A multilevel analysis of race, community disadvantage, and body mass index among adults in the US Export

@article{robert_and_reither_2004, abstract = {This study examined the contributions of both individual socioeconomic status (SES) and community disadvantage in explaining the higher body mass index (BMI) of black adults in the US. Data from a national survey of adults (1986 American's Changing Lives Study) were combined with tract-level community data from the 1980 census. Results of multilevel regression analyses showed that black women had an age-adjusted BMI score three points higher than non-black women. Individual SES (income, education, assets) was negatively associated with BMI in women, but it only reduced the association between race and BMI from 2.99 to 2.50. Adding community socioeconomic disadvantage index further reduced the race coefficient slightly from 2.50 to 2.21. Nevertheless, living in communities with higher socioeconomic disadvantage was associated with higher BMI net of age, race, individual SES, smoking, physical activity, stress, and social support. Community income inequality (Gini) had an independent positive association with BMI, but did not substantially reduce racial differences among women. Community percent black was not associated with BMI. Results for men demonstrated no statistically significant racial differences in BMI, and no association between BMI and either individual SES or community disadvantage. Although individual SES and community socioeconomic disadvantage each partly explained the higher average BMI among black women, clear racial disparities persisted. Moreover, race, individual SES, community socioeconomic disadvantage, and individual health behaviors were each independent predictors of BMI among women. Unexplained within- and between-community variance in BMI remained among both women and men, with most unexplained variation due to within-community variance. Because our evidence for women suggests that the determinants of obesity are multiple and multilevel, attempts to address this growing social problem will similarly require a multi-faceted and multilevel approach.}, author = {Robert, S. A. and Reither, E. N.}, citeulike-article-id = {3393222}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.socscimed.2004.03.034}, citeulike-linkout-1 = {http://linkinghub.elsevier.com/retrieve/pii/S0277-9536(04)00166-2}, comment = {A study which found that race, individual SES, community social disadvantage and individual health behaviours were all independent predictors of high BMI. In the pre-amble, summarises both the community and individual causal pathways that operate on risk of high BMI. Advocates a multilevel approach in health policy. Not totally relevant to mortality, but some potential for cross-pollenisation of ideas. ``...disadvantaged communities may present a psychosocial context that encourages obesity. Social contagion or epidemic models suggest that people's behavior is influenced by the norms or values of those around them (Crane, 1991; Jencks \& Mayer, 1990). Disadvantaged communities may ''spread'' obesity via cultural norms and/or exposure to chronic stressors (Ross, 2000).'' (p.2423) }, doi = {10.1016/j.socscimed.2004.03.034}, issn = {02779536}, journal = {Social Science \& Medicine}, keywords = {bmi, community, inequality, multilevel, obesity, race, usa}, month = {December}, number = {12}, pages = {2421--2434}, posted-at = {2008-10-10 13:41:21}, priority = {0}, title = {A multilevel analysis of race, community disadvantage, and body mass index among adults in the US}, url = {http://dx.doi.org/10.1016/j.socscimed.2004.03.034}, volume = {59}, year = {2004} }

TY - JOUR ID - robert_and_reither_2004 L3 - citeulike-article-id:3393222 N2 - This study examined the contributions of both individual socioeconomic status (SES) and community disadvantage in explaining the higher body mass index (BMI) of black adults in the US. Data from a national survey of adults (1986 American's Changing Lives Study) were combined with tract-level community data from the 1980 census. Results of multilevel regression analyses showed that black women had an age-adjusted BMI score three points higher than non-black women. Individual SES (income, education, assets) was negatively associated with BMI in women, but it only reduced the association between race and BMI from 2.99 to 2.50. Adding community socioeconomic disadvantage index further reduced the race coefficient slightly from 2.50 to 2.21. Nevertheless, living in communities with higher socioeconomic disadvantage was associated with higher BMI net of age, race, individual SES, smoking, physical activity, stress, and social support. Community income inequality (Gini) had an independent positive association with BMI, but did not substantially reduce racial differences among women. Community percent black was not associated with BMI. Results for men demonstrated no statistically significant racial differences in BMI, and no association between BMI and either individual SES or community disadvantage. Although individual SES and community socioeconomic disadvantage each partly explained the higher average BMI among black women, clear racial disparities persisted. Moreover, race, individual SES, community socioeconomic disadvantage, and individual health behaviors were each independent predictors of BMI among women. Unexplained within- and between-community variance in BMI remained among both women and men, with most unexplained variation due to within-community variance. Because our evidence for women suggests that the determinants of obesity are multiple and multilevel, attempts to address this growing social problem will similarly require a multi-faceted and multilevel approach. IS - 12 JF - Social Science & Medicine SN - 02779536 EP - 2434 TI - A multilevel analysis of race, community disadvantage, and body mass index among adults in the US VL - 59 SP - 2421 KW - bmi KW - community KW - inequality KW - multilevel KW - obesity KW - race KW - usa N1 - A study which found that race, individual SES, community social disadvantage and individual health behaviours were all independent predictors of high BMI. In the pre-amble, summarises both the community and individual causal pathways that operate on risk of high BMI. Advocates a multilevel approach in health policy. Not totally relevant to mortality, but some potential for cross-pollenisation of ideas. ``...disadvantaged communities may present a psychosocial context that encourages obesity. Social contagion or epidemic models suggest that people’s behavior is influenced by the norms or values of those around them (Crane, 1991; Jencks & Mayer, 1990). Disadvantaged communities may ‘‘spread’’ obesity via cultural norms and/or exposure to chronic stressors (Ross, 2000).'' (p.2423) AU - Robert, SA AU - Reither, EN PY - 2004/12// UR - http://dx.doi.org/10.1016/j.socscimed.2004.03.034 ER -