Abstract P089: Does Social Support Attenuate the Impact of Poverty Status on Body Mass Index?

Abstract

Background: Chronic stress associated with living in poverty may lead to higher levels of adiposity due to the adoption of obesity-promoting stress coping behaviors. Social support may provide an alternative means of coping with stress, but very few studies have investigated whether high levels of social support can mitigate the adverse impact of poverty on adiposity. Hypothesis: We hypothesized that social support modified the association between poverty and BMI whereby the association of poverty with BMI was weaker among adults who reported higher social support. Methods: National Health and Nutrition Examination Survey (2005–2008) participants ages 40+ (n=5,768) responded to questions about availability and adequacy of emotional social support (adequate, inadequate, and none) and about availability of financial support (yes/no). Poverty was defined as a poverty:income ratio ≤ 1.3. BMI (kg/m 2 ) was calculated from measured height and weight. Sex-stratified multivariable linear regression with interaction terms for poverty and each measure of social support were used to test for effect measure modification in the relationships between poverty and BMI. Associations of each measure of social support with BMI were modeled separately. Results: Approximately 74.7% of women and 78.3% of men reported adequate emotional support. Available financial support was reported by 80.3% of women and 73.6% of men. Among women, higher poverty was related to higher mean BMI (beta=0.96; SE=0.32). Women who reported adequate emotional support had lower BMI than those who reported inadequate support (beta= −0.83; SE=0.35). Those who reported no available emotional support also had marginally lower mean BMI than women who reported inadequate support (beta= −1.27; SE=0.65; P =0.06). Women who reported having available financial support had lower BMI than those who reported no financial support (beta= −0.97; SE=0.40). There were no significant social support*poverty interactions. The relationship between poverty and BMI was similar in magnitude across levels of emotional support. Poverty was related to higher mean BMI for women who reported available financial support (beta=1.14; SE=0.45) but there was no difference in BMI among those who reported none (beta=0.02; SE=0.54). Neither measure of support was associated with BMI among men. Conclusions: Inadequate emotional support was associated with higher mean BMI in women than those who reported adequate support and those who reported no support. Lack of financial support was also associated with higher mean BMI in women. High social support did not offset the impact of poverty on BMI among women, suggesting social support may not be a sufficient strategy for coping with the stress of poverty.