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Tan JY, Guan A, Albers AE, Canchola AJ, Allen L, Shariff-Marco S, Gomez SL. Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA. BMC Public Health 2024; 24:2128. [PMID: 39107722 PMCID: PMC11302078 DOI: 10.1186/s12889-024-19435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Dietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics. METHODS Data were from a 2013-2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation. RESULTS Three dietary patterns were identified: "Asian," "Western," and a distinct "Multicultural" factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy. CONCLUSIONS The finding of a distinct "Multicultural" factor beyond the typical "Asian" and "Western" factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.
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Affiliation(s)
- Judy Y Tan
- Cancer Research Center on Health Equity, Division of Population Sciences, Cedars-Sinai Medical Center, 6500 Wilshire Blvd., Los Angeles, CA, 90048, USA.
| | - Alice Guan
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | | | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Laura Allen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
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Agbonlahor O, DeJarnett N, Hart JL, Bhatnagar A, McLeish AC, Walker KL. Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:783-807. [PMID: 36976513 PMCID: PMC10044132 DOI: 10.1007/s40615-023-01561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases. METHODS The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease. RESULTS Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies. DISCUSSION Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.
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Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Alison C. McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
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Gilan NR, Mohamadi J, Irankhah A, Khezeli M, Zangeneh A. Review of the effect cultural capital and subjective socioeconomic status on life satisfaction in Iran: the mediating role of health-promoting lifestyle and the moderating role of ethnicity. BMC Public Health 2023; 23:2563. [PMID: 38135873 PMCID: PMC10740275 DOI: 10.1186/s12889-023-17490-x] [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] [Received: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Health-promoting lifestyle can leads to improving the quality of life, life satisfaction, well-being and reducing the burden of health care in the society. This study was carried out to investigate the mediating role of health-promoting lifestyle and moderating role of ethnicity in the effect of cultural capital and subjective socioeconomic status on life satisfaction in Iran. METHODS This cross-sectional study was conducted with 800 respondents in the cities of Kermanshah with Kurdish ethnicity and Tabriz with Azeri ethnicity. The data gathering tool was a questionnaire in five section including demographic checklist, cultural capital questionnaire (2015),Diener's life satisfaction scale, and health-promoting lifestyle questionnaire (HPLP II), and socioeconomic status scale. Data were analyzed by SPSS and AMOS software. RESULTS Life satisfaction had the highest correlation with the objective dimension of cultural capital (p < 0.001 r = 0.298). The direct standardized coefficient of the path of cultural capital to health-promoting lifestyle was 0.44 (P < 0.001). Also the direct standardized coefficient of cultural capital on Life satisfaction was 0.04 that was not significant. The standard coefficient of the path of cultural capital on life satisfaction through health-promoting lifestyle was 0.27(P < 0.001). Ethnicity variable did not moderate the effect of cultural capital on life satisfaction (p > 0.05). CONCLUSION The results of this study showed that paying attention to the concept of health-promoting lifestyle is a necessity to affect life satisfaction. It can play a role as a mediator for the path of cultural capital and socio-economic status on life satisfaction. This study also showed the role of ethnicity as a moderating variable in the relationship between socio-economic status and health-promoting lifestyle.
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Affiliation(s)
- Nader Rajabi Gilan
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jamal Mohamadi
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran.
| | - Adel Irankhah
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
| | - Mehdi Khezeli
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Harris CL, Haack S, Miao Z. Everyday discrimination is a stronger predictor of eating competence than food insecurity or perceived stress in college students amidst COVID-19. Appetite 2022; 179:106300. [PMID: 36075312 PMCID: PMC9444333 DOI: 10.1016/j.appet.2022.106300] [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: 05/21/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 12/04/2022]
Abstract
Stress is a common experience of college students, which has been exacerbated by COVID-19. Perceived stress may help predict students’ eating behaviors. Eating competence is an adaptive model of eating characterized as being flexible, comfortable, and positive with food and eating, and reliable about getting enough nourishing and enjoyable food to eat. Eating competence is associated with numerous health benefits and may be developing and/or disrupted as young adults transition to college. No prior research has explored the associations of everyday discrimination and food insecurity with eating competence, and there is limited research on the eating competence of trans and gender nonconforming (TGNC) college students. This cross-sectional study sought to examine the associations of everyday discrimination, food insecurity, and perceived stress with eating competence in a sample of 1996 undergraduate students. Participants completed an online survey comprised of validated tools assessing socio-demographics, eating competence, everyday discrimination, food insecurity, and perceived stress and stress management. After accounting for covariates (gender, stress management), multivariate regression analyses were conducted, and the coefficients of partial determination revealed that everyday discrimination was the strongest predictor of eating competence. Results demonstrated that lower experience of everyday discrimination, less stress, and being food secure were associated with greater likelihood of being eating competent (EC). Men were more likely to be EC than women or TGNC identities. Since the experience of everyday discrimination was the strongest, inverse predictor of eating competence, addressing discrimination must be considered in future efforts to improve eating competence.
