMI) varies among college-educated Black women and men. This study utilized data from an online survey of Qualtrics standing panels including 451 non-Hispanic Black college graduates. Respondents were asked if they had provided or received any monetary gift or financial help from a family member in the past 12 months as well as their height and weight. Using linear regression and multiplicative interaction terms, the association between familial financial assistance and BMI was assessed by sex. Those who reported both giving and receiving familial financial assistance had higher BMI than those who neither gave nor received assistance (β = 2.80, standard error (s.e.) = 1.16). There was a significant interaction such that this association was observed among women only (β = 6.67, s.e. = 2.32). Future studies should seek to understand the gendered impact of familial financial assistance on BMI in college-educated Black women.
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Affiliation(s)
- Caryn N Bell
- Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, 70112, USA.
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | | | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA.,Program for Research On Men's Health, Nashville, TN, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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14
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Baxter SLK, Chung R, Frerichs L, Thorpe RJ, Skinner AC, Weinberger M. Racial Residential Segregation and Race Differences in Ideal Cardiovascular Health among Young Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157755. [PMID: 34360047 PMCID: PMC8345482 DOI: 10.3390/ijerph18157755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Abstract
Background: Race disparities in cardiovascular disease (CVD) related morbidity and mortality are evident among men. While previous studies show health in young adulthood and racial residential segregation (RRS) are important factors for CVD risk, these factors have not been widely studied in male populations. We sought to examine race differences in ideal cardiovascular health (CVH) among young men (ages 24–34) and whether RRS influenced this association. Methods: We used cross-sectional data from young men who participated in Wave IV (2008) of the National Longitudinal Survey of Adolescent to Adult Health (N = 5080). The dichotomous outcome, achieving ideal CVH, was defined as having ≥4 of the American Heart Association’s Life’s Simple 7 targets. Race (Black/White) and RRS (proportion of White residents in census tract) were the independent variables. Descriptive and multivariate analyses were conducted. Results: Young Black men had lower odds of achieving ideal CVH (OR = 0.67, 95% CI = 0.49, 0.92) than young White men. However, RRS did not have a significant effect on race differences in ideal CVH until the proportion of White residents was ≥55%. Conclusions: Among young Black and White men, RRS is an important factor to consider when seeking to understand CVH and reduce future cardiovascular risk.
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Affiliation(s)
- Samuel L. K. Baxter
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
- Correspondence: ; Tel.: +1-864-722-2004
| | - Richard Chung
- Department of Pediatrics, Duke University School of Medicine, Duke University, Durham, NC 27710, USA;
| | - Leah Frerichs
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, SC 27599, USA; (L.F.); (M.W.)
| | - Roland J. Thorpe
- Hopkins Center for Health Disparities Solutions, Program for Research on Men’s Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Asheley C. Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Morris Weinberger
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, SC 27599, USA; (L.F.); (M.W.)
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15
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Mosavel M, Ferrell D, LaRose JG, Lu J, Winship J. Conducting a Community "Street Survey" to Inform an Obesity Intervention: The WE Project. FAMILY & COMMUNITY HEALTH 2021; 44:117-125. [PMID: 32842000 PMCID: PMC7902738 DOI: 10.1097/fch.0000000000000271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Using a community-based participatory research approach, a citywide survey was conducted to explore perceptions of obesity and interventions to reduce obesity within an African American urban community. More than 1300 surveys were collected within 3 months; 92.9% of respondents agreed or strongly agreed that obesity was an important health issue in the community and the majority indicated that family-based interventions were the preferred pathway for improving physical activity (86.0%) and nutrition (85.2%). Engaging community members in survey development and implementation was an effective approach to build local research capacity and establish a shared agenda of reaching a diverse sample of community residents.
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Affiliation(s)
- Maghboeba Mosavel
- Departments of Health Behavior and Policy (Drs Mosavel and LaRose), Family Medicine, Division of Epidemiology (Dr Lu), and Occupational Therapy (Dr Winship), Virginia Commonwealth University, Richmond; and Pathways, Inc, Petersburg, Virginia (Ms Ferrell)
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16
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Bruce MA, Bowie JV, Barge H, Beech BM, LaVeist TA, Howard DL, Thorpe RJ. Religious Coping and Quality of Life Among Black and White Men With Prostate Cancer. Cancer Control 2021; 27:1073274820936288. [PMID: 32638611 PMCID: PMC7346696 DOI: 10.1177/1073274820936288] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Prostate cancer is a significant impediment in men’s lives as this condition often exacerbates stress and reduces quality of life. Faith can be a resource through which men cope with health crises; however, few studies examine how religion or spirituality can have implications for racial disparities in health outcomes among men. The purpose of this study is to assess the associations between religious coping and quality of life among black and white men with prostate cancer. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 624 black and white men with complete information on the primary outcome and predictor variables. The primary outcome for this study was overall quality of life as measured by the Functional Assessment of Cancer Therapy-Prostate questionnaire. The main independent variable was religious coping measured by 2 subscales capturing positive and negative forms of coping. Black men in the study had lower overall quality of life scores (134.6 ± 19.6) than their white peers (139.8 ± 14.1). Black men in the sample also had higher average positive religious coping scores (12.9 ± 3.3) than white men (10.3 ± 4.5). Fully adjusted linear regression models of the total sample produced results indicating that positive religious coping was correlated with an increase in quality of life (β = .38, standard error [SE] = 0.18, P < .05). Negative religious coping was associated with a reduction in quality of life (β = −1.48, SE = 0.40, P < .001). Faith-oriented beliefs or perceptions can have implications for quality of life among men with prostate cancer. Sensitivity to the role of religion, spirituality, and faith should be seen by providers of health care as potential opportunities for improved outcomes in patients with prostate cancer and survivors.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Janice V Bowie
- Hopkins Center for Health Disparities Solutions, Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haley Barge
- Franklin and Marshall University, Lancaster, PA, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bettina M Beech
- Department of Health Systems and Population Health Sciences, University of Houston College of Medicine, University of Houston, Houston, TX, USA
| | | | - Daniel L Howard
- Department of Psychological and Brain Sciences, Diversity Science Research Cluster, Texas A&M University, College Station, TX, USA
| | - Roland J Thorpe
- Program for Research on Faith, Justice, and Health, Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Hopkins Center for Health Disparities Solutions, Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Program for Research on Men's Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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17
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Herren OM, Agurs-Collins T, Dwyer LA, Perna FM, Ferrer R. Emotion suppression, coping strategies, dietary patterns, and BMI. Eat Behav 2021; 41:101500. [PMID: 33812125 PMCID: PMC8131265 DOI: 10.1016/j.eatbeh.2021.101500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/26/2021] [Accepted: 03/16/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Emotion suppression (ES) is associated with unhealthy coping strategies, such as emotional eating. Physical activity (PA) is a healthy coping strategy that may attenuate the association between emotion suppression and emotional eating (EE). This study evaluated whether: 1) ES is associated with body mass index (BMI) through EE and/or dietary patterns, 2) PA moderates these relationships, and 3) these patterns differ by race/ethnicity and gender. METHODS Adult participants (N = 1674) of the Family Life, Activity, Sun, Health, and Eating study completed modified versions of the Emotion Regulation, Eating in the Absence of Hunger, and International Physical Activity Questionnaires; a validated dietary assessment; and items on demographics, height, and weight. RESULTS Analyses revealed a serial mediation pathway in the full sample where greater ES was associated with higher BMI through greater EE and lower fruit and vegetable (F&V) intake (B = 0.0017, CI 95% [0.0001, 0.0042]) after controlling for age, gender, and education. Hedonic snack food (HSF) intake was not a significant mediator of the ES-BMI association. Greater PA attenuated associations of ES and EE with dietary intake and BMI. The serial pathway remained significant for non-Hispanic White women only in subgroup analyses. EE was a significant mediator among women, and PA effects were largely found among Hispanics and men. CONCLUSIONS ES was associated with higher BMI through greater EE and lower F&V, but not HSF intake. PA attenuated these associations. Differences in patterns of coping strategies may help to explain disparities in obesity-related health behavior.
