Measuring Structural Racism and Its Association With BMI.
Measuring Structural Racism and Its Association With BMI.
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DOI：
10.1016/j.amepre.2020.05.019
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发表时间：
2020-10
影响因子：
5.5
通讯作者：
Dean LT
中科院分区：
文献类型：
--
作者：
Dougherty GB;Golden SH;Gross AL;Colantuoni E;Dean LT
结构性种族主义吸引了人们越来越多的兴趣，将其作为健康方面的种族差异的解释，包括肥胖方面的差异。结构性种族主义最常用单一指标指标(例如住房歧视)来衡量，这可能使结构性种族主义的重要方面得不到解释。本文开发了一种多指标量表，用于测量美国的县级结构性种族主义，并评估其与BMI的相关性。使用验证性因素模型估计了县的结构性种族主义，该模型包括反映教育、住房、就业、刑事司法和医疗保健的指标。利用行为危险因素监测调查数据(2011-2012年)和混合效应模型，将个人BMI与县级结构性种族主义进行回归，控制县级特征(平均年龄、黑人百分比、女性百分比、农村百分比、收入中位数和地区)。分析发生在2017-2019年。这项研究包括324,572名美国成年人。一个7个指标的县结构性种族主义模型显示出可接受的拟合。县级结构性种族主义与较低的BMI有关。结构性种族主义和黑人种族与BMI呈现出质的交互作用，即种族主义与白人的低BMI和黑人的高BMI相关。在进一步的交互作用分析中，县结构性种族主义与黑人男性比黑人女性体重指数的增加更大相关。县结构性种族主义与白人男性体重指数下降和白人女性体重指数没有变化有关。结果证实结构性种族主义是一个潜在的结构，并证明结构性种族主义可以使用公开的数据在美国各县进行测量，方法提供了强大的概念基础和内容效度。有必要进行进一步的研究，以确定解决结构性种族主义是否可以降低黑人的BMI。
Structural racism has attracted increasing interest as an explanation for racial disparities in health, including differences in adiposity. Structural racism has been measured most often with single-indicator proxies (e.g., housing discrimination), which may leave important aspects of structural racism unaccounted for. This paper develops a multi-indicator scale measuring county structural racism in the U.S. and evaluates its association with BMI. County structural racism was estimated with a confirmatory factor model including indicators reflecting education, housing, employment, criminal justice, and health care. Using Behavioral Risk Factor Surveillance Survey data (2011–2012) and a mixed-effects model, individual BMI was regressed on county structural racism, controlling for county characteristics (mean age, percentage black, percentage female, percentage rural, median income, and region). Analysis occurred 2017–2019. The study included 324,572 U.S. adults. A 7-indicator county structural racism model demonstrated acceptable fit. County structural racism was associated with lower BMI. Structural racism and black race exhibited a qualitative interaction with BMI, such that racism was associated with lower BMI in whites and higher BMI in blacks. In a further interaction analysis, county structural racism was associated with larger increases in BMI among black men than black women. County structural racism was associated with reduced BMI for white men and no change for white women. The results confirm structural racism as a latent construct and demonstrate that structural racism can be measured in U.S. counties using publicly available data with methods offering a strong conceptual underpinning and content validity. Further study is necessary to determine whether addressing structural racism may reduce BMI among blacks.
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DOI：
10.1001/jama.2014.732
发表时间：
2014-02-26
期刊：
JAMA
影响因子：
--
作者：
Ogden CL;Carroll MD;Kit BK;Flegal KM
通讯作者：
Flegal KM
DOI：
10.3390/ijerph16050861
发表时间：
2019-03-01
影响因子：
--
作者：
Bell, Caryn N.;Kerr, Jordan;Young, Jessica L.
通讯作者：
Young, Jessica L.
影响因子：
3.9
作者：
Houle, Brian
通讯作者：
Houle, Brian
影响因子：
4.8
作者：
MASSEY, DS;DENTON, NA
通讯作者：
DENTON, NA
影响因子：
6.9
作者：
McAdams, Mara A.;Van Dam, Rob M.;Hu, Frank B.
通讯作者：
Hu, Frank B.