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Affiliation(s)
- Cristen L Harris
- Department of Epidemiology, Nutritional Sciences Program, School of Public Health, University of Washington, 305 Raitt Hall, Box 353410, Seattle, WA, 98195-3410, USA.
| | - Sarah Haack
- Nutritional Sciences Program, School of Public Health, University of Washington, USA.
| | - Zhen Miao
- Department of Statistics, College of Arts and Sciences, University of Washington, USA.
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Su D, Alshehri K, Ern J, Chen B, Chen L, Chen Z, Han X, King KM, Li H, Li J, Li Y, Michaud T, Shi L, Ramos AK, Wen M, Zhang D. Racism Experience Among American Adults During COVID-19: A Mixed-Methods Study. Health Equity 2022; 6:554-563. [PMID: 36081888 PMCID: PMC9448514 DOI: 10.1089/heq.2022.0070] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Khalid Alshehri
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jessica Ern
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Keyonna M. King
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Hongmei Li
- Department of Media, Journalism and Film, Miami University, Oxford, Ohio, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tzeyu Michaud
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina, USA
| | - Athena K. Ramos
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, New York, USA
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Ifatunji MA, Faustin Y, Lee W, Wallace D. Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159166. [PMID: 35954520 PMCID: PMC9367942 DOI: 10.3390/ijerph19159166] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
After more than a century of research and debate, the scientific community has yet to reach agreement on the principal causes of racialized disparities in population health. This debate currently centers on the degree to which "race residuals" are a result of unobserved differences in the social context or unobserved differences in population characteristics. The comparative study of native and foreign-born Black populations represents a quasi-experimental design where race is "held constant". Such studies present a unique opportunity to improve our understanding of the social determinants of population health disparities. Since native and foreign-born Black populations occupy different sociocultural locations, and since populations with greater African ancestry have greater genetic diversity, comparative studies of these populations will advance our understanding of the complex relationship between sociocultural context, population characteristics and health outcomes. Therefore, we offer a conceptual framing for the comparative study of native and foreign-born Blacks along with a review of 208 studies that compare the mental and physical health of these populations. Although there is some complexity, especially with respect to mental health, the overall pattern is that foreign-born Blacks have better health outcomes than native-born Blacks. After reviewing these studies, we conclude with suggestions for future studies in this promising area of social and medical research.
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Affiliation(s)
- Mosi Adesina Ifatunji
- Departments of African American Studies and Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 53706, USA
- Correspondence:
| | - Yanica Faustin
- Department of Public Health Studies, College of Arts and Sciences, Elon University, Elon, NC 27244, USA;
| | - Wendy Lee
- Department of Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 54706, USA;
| | - Deshira Wallace
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
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Miller HN, Perrin N, Thorpe RJ, Evans MK, Zonderman AB, Allen J. The Association Between Perceived Discrimination and BMI Trajectory: A Prospective Study of African American and White Adults. FAMILY & COMMUNITY HEALTH 2022; 45:206-213. [PMID: 35385415 PMCID: PMC9156529 DOI: 10.1097/fch.0000000000000326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evidence suggests that socioenvironmental stressors, such as discrimination, may serve as determinants of the ongoing obesity epidemic and persisting disparities in obesity prevalence. The objectives of these analyses were to examine whether perceived discrimination was associated with body mass index (BMI) trajectory and whether this relationship differed by race or sex. Data for these analyses came from the Healthy Aging in Neighborhoods of Diversity across the Life Span study, a prospective cohort study in Baltimore City. Mixed-effects linear regression was used in a sample of 1962 African American and white adults to test our hypotheses. We found that race was an effect modifier in the relationship between perceived discrimination and BMI trajectory (B = 0.063, P = .014). Specifically, higher baseline perceived discrimination was associated with positive BMI trajectory in African American adults (B = 0.031, P = .033) but not in white adults (B = -0.032 P = .128). In this longitudinal study of African American and white adults, the relationship between perceived discrimination and BMI trajectory differed by race. Future research should be conducted in diverse samples to understand the risk socioenvironmental stressors pose on the development and progression of overweight and obesity, in addition to how these differ in subgroups.