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Affiliation(s)
- Olga M. Herren
- National Cancer Institute, 9609 Medical Center Drive, Rockville MD 20850
| | | | - Laura A. Dwyer
- National Cancer Institute, 9609 Medical Center Drive, Rockville MD 20850
| | - Frank M. Perna
- National Cancer Institute, 9609 Medical Center Drive, Rockville MD 20850
| | - Rebecca Ferrer
- National Cancer Institute, 9609 Medical Center Drive, Rockville MD 20850
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18
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Thorpe RJ, Cobb R, King K, Bruce MA, Archibald P, Jones HP, Norris KC, Whitfield KE, Hudson D. The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study. Innov Aging 2020; 4:igaa047. [PMID: 33354627 PMCID: PMC7737789 DOI: 10.1093/geroni/igaa047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men. RESEARCH DESIGN AND METHODS This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies-Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs). RESULTS There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0% vs. 20.0%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95% CI: 1.20-2.17]) than black men in the low AL group. DISCUSSION AND IMPLICATIONS Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms.
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Affiliation(s)
- Roland J Thorpe
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ryon Cobb
- Department of Sociology, University of Georgia, Athens
| | - Keyonna King
- Department of Health Promotion, University of Nebraska Medical Center, Omaha
| | - Marino A Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson
| | - Paul Archibald
- Department of Social Work, College of Staten Island, The City University of New York
| | - Harlan P Jones
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth
| | - Keith C Norris
- Department of Medicine, University of California, Los Angeles
| | | | - Darrell Hudson
- Brown School at Washington University in St. Louis, Missouri
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19
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Barajas CB, Jones SCT, Milam AJ, Thorpe RJ, Gaskin DJ, LaVeist TA, Furr-Holden CDM. Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services. J Community Health 2020; 44:954-962. [PMID: 30915675 DOI: 10.1007/s10900-019-00650-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = - 12.50, 95% CI = - 23.05, - 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.
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Affiliation(s)
- Clara B Barajas
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA
| | - Shawn C T Jones
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Adam J Milam
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA. .,The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - Roland J Thorpe
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Darrell J Gaskin
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Thomas A LaVeist
- The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.,Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - C Debra M Furr-Holden
- Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA. .,The Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
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20
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Forrester SN, Taylor JL, Whitfield KE, Thorpe RJ. Advances in Understanding the Causes and Consequences of Health Disparities in Aging Minorities. CURR EPIDEMIOL REP 2020; 7:59-67. [PMID: 33868898 PMCID: PMC8045783 DOI: 10.1007/s40471-020-00234-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The purpose was to discuss appropriate methods for advancing our understanding of health disparities or minority aging including life-course perspectives, biological measures, pain measurement, and generational approaches. RECENT FINDINGS Life course perspectives provide an orientation for studying older minorities that concomitantly captures exposures and stressors that may lead to earlier onset of disease and premature mortality. The use of biological markers to study health disparities in older minorities is necessary in order to identify pathways between psychosocial factors and health outcomes. Work focusing on pain disparities should include explorations of relationships between psychosocial factors, and subjective and objective measures of pain. Studying families can provide insight into genetic associations and coping styles in older minorities. SUMMARY Methodological approaches that take life course, biology, and social factors into account may help identify causal pathways between social determinants of health and health outcomes among older minorities. Once these causal pathways have been identified, more strategies and interventions that strive toward health equity across older adults of all race/ethnic groups can be developed.
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Affiliation(s)
- Sarah N Forrester
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School
| | | | | | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health
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21
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Thompson TL, Singleton CR, Springfield SE, Thorpe RJ, Odoms-Young A. Differences in Nutrient Intake and Diet Quality Between Non-Hispanic Black and Non-Hispanic White Men in the United States. Public Health Rep 2020; 135:334-342. [PMID: 32250708 DOI: 10.1177/0033354920913058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Non-Hispanic black (NHB) men have higher rates of chronic disease than men in other racial/ethnic groups. Poor diet quality is one risk factor for chronic disease, but research on the diet quality and nutrient intake of NHB men is sparse. The objective of this study was to describe and compare the diet quality and nutrient intake of NHB and non-Hispanic white (NHW) men in the United States. METHODS We analyzed cross-sectional data on 5050 men (31.3% NHB, 68.7% NHW) who participated in the National Health and Nutrition Examination Survey (NHANES) during 2007-2012. To assess diet quality, we calculated Healthy Eating Index (HEI)-2010 scores from each participant's 24-hour recall data. We used logistic regression models to determine if NHB men had lower odds of meeting dietary recommendations for nutrient intake than NHW men. We used linear regression models to identify significant differences in HEI-2010 scores between NHB and NHW men. RESULTS After adjusting for sociodemographic measures, NHB and NHW men had similar diet quality (P = .59). Compared with NHW men, NHB men had lower odds of meeting recommendations for dietary fiber and cholesterol intake and higher odds of meeting recommendations for saturated fat and sodium intake. CONCLUSION Differences between NHB and NHW men in the intake of certain nutrients may be related to chronic disease disparities. Future research should consider racial/ethnic differences in dietary intake among men and the impact these differences have on men's health.
