Recent Developments and New Directions Ellen Granberg Clemson University, Clemson SC

Counts of articles from major sociology journals: ASR, JHSB, SPQ, Soc of Education, Sociology of Health and Illness, Social Science and Medicine using search terms: BMI, overweight, and obes*

Consequences of Obesity Sociological research on obesity has typically focused on the consequences of excessive weight rather than the causes. Emphasized obesity as a stigmatized status characteristic. Explored differential treatment and differential distribution of valued social resources on the basis of body weight. Findings reinforce the contingent nature of obesity’s associations and the power of social context to shield overweight persons from stigma.

The Rise of a New “Issue”

African American Adolescents and Obesity Age adjusted obesity rate among African American women is 48.8% whereas the rate among European American women is about 37% (CDC 2005). Prevalence of morbid obesity among adult black women has doubled since 1988 (CDC 2005). Proportion of overweight black adolescents has increased 120% since 1980, about double that of white teens (Swallen et al. 2005). Underlying contributors are not well understood.

Theoretical Perspectives on Social Location and Health Social conditions influence health outcomes and mortality. (Link and Phelan 1995; Lutfey and Freese 2005). Probability of disease risk factors (e.g., diet, activity, smoking). Fundamental causes of health and illness. Structure versus Culture Cultural explanations for health disparities often mask underlying structure causes (Williams and Collins 2001).

Family and Community Health Study -- FACHS Four wave panel study of the social, emotional, and physical health of African American children and their parents. 900 families – 1 target child age 10, 1 older sibling, 1 primary caregiver, 1 secondary caregiver (if present in the home). Experience of African American adolescents growing up outside the urban inner city core. Families originally lived in rural and suburban Iowa and Georgia. Included an oversample of middle and upper middle class black families.

Family and Community Health Study Data collected over four waves: 1997 (10-11), 1999 (12-14); 2001 (14-16); (17-20). Included mental health, family function, and neighborhood function measures wave included a GIS component. Two additional waves planned. Health Data: Self report BMI available in waves 1, 2, and 4. Dietary intake, physical activity, and sedentary activity measures included in waves 3 and 4. GIS data being expanded to include access to healthy and unhealthy food resources.

Average BMI Across Waves

Cultural Contributors to Obesity No longitudinal associations between racial socialization and BMI. Cross-sectional associations show a negative relationship between cultural education and BMI, for girls only. Among girls positive ethnic identity at ages & is negatively associated with obesity at age net of BMI at age Among boys, positive ethnic identity at ages is positively associated with BMI at age Relationships disappears after BMI at ag e included. Table 1: Association between Ethnic Identity in early adolescence and BMI at age 17: Wave 1 (10-12)Wave 2 (12-14) BoysNo AssociationPositive GirlsNegative

Possible Structural Contributors to Obesity Potential structural contributors to obesity among AA teens: Individual socioeconomic status Neighborhood socioeconomic status Neighborhood racial composition Neighborhood resources Exposure to racial discrimination

Conceptualizing Structural Contributors to Obesity 2004 FACHS added a GIS component. Modeling community context using census data but centered at respondent’s residence. Obtained residential data from U.S. Bureau of the Census & Department of Health and Human Services. Modeled a “buffer” around the target’s residence that incorporates multiple block groups. Obtained counts of commercial food establishments around each target residence. Distance measured from each target residence to each commercial concern. Counts of commercial establishments within a specific distance from residence (<.10 miles, <.75 miles, <1.5 miles, etc.)

Structural Contributors to Obesity Few correlations within the full sample between neighborhood advantage or neighborhood racial composition and body size. Due to the transience in this age group. Isolated the sample to respondents who had not moved since the previous wave. Full Sample: % white – positively associated with BMI % Black – negatively associated with BMI Count of convenience stores with.75 miles marginally associated with overweight.

Structural Contributors to Obesity Among boys: Proportion of unemployed males positively associated with BMI and morbid obesity. Urbanization negatively associated with BMI and overweight. Per capita income negatively associated with morbid obesity. Among girls: Percent white positively associated with BMI. Per capita income positively associated with BMI and morbid obesity.

Structural Contributors to Obesity Wave 4, Girls, N: 230; Standardized Regr. Coeff BMI ***.453***.449***.440***.415*** % White Cond Dis Discrim Parenting Ethnic ID-.174** Adj R-Sq

Structural Contributors to Obesity Wave 4, Girls, N: 230; Standardized Regr. Coeff BMI99.449***.446***.436***.409*** Per Cap Inc * Cond Dis Discrim Parenting Ethnic ID-.191* Adj R-Sq

Concluding Thoughts Next steps: Examine the influence of residential racial composition and per capita income across time. Consider neighborhood food resources as a mediator of this relationship. Food deserts versus Food oases. Reconsider the question of “culture” as an explanatory mechanism. Gender culture versus raceculture. Favorite “hang out”

Neighborhood Contexts and Obesity – FACHS (2004)