American Indian, Alaska Native, Native Hawaiian, and Pacific Islander Children's Body Mass Index: Diminished Returns of Parental Education and Family Income.

Shervin Assari

doi:10.22158/rhs.v5n1p64

Abstract

Socioeconomic status (SES) is associated with several health-related outcomes, such as obesity and body mass index (BMI). However, we do not know whether SES is associated differently with children's BMI from American Indian and Alaska Native and Native Hawaiian and Pacific Islander (AIAN/NHPI) families when compared to non-Hispanic White (NHW) families. To compare AIAN/NHPI and NHW families for associations between parental education, family income, and children's BMI in the United States (U.S). This cross-sectional investigation used the Adolescent Brain Cognitive Development (ABCD) study data. Participants (n = 8580) included 63 AIAN/NHPI and 8517 NHW children between ages 9 and 10. The independent variables were parental education and family income. The primary outcome was BMI. Race was the moderator. Age, sex, and family structure were covariates. Mixed-effects regression models were used for data analysis. In the pooled sample, higher parental education and family income were associated with lower children's BMI. We found interactions between race and parental education and family income indicating weaker associations between parental education and family income and children's BMI in AIAN/NHPI families than in NHW families. The salience of parental education and family income as social determinants of children's BMI is diminished for AIAN/NHPI families than NHW families. As a result, AIAN/NHPI children with high SES remain at risk for high BMI, while high-SES NHW children show the lowest BMI. Future research should test if obesogenic environments, food options, and physical activity-friendly neighborhoods can explain higher-than-expected BMI in high-SES AIAN/NHPI children. In other terms, more research is needed to understand if residential segregation, discrimination, and historical trauma explain the observed differences in the social patterning of childhood BMI in AIAN/NHPI and NHW communities.

Highlights

High socioeconomic status (SES) is associated with several health-related outcomes, such as obesity and body mass index (BMI)
While higher family SES is expected to be associated with lower BMI (Hypothesis 1), we expect the associations between family income and parental education and childhood BMI to be less salient for AIAN/Native Hawaiian Pacific Islander (NHPI) children than for non-Hispanic White (NHW) children (Hypothesis 2)
The current analysis was performed on 8580 BMI observations that were for participants who AIAN/NHPI (n = 63) or NHW (n = 8517) children between the ages 9 and 10

Summary

Introduction

High socioeconomic status (SES) is associated with several health-related outcomes, such as obesity and body mass index (BMI). There is at least some evidence that suggests that the SES gradient in childhood BMI may be weaker in AIAN/NHPI populations than the SES effects in NHW families This is based on the observations that SES effects on obesity (Assari, Chalian, & Bazargan, 2019; Assari, Thomas, Caldwell, & Mincy, 2018), exercise (Assari, 2019), and diet (Assari, Boyce, Bazargan, Caldwell, & Mincy, 2020; Assari & Lankarani, 2018) are weaker in Hispanic and Non-Hispanic Black families than in NHW families, a pattern called Minorities’ Diminished Returns (MDRs) The weaker association between family SES and childhood BMI in AIAN/NHPI families rather than NHW families is in line with the previously published work on weaker effects of family SES indicators, such as parental education and family income on BMI of children and adults in Black and Hispanic than NHW families (Assari, 2020c; Assari, Caldwell, & Mincy, 2018; Assari & Lankarani, 2016)

Objectives

Methods

Discussion

Conclusion