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Affiliation(s)
- Terry L Thompson
- 6527 Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Chelsea R Singleton
- 14589 Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Roland J Thorpe
- 1466 Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins University, Baltimore, MD, USA
| | - Angela Odoms-Young
- 14681 Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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22
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Oshan TM, Smith JP, Fotheringham AS. Targeting the spatial context of obesity determinants via multiscale geographically weighted regression. Int J Health Geogr 2020; 19:11. [PMID: 32248807 PMCID: PMC7132879 DOI: 10.1186/s12942-020-00204-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/12/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Obesity rates are recognized to be at epidemic levels throughout much of the world, posing significant threats to both the health and financial security of many nations. The causes of obesity can vary but are often complex and multifactorial, and while many contributing factors can be targeted for intervention, an understanding of where these interventions are needed is necessary in order to implement effective policy. This has prompted an interest in incorporating spatial context into the analysis and modeling of obesity determinants, especially through the use of geographically weighted regression (GWR). METHOD This paper provides a critical review of previous GWR models of obesogenic processes and then presents a novel application of multiscale (M)GWR using the Phoenix metropolitan area as a case study. RESULTS Though the MGWR model consumes more degrees of freedom than OLS, it consumes far fewer degrees of freedom than GWR, ultimately resulting in a more nuanced analysis that can incorporate spatial context but does not force every relationship to become local a priori. In addition, MGWR yields a lower AIC and AICc value than GWR and is also less prone to issues of multicollinearity. Consequently, MGWR is able to improve our understanding of the factors that influence obesity rates by providing determinant-specific spatial contexts. CONCLUSION The results show that a mix of global and local processes are able to best model obesity rates and that MGWR provides a richer yet more parsimonious quantitative representation of obesity rate determinants compared to both GWR and ordinary least squares.
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Affiliation(s)
- Taylor M Oshan
- Center for Geospatial Information Science, Department of Geographical Sciences, University of Maryland, College Park, MD, 20740, USA.
| | - Jordan P Smith
- School of Geographical Sciences & Urban Planning, Arizona State University, Tempe, AZ, 85281, USA
| | - A Stewart Fotheringham
- School of Geographical Sciences & Urban Planning, Arizona State University, Tempe, AZ, 85281, USA
- Spatial Analysis Research Center, School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, 85281, USA
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23
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Bruce MA, Beech BM, Wilder T, Burton ET, Sheats JL, Norris KC, Thorpe RJ. Religiosity and Excess Weight Among African-American Adolescents: The Jackson Heart KIDS Study. JOURNAL OF RELIGION AND HEALTH 2020; 59:223-233. [PMID: 30649707 PMCID: PMC8559570 DOI: 10.1007/s10943-019-00762-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent studies suggest that religion and spirituality can yield health benefits for young African-Americans. We examined the relationship between religious practices, spirituality, and excess weight among African-American adolescents (N = 212) residing in the Deep South. Results from modified Poisson regression analysis indicate that adolescents who prayed daily had a lower prevalence of excess weight (PR 0.77 [95% CI 0.62-0.96]) than those who did not. This relationship was only significant for 12-15 year-old participants in age-stratified analysis. These findings suggest that preventive interventions offered to children and younger adolescents can have implications for weight status across the lifespan.
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Affiliation(s)
- Marino A Bruce
- Program for Research on Faith and Health, Center for Research on Men's Health, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN, 37235-1665, USA.
- Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA.
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tanganyika Wilder
- Department of Biological Sciences, Florida A&M University, Tallahassee, FL, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Jylana L Sheats
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Keith C Norris
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- David C. Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Roland J Thorpe
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
- Myrlie Evers Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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24
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Falasinnu T, O'Shaughnessy MM, Troxell ML, Charu V, Weisman MH, Simard JF. A review of non-immune mediated kidney disease in systemic lupus erythematosus: A hypothetical model of putative risk factors. Semin Arthritis Rheum 2019; 50:463-472. [PMID: 31866044 DOI: 10.1016/j.semarthrit.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/08/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
Abstract
About half of patients with systemic lupus erythematosus (SLE) are diagnosed with lupus nephritis (LN). Patients with SLE are also at increased risk for diabetes, hypertension and obesity, which together account for >70% of end-stage renal disease in the general population. The frequencies of non-LN related causes of kidney disease, and their contribution to kidney disease development and progression among patients with SLE have been inadequately studied. We hypothesize that a substantial, and increasing proportion of kidney pathology in patients with SLE might not directly relate to LN but instead might be explained by non-immune mediated factors such as diabetes, hypertension, and obesity. The goal of the manuscript is to draw attention to hypertension, diabetes and obesity as potential alternative causes of kidney damage in patients with SLE. Further, we suggest that misclassification of kidney disease etiology in patients with SLE might have important ramifications for clinical trial recruitment, epidemiologic investigation, and clinical care. Future studies aiming to elucidate and distinguish discrete causes of kidney disease - both clinically and histologically - among patients with SLE are desperately needed as improved understanding of disease mechanisms is paramount to advancing therapeutic discovery. Collaboration among rheumatologists, pathologists, nephrologists, and endocrinologists, and the availability of dedicated research funding, will be critical to the success of such efforts.
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Affiliation(s)
- Titilola Falasinnu
- Department of Health Research and Policy, Stanford University School of Medicine, 150 Governor's Lane Stanford, Palo Alto, CA 94305, United States
| | | | - Megan L Troxell
- Department of Pathology, Stanford University Medical Center, Palo Alto, CA. United States
| | - Vivek Charu
- Department of Pathology, Stanford University Medical Center, Palo Alto, CA. United States
| | - Michael H Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, United States
| | - Julia F Simard
- Department of Health Research and Policy, Stanford University School of Medicine, 150 Governor's Lane Stanford, Palo Alto, CA 94305, United States; Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, United States.
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25
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Bell CN, Kerr J, Young JL. Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050861. [PMID: 30857286 PMCID: PMC6427384 DOI: 10.3390/ijerph16050861] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
Obesity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007–2014 County Health Rankings and 2012–2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD 20724, USA.
| | - Jordan Kerr
- School of Public Health, University of Maryland, College Park, MD 20724, USA.
| | - Jessica L Young
- Department of Health Studies, American University, Washington, DC 20016, USA.