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Affiliation(s)
- Hailey N Miller
- School of Nursing, Duke University, Durham, North Carolina (Dr Miller); School of Nursing (Drs Perrin and Allen) and Bloomberg School of Public Health (Dr Thorpe), Johns Hopkins University, Baltimore, Maryland; and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland (Drs Evans and Zonderman)
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Roberts SB, Anton S, Dao MC. Weight Loss Strategies. Handb Exp Pharmacol 2022; 274:331-348. [PMID: 35624229 DOI: 10.1007/164_2022_580] [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: 06/15/2023]
Abstract
Lifestyle interventions for weight loss combine support for changing diet and physical activity with weight management education and are considered the first line treatment for obesity. A variety of diet-focused interventions including time-restricted eating are also increasingly being promoted for weight management. This chapter reviews different types of interventions for weight management, their underlying health behavior change models, and effectiveness to date in randomized trials. The results justify increasing efforts to improve program effectiveness generally, and to personalize interventions to support long-term adherence. The high prevalence of obesity worldwide, combined with the known increase in risk of non-communicable diseases with duration of excess weight, provides a compelling justification for routine delivery of effective weight management interventions in the community and in clinical care.
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Affiliation(s)
- Susan B Roberts
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Stephen Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Maria C Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, USA
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Merriwether EN, Wittleder S, Cho G, Bogan E, Thomas R, Bostwick N, Wang B, Ravenell J, Jay M. Racial and weight discrimination associations with pain intensity and pain interference in an ethnically diverse sample of adults with obesity: a baseline analysis of the clustered randomized-controlled clinical trial the goals for eating and moving (GEM) study. BMC Public Health 2021; 21:2201. [PMID: 34856961 PMCID: PMC8638106 DOI: 10.1186/s12889-021-12199-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Everyday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD and WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD, WD, and pain outcomes in ethnically diverse adults with obesity is unclear. Thus, the purposes of this study were to: 1) examine whether RD and WD are associated with pain intensity and interference, and 2) explore gender as a moderator of the associations between RD, WD, and pain. METHODS This is a baseline data analysis from a randomized, controlled clinical trial of a lifestyle weight-management intervention. Eligible participants were English or Spanish-speaking (ages 18-69 years) and had either a body mass index of ≥30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. RD and WD were measured using questions derived from the Experiences of Discrimination questionnaire (EOD). Pain interference and intensity were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, gender, and pain outcomes. RESULTS Participants (n = 483) reported mild pain interference (T-score: 52.65 ± 10.29) and moderate pain intensity (4.23 ± 3.15). RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). Also, there were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or pain intensity. CONCLUSIONS Pain is highly prevalent in adults with obesity, and is impacted by the frequencies of experiences with RD and WD. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of RD and WD could help clinicians make culturally informed assessment and intervention decisions that address barriers to pain relief and weight loss. TRIAL REGISTRATION NCT03006328.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Melanie Jay
- NYU Grossman School of Medicine, New York, USA
- New York Harbor VA, New York, USA
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Kamody RC, Grilo CM, Vásquez E, Udo T. Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI. Eat Weight Disord 2021; 26:2673-2682. [PMID: 33594660 DOI: 10.1007/s40519-021-01138-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To compare prevalence of self-reported diabetes between U.S. state-born, Puerto Rico-born, Mexico-born, Cuba-born, and South/Central America-born Hispanic groups, and examine whether risk for diabetes differs by country of origin and experiences with discrimination when accounting for BMI. METHODS Data from 6223 Hispanic respondents from the nationally representative NESARC-III study was used. Sociodemographic characteristics were compared across nativity groups, and adjusted odds of self-reported diabetes diagnosis (past year) tested. Differences by perceived discrimination (using endorsement of individual items assessing specific experiences) and by nativity were examined when accounting for sociodemographic characteristics, acculturation, and BMI. RESULTS Prevalence of self-reported diabetes diagnosis was significantly higher among the Puerto Rico-born Hispanics, and remained significantly elevated when adjusting for perceived discrimination, acculturation, and health risk behaviors. When adjusting further for BMI, there were no significant differences in the odds of diabetes by nativity. Prevalence of lifetime perceived discrimination was significantly lower among Cuba-born Hispanics. Mean BMI was significantly lower in South/Central America-born Hispanic individuals relative to U.S. state-, Mexico-, and Puerto Rico-born Hispanic groups. Higher BMI was associated with significantly greater risk of diabetes diagnosis across groups. CONCLUSION Marked heterogeneity exists in prevalence and in factors associated with diabetes risk and weight status across Hispanic groups in the U.S. Experiences with discrimination may play an important role in accounting for these differences. This should be considered when planning future research to inform the most optimal patient-centered prevention efforts. LEVEL OF EVIDENCE Level III, Evidence obtained from well-designed cohort analytic study.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Child Study Center, Yale University School of Medicine, 350 George Street, New Haven, CT, 06511, USA.
