Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study.

Julia D Carter,Shervin Assari

doi:10.3389/fnagi.2016.00312

Abstract

Background: Although obesity and physical activity influence psychosocial well-being, these effects may vary based on race, gender, and their intersection. Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH).Methods: Data came from waves 7, 8, and 10 (2004–2010) of the Health and Retirement Study (HRS), an ongoing national cohort started in 1992. The study enrolled a representative sample of Americans (n = 19,280) over the age of 50. Latent factors were used to calculate sustained high BMI and physical activity (predictors) and sustained poor SRH and high depressive symptoms (outcomes) based on measurements in 2004, 2006, and 2010. Age, education, and income were confounders. Multi-group structural equation modeling (SEM) was used to test the additive effects of BMI and physical activity on depressive symptoms and SRH, where the groups were defined based on race by gender.Results: Group differences were apparent in the direction and significance of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was positive and significant for White women (B = 0.03, p = 0.007) and non-significant for White men (B = −0.03, p = 0.062), Black men (B = −0.02, p = 0.564) and Black women (B = 0.03, p = 0.110). No group differences were found in the paths from sustained physical activity to depressive symptoms, or from physical activity or BMI to SRH.Conclusion: Sustained high BMI and high depressive symptoms after age 50 are positively associated only for White women. As the association between sustained health problems such as depression and obesity are not universal across race and gender groups, clinical and public health interventions and programs that simultaneously target multiple health problems may have differential effects across race by gender groups.

Highlights

Increasing prevalence of obesity in the United States has become a significant public health concern (Office of Disease Prevention and Health Promotion, 2014)
Research has consistently shown that obesity impacts psychological well-being (Wynne et al, 2014; Chang et al, 2016; Global BMIMC, 2016), a growing body of evidence suggests that psychosocial correlates of obesity may depend on race (Kodjebacheva et al, 2015; Murphy et al, 2015; Kelley et al, 2016), gender (Assari and Caldwell, 2015; Kodjebacheva et al, 2015), and their intersection (Assari and Lankarani, 2015a)
Using structural equation modeling (SEM), in this study we investigated the links between sustained Body Mass Index (BMI), physical activity, depressive symptoms, and self-rated health over time, using multiple measures

Summary

Introduction

Increasing prevalence of obesity in the United States has become a significant public health concern (Office of Disease Prevention and Health Promotion, 2014). In a series of studies, Assari has shown that depressive symptoms and negative affect better predict subsequent change in physical health outcomes such as chronic medical conditions and mortality for Whites than Blacks (Assari and Burgard, 2015; Assari et al, 2015b, 2016a,b; Assari and Lankarani, 2016b). Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH)

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Discussion

Conclusion