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Hawkins J, Watkins D, Allen JO, Mitchell J. Identifying subgroups of Black, Hispanic and Asian men at increased risk for comorbid depression and overweight or obesity. Prev Med Rep 2018; 12:268-270. [PMID: 30406004 PMCID: PMC6214873 DOI: 10.1016/j.pmedr.2018.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 11/19/2022] Open
Abstract
Comorbid depression and overweight or obesity increase risk for developing many chronic diseases. Investigating men of color without using a non-Hispanic White male reference group will capture a more nuanced picture of how socio-demographic factors contribute to increased risk for comorbid depression and overweight or obesity among and between men of color. This study used the U.S.-based 2014 National Health Interview Survey (n = 1363) in May 2018 to examine associations between race/ethnicity and comorbid overweight or obesity and depression in men. Men were more likely to be obese or overweight and depressed if they were older (31-54 years old and 55+) [OR = 2.387, 95% CI: 1.526, 3.873, p = 0.000; OR = 2.220, 95% CI: 1.355, 3.635, p = 0.002], Black [OR = 2.745, 95% CI: 1.622, 4.646, p < 0.001], Hispanic [OR = 2.967, 95% CI: 1.762, 4.995, p < 0.001], or earned $35,000-$74,999 [OR = 1.987, 95% CI: 1.255-3.152, p = 0.004]. We identified socio-demographic sub-groups of men at increased risk for comorbid depression and overweight or obesity. Examining intra-group differences among men of color will help clinicians and researchers to address more nuanced socio-demographic characteristics of groups of men who are more at risk for developing a chronic disease.
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Affiliation(s)
- Jaclynn Hawkins
- University of Michigan, School of Social Work, United States
| | - Daphne Watkins
- University of Michigan, School of Social Work, United States
| | - Julie Ober Allen
- University of Michigan, Population Studies Center, United States
| | - Jamie Mitchell
- University of Michigan, School of Social Work, United States
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Andolfi C, Fisichella PM. Epidemiology of Obesity and Associated Comorbidities. J Laparoendosc Adv Surg Tech A 2018; 28:919-924. [DOI: 10.1089/lap.2018.0380] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Ciro Andolfi
- Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - P. Marco Fisichella
- Department of Surgery, Harvard Medical School, Brigham and Women's Hospital and Boston VA Healthcare System, Boston, Massachusetts
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Abstract
Race disparities in self-rated health in the USA are well-documented, such that African Americans rate their health more poorly than whites. However, after adjusting for health status, socioeconomic status (SES), and health behaviors, residual race differences are observed. This suggests the importance of unmeasured variables. Because African Americans and whites tend to live in differing social contexts, it is possible that accounting for social and environmental conditions may reduce racial disparities in self-rated health. Differences in self-rated health among whites and African Americans were assessed in a low-income, urban integrated community (Exploring Health Disparities in Integrated Communities (EHDIC)) and compared with a national sample (National Health Interview Survey (NHIS)). Controlling for demographics, SES, health insurance, status, and behaviors, African Americans in NHIS had higher odds of reporting fair or poor health (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.18-1.66) than whites. In EHDIC, there was no race difference in self-rated health (OR = 0.83, 95% CI = 0.63-1.11). These results demonstrate the importance of social context in understanding race disparities in self-rated health.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD, 20742, USA.
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas A LaVeist
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health Policy and Management, George Washington University, Washington, DC, USA
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Lemacks JL, James RE, Abbott L, Choi H, Parker A, Bryant A, Ralston PA, Rigsby AG, Gilner P. The Church Bridge Project: An Academic-Community Perspective of a Church-Based Weight Management Pilot Intervention among Young Adult African Americans. Prog Community Health Partnersh 2018; 12:23-34. [PMID: 29755046 PMCID: PMC6767920 DOI: 10.1353/cpr.2018.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Churches are effective community partners and settings to address weight management among African Americans. There is limited information on the use of churches to reach young adult populations and church collaborations with primary care clinics. OBJECTIVES The Church Bridge Project represents a community-academic partnership that presents the recruitment process of a church-based weight management intervention and describes baseline data of participants recruited from churches and primary care providers. We also discuss research contributions, challenges and limitations, study applicability, and practice implications from an academic and community perspective. METHODS Church leaders were involved in the entire research process. The theory-driven intervention included 12 diabetes prevention program-adapted education and motivational interviewing (MI)-guided sessions. Participants were recruited through primary care providers and church leaders. Demographics, medical and weight history, stage of change for weight loss, social support, and self-efficacy for diet and physical activity, weight, and girth circumferences were measured. Baseline descriptive data were analyzed. RESULTS Of 64 potential participants, 42 (65.6%) were enrolled in the study and 16 (25.0%) completed baseline data collection. No participants were recruited through primary care providers. Recruited participants were similar to the target population except for being all obese and mostly female. The mean ± SD age of participants was 34.31 ± 8.86 years with most reporting having more than a high school education (n = 14 [87.5%]), individual yearly income of less than $59,000 (n = 12 [75.0%]), and been married or living with a partner (n = 9 [56.3%]). Most reported a history of hypertension and an immediate family history of diabetes and hypertension. Most participants were classified as class III obesity. CONCLUSIONS Young adults and primary care providers are difficult to engage in church-based interventions. Church leaders were comfortable with a collaborate model for decision making, but not an empower model. Churches remain a successful method to reach African Americans; however, more research is needed to motivate young adults to participate in health intervention research.
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Bell CN, Thorpe RJ, Bowie JV, LaVeist TA. Race disparities in cardiovascular disease risk factors within socioeconomic status strata. Ann Epidemiol 2017; 28:147-152. [PMID: 29317176 DOI: 10.1016/j.annepidem.2017.12.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/31/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Racial differences in socioeconomic status (SES) explain some, but not all, of racial disparities in cardiovascular disease (CVD) risk. To address this, race disparities among higher SES individuals need to be assessed. The purpose of this study was to assess whether racial disparities in CVD risk factors differ by SES levels. METHODS Data from the National Health and Nutritional Examination Survey 2007-2014 were used to calculate racial differences in hypertension, high cholesterol, diabetes, and obesity. Interactions between race and SES were assessed. RESULTS African Americans had higher odds of hypertension (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.72-2.09), diabetes (OR, 1.66; 95% CI, 1.33-2.07), and obesity (OR, 1.64; 95% CI, 1.46-1.83) than whites. Significant interactions between race and income greater than or equal to $100,000 were observed for obesity (OR, 1.55; 95% CI, 1.24-1.94) and between race and education (college graduate or more; OR, 1.58; 95% CI, 1.16-2.15). Disparities in diabetes were observed in the highest SES groups, but not among those in the lowest SES groups. CONCLUSIONS Race disparities in some CVD risk factors varied by SES levels. Results suggest that race disparities in obesity are larger among those with income greater than or equal to $100,000 and who are college graduates. It is possible that African Americans experience fewer health-related benefits of increased income and education levels compared with whites.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD.