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Elizabeth Vásquez
- Department of Epidemiology & Biostatistics, School of Public Health, University of Albany, State University of New York, Albany, NY, USA
| | - Tomoko Udo
- Department of Health Policy, Management, and Behavior, School of Public Health, University of Albany, State University of New York, Albany, NY, USA
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Haddad MR, Sarti FM, Nishijima M. Association between selected individual and environmental characteristics in relation to health behavior of Brazilian adolescents. Eat Weight Disord 2021; 26:331-343. [PMID: 32026377 DOI: 10.1007/s40519-020-00856-0] [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: 08/27/2019] [Accepted: 01/22/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The study investigates the evolution of healthy behaviors (healthy eating and regular physical activity) in Brazilian adolescents during 2012 and 2015, and its associations with self-assessment of body weight and adoption of weight control attitudes, in the context of diverse household features, school environments, and regional characteristics. METHODS Two cross-sectional surveys of Brazilian adolescents attending the ninth grade in 2012 and 2015 were gathered comprising a national sample. Data from 209,601 completed surveys were analyzed using robust error estimates of ordinary least squares regressions. RESULTS Results showed that there was a decrease in the frequency of healthy foods consumption and recommended physical activity level between 2012 and 2015. The regression analyses revealed that healthy eating and physical activity were significantly higher for adolescents with normal weight perception (i.e., did not perceive themselves to have either low or excess body weight) and for adolescents who were male, were members of middle socioeconomic stratum families, and had mothers with college degrees. In addition, healthy eating was significantly higher for adolescents who did not wish to lose weight, did not watch TV while eating, went to public schools, and lived with both parents. Ethnic differences varied based on region, with healthy eating being significantly higher among black/mulato/indigenous adolescents in the South and Southeast regions, but significantly higher among white/yellow adolescents in the North region. CONCLUSIONS Ethnic and gender-related differences were identified in health behaviors and attitudes towards weight control of Brazilian adolescents. Findings indicate the relevance of individual characteristics combined with the influence of social networks for the adoption of healthy behaviors among adolescent students. LEVEL OF EVIDENCE Level IV, evidence obtained from multiple time series without intervention.
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Affiliation(s)
- Mariana R Haddad
- Department of Integrated Education in Health, Federal University of Espirito Santo, Av. Marechal Campos, 1468 - Maruipe, Vitoria, 29040-090, ES, Brazil.
| | - Flavia M Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Av. Arlindo Bettio, 1000, Sao Paulo, 03828-000, Sao Paulo, Brasil
| | - Marislei Nishijima
- Institute of International Relations, University of Sao Paulo, Av Prof Lúcio Martins Rodrigues, Tv. 4/5, Sao Paulo, 05508-020, SP, Brazil
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De PK. Beyond race: Impacts of non-racial perceived discrimination on health access and outcomes in New York City. PLoS One 2020; 15:e0239482. [PMID: 32970711 PMCID: PMC7514095 DOI: 10.1371/journal.pone.0239482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND I investigate the association of perceived discrimination based both on race and other attributes such as age, gender, and insurance status on self-reported health access and health outcomes in a diverse and densely populated metropolitan area. METHODS Restricted data from the 2016 round of the New York City Community Health Survey was used to create prevalence estimates for both racial and non-racial discrimination. Logistic regression models were used to estimate the association of these discrimination measures with health access and health outcome variables. RESULTS Among residents who perceived discrimination receiving health care during the previous year, 15% reported the reason behind such discrimination to race, while the rest chose other reasons. Among the non-race based categories, 34% reported the reason behind such discrimination to be insurance status, followed by other reasons (26.83%) and income (11.76%). Non-racial discrimination was significantly associated with the adjusted odds of not receiving care when needed (AOR = 6.96; CI: [5.00 9.70]), and seeking informal care (AOR = 2.24; CI: [1.13 4.48] respectively, after adjusting for insurance status, age, gender, marital status, race/ethnicity, nativity, and poverty. It was also associated with higher adjusted odds of reporting poor health (AOR = 2.49; CI: [1.65 3.75]) and being diagnosed with hypertension (AOR = 1.75; CI: [1.21 2.52]), and diabetes (AOR = 1.84; CI: [1.22 2.77]) respectively. CONCLUSIONS Perceived discrimination in health care exists in multiple forms. Non-racial discrimination was strongly associated with worse health access and outcomes, and such experiences may contribute to health disparities between different socioeconomic groups.
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Affiliation(s)
- Prabal K. De
- Department of Economics and Business, City College, City University of New York, New York, NY, United States of America
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