Abstract P078: Childhood Social Determinants Explain Ethnic Disparities in Obesity Among Black American Women

Abstract

Introduction: Black American women have the highest prevalence of obesity in the United States (US). Ethnic disparities in this risk factor for cardiovascular disease have been found; Afro-Caribbean women have lower rates of obesity compared with African American women. Contributing factors of the ethnic disparity in adult obesity have yet to be fully elucidated. However, the emergence of the ethnic disparity in adolescence suggests a potential role for childhood social determinants. Hypothesis: Childhood social determinants are hypothesized to explain the ethnic disparity in obesity between African American and Afro-Caribbean women in the United States. Methods: Multiple logistic regression models were used to examine childhood social factors and adult social, health and lifestyle risk factors that explain the ethnic disparity in obesity between African American (N = 2299) and Afro-Caribbean women (N = 978), 18 years and older, in the National Survey of American Life (2001-2003). Adult socioeconomic factors included marital status, education, occupation, home ownership and poverty status. Adult health and lifestyle risk covariates included hypertension, diabetes, menopausal status, smoking, alcohol use and physical activity. Childhood social factors included measures of parental education, receipt of public assistance prior to 18 years of age, and type of high school attended (private/parochial vs. public). Odds ratios (OR) of the association between ethnicity and adult obesity were estimated after adjusting age and adult socioeconomic measures, adult health and lifestyle measures and childhood social factors within the models. Results: The prevalence of obesity was 40.5% among African American women and 30.8% among Afro-Caribbean women. Afro-Caribbean women had 34% lower odds of obesity than African American women; age-adjusted OR = 0.66; 95%CI: (0.52, 0.82). Adjusting for age and adult socioeconomic factors slightly decreased the ethnic disparity; adjusted OR = 0.70; 95%CI: (0.53, 0.94). Adjusting for age and adult health and lifestyle factors decreased the disparity by 11%; adjusted OR = 0.73; 95%CI: (0.55, 0.97). Adjusting for age and childhood social factors eliminated the ethnic disparity; adjusted OR = 1.00; 95%CI: (0.82, 1.23). Conclusions: These findings suggest that childhood social factors are key contributors to the ethnic disparities in obesity between African American and Afro-Caribbean women in the US.