| | - Roland J Thorpe
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Janice V Bowie
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Thomas A LaVeist
- Department of Health Policy and Management, George Washington University, Washington, DC
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Halpern MT, Arena LC, Royce RA, Soler RE, Munoz B, Hennessy CM. Neighborhood and Individual Sociodemographic Characteristics Associated with Disparities in Adult Obesity and Perceptions of the Home Food Environment. Health Equity 2017; 1:139-149. [PMID: 29167837 PMCID: PMC5685320 DOI: 10.1089/heq.2017.0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Multiple studies have demonstrated significant disparities in the relationship between individual sociodemographic characteristics and risk of overweight or obesity. However, little information is available for assessing the complex associations among being overweight or obese with neighborhood and individual sociodemographic factors and the measured and perceived community food environment. Methods: Using 2014 national evaluation data from 20 communities (analyzed 2015-2016) that participated in the U.S. Centers for Disease Control and Prevention Community Transformation Grants Program, we used multilevel multivariable models to assess associations among factors at the individual, census tract, and county levels with being overweight or obese and with the perceived home food environment. Results: Individual level factors (age, sex, race/ethnicity, household income, and education) were significantly associated with the likelihood of being overweight or obese in every model tested. Census tract level poverty and education were significantly associated with the likelihood of being overweight or obese in univariate but not multivariable analyses. Perceived community food environment was a significant predictor of the perceived home food environment; the objective measure of county-level grocery store access was not. Neither perceived nor objective community food environment measures were significantly associated with overweight/obesity in multivariable analyses. Conclusion: Individual-level sociodemographic characteristics are more strongly associated with obesity-related outcomes than are area-level measures. Future interventions designed to address health equity issues in obesity among underserved populations may benefit from focusing on nutrition education tailored to individuals, to encourage purchase and consumption of healthy food. Improving healthy food availability in underserved communities may also be critical for nutrition education to have a meaningful impact.
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Affiliation(s)
- Michael T Halpern
- RTI International, Social, Statistical, and Environmental Sciences, Research Triangle Park, North Carolina and Washington, DC.,Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Laura C Arena
- RTI International, Social, Statistical, and Environmental Sciences, Research Triangle Park, North Carolina and Washington, DC
| | - Rachel A Royce
- RTI International, Social, Statistical, and Environmental Sciences, Research Triangle Park, North Carolina and Washington, DC
| | - Robin E Soler
- Division of Community Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Breda Munoz
- RTI International, Social, Statistical, and Environmental Sciences, Research Triangle Park, North Carolina and Washington, DC
| | - Caitlin M Hennessy
- RTI International, Social, Statistical, and Environmental Sciences, Research Triangle Park, North Carolina and Washington, DC
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Schulz E, Bay RC, Williams BR, Clark EM, Huang J, Holt CL. Fruit and Vegetable Consumption, and Physical Activity with Partner and Parental Status in African American Adults. JOURNAL OF FAMILY MEDICINE & COMMUNITY HEALTH 2017; 4:1115. [PMID: 29651465 PMCID: PMC5891144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the relationships between partner and parental status and self-reported weekly fruit and vegetable consumption and level of physical activity in African American adults. METHODS A national sample of 2,370 African Americans participated in a telephone survey. Demographic data were collected and compared with fruit and vegetable consumption and physical activity responses. RESULTS When controlling for age (mean age = 53.6 ± 14.8 years) and education level, having children in the household was associated with greater fruit consumption. Being partnered was associated with moderate physical activity weekly for a higher percentage of women, and yet a shorter duration of minutes of moderate physical activity weekly for both women and men. Males (38.2% of the sample) reported being more physically active and females (61.8% of the sample) reported eating more fruits and vegetables. CONCLUSIONS By understanding the role of partner and parental status in relation to healthy lifestyle for African Americans, family scientists and health care practitioners may be able to target the needs of this population to help prevent obesity and chronic illness.
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Affiliation(s)
- Emily Schulz
- Emily Schulz, PhD, OTR/L, CFLE, Associate Professor, Department of Occupational Therapy, A.T. Still University- Arizona School of Health Sciences, 5850 E. Still Circle, Mesa, AZ 85206 office phone: 480-245-6255,
| | - R Curtis Bay
- R. Curtis Bay, PhD, Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ
| | - Beverly Rosa Williams
- Beverly Rosa Williams, PhD, University of Alabama at Birmingham, School/Department of Medicine, Birmingham, AL
| | - Eddie M Clark
- Eddie M. Clark, PhD, Department of Psychology, Saint Louis University, St Louis, MO
| | - Jin Huang
- Jin Huang, PhD, Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD
| | - Cheryl L Holt
- Cheryl L. Holt, PhD, Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD
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Parker LJ, Hunte H, Ohmit A. Discrimination in Health Care: Correlates of Health Care Discrimination Among Black Males. Am J Mens Health 2017; 11:999-1007. [PMID: 25957248 PMCID: PMC5675332 DOI: 10.1177/1557988315585164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Using data from the Indiana Black Men's Health Study ( N = 455), a community-based sample of adult Black men, the primary aim of this study was to explore factors of health care discrimination, and to examine if such reports differed by age and the frequency of race thoughts. Approximately one in four men reported experiencing discrimination in the health care setting. Results from the multivariable logistic regression models suggested that frequent race thoughts (odds ratio [ OR]: 1.89, p < .05), not having health insurance ( OR: 1.80, p < .05), and increased depressive symptomology ( OR: 1.06, p < .01) were positively associated with reports of health care discrimination. A multiplicative interaction coefficient of age and frequency of race thoughts was included to determine if health care discrimination differed by age and frequency of race thoughts ( OR: 1.03, p = .08). Results from the predicted probability plot suggested that the likelihood of experiencing health care discrimination decreases with age ( OR: 0.97, p < .05). In particular, results suggested that between the ages of 33 and 53 years, Black men who experienced frequent race thoughts were more likely to report experiences of discrimination in the health care setting than men of the same age that did not experience frequent race thoughts. These results highlight the need for empirical work to better understand the experiences of Black men, a group less likely to utilize health care services than most adult groups within the health care setting.
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Affiliation(s)
| | | | - Anita Ohmit
- Indiana Minority Health Coalition, Indianapolis, IN, USA
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34
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Wilson KB, Thorpe RJ, LaVeist TA. Dollar for Dollar: Racial and ethnic inequalities in health and health-related outcomes among persons with very high income. Prev Med 2017; 96:149-153. [PMID: 28237367 DOI: 10.1016/j.ypmed.2016.08.038] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/25/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022]
Abstract
Racial and ethnic disparities in health have been well-documented, and low SES is widely considered to be a driver of this relationship. However, the race-social class-health interrelationship is complex, as several studies have found race disparities between racial/ethnic minorities and whites at middle- income levels. Research on higher income persons is complicated by the lack of data for persons with incomes about $75,000. Most national datasets collect income data in categories with the highest income category being $75,000 and above. In our study, we examined racial/ethnic disparities in health status and behaviors among persons of very high income, reported income of $175,000 or above per year. Data are from the Medical Expenditure Panel Surveys (MEPS). Our findings revealed health disparities in 10 of the 16 health-related outcomes selected. African Americans were most dissimilar to whites at this income and with disadvantages on 6 health outcomes relative to whites. While results also showed some disparities for Asian Americans and Hispanic Americans relative to whites, these groups were advantaged, relative to whites on several health outcomes. Our findings indicate that income does not fully explain racial/ethnic disparities in health. Most public interventions are targeted to low income persons. However, public health interventions should target minority individuals of very high income as well, especially African Americans.
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35
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Sohn EK, Porch T, Hill S, Thorpe RJ. Geography, Race/Ethnicity, and Physical Activity Among Men in the United States. Am J Mens Health 2017; 11:1019-1027. [PMID: 28147893 PMCID: PMC5675347 DOI: 10.1177/1557988316689498] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Engaging in regular physical activity reduces one’s risk of chronic disease, stroke, cardiovascular disease, and some forms of cancer. These preventive benefits associated with physical activity are of particular importance for men, who have shorter life expectancy and experience higher rates of chronic diseases as compared to women. Studies at the community and national levels have found that social and environmental factors are important determinants of men’s physical activity, but little is known about how regional influences affect physical activity behaviors among men. The objective of this study is to examine the association between geographic region and physical activity among men in the United States, and to determine if there are racial/ethnic differences in physical activity within these geographic regions. Cross-sectional data from men who participated the 2000 to 2010 National Health Interview Survey (N = 327,556) was used. The primary outcome in this study was whether or not men had engaged in sufficient physical activity to receive health benefits, defined as meeting the 2008 Physical Activity Guidelines for Americans. Race/ethnicity and geographic region were the primary independent variables. Within every region, Hispanic and Asian men had lower odds of engaging in sufficient physical activity compared to white men. Within the Northeast, South, and West, black men had lower odds of engaging in sufficient physical activity compared to white men. The key findings indicate that the odds of engaging in sufficient physical activity among men differ significantly between geographic regions and within regions by race/ethnicity.
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Affiliation(s)
- Elizabeth Kelley Sohn
- 1 Program of Research for Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tichelle Porch
- 1 Program of Research for Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah Hill
- 1 Program of Research for Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- 1 Program of Research for Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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36
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Thorpe RJ, Parker LJ, Cobb RJ, Dillard F, Bowie J. Association between discrimination and obesity in African-American men. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:253-261. [PMID: 29035104 PMCID: PMC5889913 DOI: 10.1080/19485565.2017.1353406] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The objective of this study was to examine the association between discrimination and obesity among a U.S. nationally representative sample of African-American men. Data from the 2001-2003 National Survey of American Life (NSAL) were used to collect measures of everyday and major discrimination, and body mass index (BMI) taken from self-reports. Poisson regression with robust standard errors was applied to estimate the prevalence ratios of everyday and major discrimination as it relates to obesity (BMI ≥ 30 kg/m2), controlling for potential confounders. In the model that included both everyday and major discrimination, men who experienced any major discrimination had a higher likelihood of obesity (prevalence ratio [PR] = 1.33, 95% confidence interval [CI], 1.06, 1.66) than those who did not experience any major discrimination, controlling for age, marital status, income, education, major stressors, two or more chronic conditions, and physical activity. Exposure to any major discrimination was found to be associated with obesity in African-American men. Future studies among this population are needed to examine whether the observed changes in self-reports of major discrimination are associated with obesity, measured by BMI, over time. The health of African-American men must be a priority in reducing excess disparities in disease, disability, and death.
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Affiliation(s)
- Roland J. Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lauren J. Parker
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryon J. Cobb
- Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Felicia Dillard
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Janice Bowie
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Thorpe RJ, Fesahazion RG, Parker L, Wilder T, Rooks RN, Bowie JV, Bell CN, Szanton SL, LaVeist TA. Accelerated Health Declines among African Americans in the USA. J Urban Health 2016; 93:808-819. [PMID: 27653384 PMCID: PMC5052148 DOI: 10.1007/s11524-016-0075-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The weathering hypothesis, an explanation for race disparities in the USA, asserts that the health of African Americans begin to deteriorate prematurely compared to whites as a consequence of long-term exposure to social and environmental risk factors. Using data from 2000-2009 National Health Interview Surveys (NHIS), we sought to describe differences in age-related health outcomes in 619,130 African Americans and whites. Outcome measures included hypertension, diabetes, stroke, and cardiovascular disease. Using a mixed models approach to age-period-cohort analysis, we calculated age- and race-specific prevalence rates that accounted for the complex sampling design of NHIS. African Americans exhibited higher prevalence rates of hypertension, diabetes, and stroke than whites across all age groups. Consistent with the weathering hypothesis, African Americans exhibited equivalent prevalence rates for these three conditions 10 years earlier than whites. This suggests that African Americans are acquiring age-related conditions prematurely compared to whites.
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Affiliation(s)
- Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, 21205, USA.
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
- Center for Biobehavioral Health Disparities Research, Duke University, Durham, USA.
| | - Ruth G Fesahazion
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, 21205, USA
| | - Lauren Parker
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tanganiyka Wilder
- Department of Biological Sciences, Florida A&M University, Tallahassee, FL, USA
| | - Ronica N Rooks
- Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, USA
| | - Janice V Bowie
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, 21205, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Caryn N Bell
- Department of African American Studies, University of Maryland College Park, College Park, MD, USA
| | - Sarah L Szanton
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, 21205, USA
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, USA
| | - Thomas A LaVeist
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, 21205, USA
- Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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38
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Bruce MA, Beech BM, Griffith DM, Thorpe RJ. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study. Behav Med 2016; 42:183-9. [PMID: 27337622 PMCID: PMC5656381 DOI: 10.1080/08964289.2015.1121133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.
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Affiliation(s)
- Marino A. Bruce
- Center for Health of Minority Males, Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Jackson MS, USA, ,Department of Sociology and Criminal Justice, Jackson State University, Jackson, MS
| | - Bettina M. Beech
- Center for Health of Minority Males, Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Jackson MS, USA, ,Departments of Pediatrics and Family Medicine, University of Mississippi Medical Center, Jackson, MS, USA,
| | - Derek M. Griffith
- Institute for Research on Men’s Health, Vanderbilt University, Nashville, TN, USA, ,Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
| | - Roland J. Thorpe
- Program for Research on Men’s Health, Johns Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA, ,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Baltimore, MD, USA
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Brown TH, Hargrove TW, Griffith DM. Racial/Ethnic Disparities in Men's Health: Examining Psychosocial Mechanisms. FAMILY & COMMUNITY HEALTH 2015; 38:307-18. [PMID: 26291191 PMCID: PMC4547357 DOI: 10.1097/fch.0000000000000080] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study uses data from the Health and Retirement Study and an approach informed by the Biopsychosocial Model of Racism as a Stressor to examine the extent to which socioeconomic status, stressors, discrimination, and neighborhood conditions are mechanisms underlying racial/ethnic disparities in functional limitations among men. Results reveal that racial/ethnic differences in socioeconomic status, stressors, discrimination, and neighborhood conditions-individually and collectively-account for a substantial proportion of racial/ethnic disparities in functional limitations. Findings suggest that the social determinants of health for men of color need to be more seriously considered in investigations of and efforts to address health disparities.
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Affiliation(s)
- Tyson H Brown
- Department of Sociology, Vanderbilt University, Nashville, Tennessee
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Bruce MA, Beech BM, Thorpe RJ, Griffith DM. Racial Disparities in Sugar-Sweetened Beverage Consumption Change Efficacy Among Male First-Year College Students. Am J Mens Health 2015; 10:NP168-NP175. [PMID: 26272888 DOI: 10.1177/1557988315599825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Racial disparities in weight-related outcomes among males may be linked to differences in behavioral change efficacy; however, few studies have pursued this line of inquiry. The purpose of this study was to determine the degree to which self-efficacy associated with changing sugar-sweetened beverage (SSB) consumption intake varies by race among male first-year college students. A self-administered, cross-sectional survey was completed by a subsample of freshmen males (N = 203) at a medium-sized southern university. Key variables of interest were SSB intake and self-efficacy in reducing consumption of sugared beverages. African American and Whites had similar patterns of SSB intake (10.2 ± 2.8 vs. 10.1 ± 2.6); however, African Americans had lower proportions of individuals who were sure they could substitute sugared beverages with water (42.2% vs. 57.5%, p < .03). The results from logistic regression models suggest that self-efficacy to reduce SSB intake among males vary by race. African American males were less likely to assert confidence in their ability to change behaviors associated with SSB (odds ratio = 0.51; confidence interval [0.27, 0.95]) in the full model adjusting for weight-related variables including SSB consumption. The findings suggest that weight loss and weight prevention interventions targeting young African American males require components that can elevate self-efficacy of this group to facilitate behavioral modifications that reduce SSB consumption and their risk for obesity-related diseases.
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Affiliation(s)
- Marino A Bruce
- University of Mississippi Medical Center, Jackson, MS, USA Jackson State University, Jackson, MS, USA
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Hargrove TW, Brown TH. A Life Course Approach to Inequality: Examining Racial/Ethnic Differences in the Relationship between Early Life Socioeconomic Conditions and Adult Health Among Men. Ethn Dis 2015; 25:313-20. [PMID: 26674267 DOI: 10.18865/ed.25.3.313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men. DESIGN Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147). RESULTS Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men. CONCLUSIONS The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men.
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Affiliation(s)
| | - Tyson H Brown
- 1. Sociology Department, Vanderbilt University, Nashville, Tenn
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Abstract
OBJECTIVE To consider how manhood is a key social determinant of minority men's health. DESIGN This commentary explicates how manhood intersects with other determinants of health to shape minority men's stress responses, health behaviors and health outcomes across the life course. RESULTS Manhood, which perpetually needs to be proven, is an aspirational identity that is defined by the intersection of age, race/ethnicity and other identities. Minority men seek to and successfully embody US-cultural and ethnic-specific aspects of manhood in their daily lives by engaging in behaviors that constantly reaffirm their gender identity through a complex internal and social calculus that varies by intra-personal characteristics and context. Manhood and health are relational constructs that highlight how the salience of masculinities are shaped by perceived and actual social norms and expectations. A life course perspective adds a framework for considering how some gendered beliefs, goals and behaviors change over time while others remain static. Three life course frameworks highlight different mechanisms through which minority men's life experiences and physiological and behavioral responses to gendered social norms, beliefs and expectations become embodied as premature mortality and other health outcomes over the life course. CONCLUSION Manhood represents an important lens to understand how minority men's identities, goals and priorities affect their health, yet the role of manhood in minority men's health is understudied and underdeveloped. To achieve health equity, it is critical to consider how manhood shapes minority men's lives and health across the life course, and to address how manhood affects gendered and non-gendered mechanisms and pathways that explain minority men's health over time.
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Affiliation(s)
- Derek M. Griffith
- 1. Institute for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee
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Mehta NK, Elo IT, Ford ND, Siegel KR. Obesity Among U.S.- and Foreign-Born Blacks by Region of Birth. Am J Prev Med 2015; 49:269-73. [PMID: 25896192 PMCID: PMC4509865 DOI: 10.1016/j.amepre.2015.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 01/26/2015] [Accepted: 02/24/2015] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Large, recent migration streams from the non-Hispanic Caribbean islands and Africa have increased the share of U.S. blacks born outside of the U.S. Little is known about health patterns in these foreign-born populations. The purpose of this study is to compare obesity levels among self-identified U.S. blacks across birth regions and examine potential explanations for subgroup differences. METHODS Data were from the 2000-2013 National Health Interview Surveys. Three birthplace subgroups were examined: individuals born in the U.S., Caribbean/South America, and Africa, aged 25-59 years. Data were analyzed in 2013-2014. RESULTS Compared to U.S.-born participants, foreign-born participants had significantly lower obesity (BMI ≥30) odds. The AORs were 0.51 (Caribbean/South American-born, 95% CI=0.44, 0.58) and 0.41 (African-born, 95% CI=0.34, 0.50) with reference to U.S.-born individuals. Education, income, and cigarette smoking did not explain the favorable weight pattern of the foreign born. Among the foreign born, those residing in the U.S. for ≥15 years had 51% (95% CI=10%, 108%) higher obesity odds compared with those residing for <5 years. No statistically significant differences in obesity odds between those born in the Caribbean/South America and Africa were detected. CONCLUSION Foreign-born blacks generally had lower obesity levels compared to their U.S.-born counterparts, which was not explained by SES or smoking behaviors. Despite this advantage, obesity prevalence among foreign-born black women was around 30%, suggesting that obesity poses a significant health risk this population.
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Affiliation(s)
- Neil K Mehta
- Hubert Department of Global Health, Rollins School of Public Health.
| | - Irma T Elo
- Department of Sociology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicole D Ford
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia
| | - Karen R Siegel
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia
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Corral I, Landrine H, Hall MB, Bess JJ, Mills KR, Efird JT. Residential Segregation and Overweight/Obesity Among African-American Adults: A Critical Review. Front Public Health 2015; 3:169. [PMID: 26191522 PMCID: PMC4489328 DOI: 10.3389/fpubh.2015.00169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/17/2015] [Indexed: 11/13/2022] Open
Abstract
The relationship between residential segregation and overweight/obesity among African-American adults remains unclear. Elucidating that relationship is relevant to efforts to prevent and to reduce racial disparities in obesity. This article provides a critical review of the 11 empirical studies of segregation and overweight/obesity among African-American adults. Results revealed that most studies did not use a valid measure of segregation, many did not use a valid measure of overweight/obesity, and many did not control for neighborhood poverty. Only four (36% of the) studies used valid measures of both segregation and overweight/obesity and also controlled for area-poverty. Those four studies suggest that segregation contributes to overweight and obesity among African-American adults, but that conclusion cannot be drawn with certainty in light of the considerable methodologic problems in this area of research. Suggestions for improving research on this topic are provided.
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Affiliation(s)
- Irma Corral
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | - Hope Landrine
- Center for Health Disparities, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | - Marla B Hall
- Department of Public Health, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | - Jukelia J Bess
- Center for Health Disparities, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | - Kevin R Mills
- Center for Health Disparities, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | - Jimmy T Efird
- Center for Health Disparities, Brody School of Medicine, East Carolina University , Greenville, NC , USA
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Hill SE, Bell C, Bowie JV, Kelley E, Furr-Holden D, LaVeist TA, Thorpe RJ. Differences in Obesity Among Men of Diverse Racial and Ethnic Background. Am J Mens Health 2015; 11:984-989. [PMID: 25862694 DOI: 10.1177/1557988315580348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Racial/ethnic disparities exist in obesity prevalence among men, with Hispanic men exhibiting the highest prevalence compared with non-Hispanic White and non-Hispanic Black men. Most studies do not parse out Hispanic groups; therefore, it is unclear whether the increases in obesity rates among Hispanic men applies to all groups or if there are particular groups of Hispanic men that are driving the increase. The goal of this study is to examine the variations in obesity among men of diverse racial/ethnic backgrounds and determine if obesity is affected by nativity. The data used in this study were from 11 years (2002-2012) of the National Health Interview Survey. Logistic regression was used to examine the relationship between race/ethnicity, obesity, and nativity. After adjusting for covariates, there are differences in obesity prevalence, with the largest prevalence among Puerto Rican men and Mexican American men. Consistent with previous literature, it has been suggested that men born in the United States are more likely to be obese than men born outside the United States. This study underscores the importance of distinguishing Hispanic groups when examining obesity, and provides information for future, targeted intervention strategies related to obesity among high-risk groups.
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Affiliation(s)
- Sarah E Hill
- 1 Undergraduate Program in Public Health Studies, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD, USA.,2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caryn Bell
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janice V Bowie
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Kelley
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Debra Furr-Holden
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas A LaVeist
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- 2 Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Seamans MJ, Robinson WR, Thorpe RJ, Cole SR, LaVeist TA. Exploring racial differences in the obesity gender gap. Ann Epidemiol 2015; 25:420-5. [PMID: 25887701 DOI: 10.1016/j.annepidem.2015.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 02/09/2015] [Accepted: 03/13/2015] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate whether the gender gap in obesity prevalence is greater among U.S. blacks than whites in a study designed to account for racial differences in socioeconomic and environmental conditions. METHODS We estimated age-adjusted, race-stratified gender gaps in obesity (% female obese - % male obese, defined as body mass index ≥30 kg/m(2)) in the National Health Interview Survey 2003 and the Exploring Health Disparities in Integrated Communities-Southwest Baltimore 2003 study (EHDIC-SWB). EHDIC-SWB is a population-based survey of 1381 adults living in two urban, low-income, racially integrated census tracts with no race difference in income. RESULTS In the National Health Interview Survey, the obesity gender gap was larger in blacks than whites as follows: 7.7 percentage points (ppts; 95% confidence interval (CI): 3.4-11.9) in blacks versus -1.5 ppts (95% CI: -2.8 to -0.2) in whites. In EHDIC-SWB, the gender gap was similarly large for blacks and whites as follows: 15.3 ppts (95% CI: 8.6-22.0) in blacks versus 14.0 ppts (95% CI: 7.1-20.9) in whites. CONCLUSIONS In a racially integrated, low-income urban community, gender gaps in obesity prevalence were similar for blacks and whites.
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Affiliation(s)
- Marissa J Seamans
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill.
| | - Whitney R Robinson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Stephen R Cole
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Thomas A LaVeist
- Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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47
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Kelley EA, Bowie JV, Griffith DM, Bruce M, Hill S, Thorpe RJ. Geography, Race/Ethnicity, and Obesity Among Men in the United States. Am J Mens Health 2015; 10:228-36. [PMID: 25567236 DOI: 10.1177/1557988314565811] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The prevalence of obesity in the United States has increased significantly and is a particular concern for minority men. Studies focused at the community and national levels have reported that geography can play a substantial role in contributing to obesity, but little is known about how regional influences contribute to obesity among men. The objective of this study is to examine the association between geographic region and obesity among men in the United States and to determine if there are racial/ethnic differences in obesity within these geographic regions. Data from men, aged 18 years and older, from the National Health Interview Survey were combined for the years 2000 to 2010. Obesity was defined as body mass index (BMI) ≥30 kg/m(2) Logistic regression models were specified to calculate the odds ratio (OR) and 95% confidence interval (CI) for the association between geographic region and obesity and for race and obesity within geographic regions. Compared to men living in the Northeast, men living in the Midwest had significantly greater odds of being obese (OR = 1.09, 95% CI [1.02, 1.17]), and men living in the West had lower odds of being obese (OR = 0.82, 95% CI [0.76, 0.89]). Racial/ethnic differences were also observed within geographic region. Black men have greater odds of obesity than White men in the South, West, and Midwest. In the South and West, Hispanic men also have greater odds of obesity than White men. In all regions, Asian men have lower odds of obesity than White men.
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Affiliation(s)
- Elizabeth A Kelley
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janice V Bowie
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek M Griffith
- Institute for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Marino Bruce
- Center for Health of Minority Males, University of Mississippi Medical Center, Jackson, MS, USA Jackson State University, Jackson, MS, USA
| | - Sarah Hill
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Johns Hopkins University, Baltimore, MD, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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