Relationship of Socioeconomic Status Indicators to Obesity in Hispanic and Non-Hispanic White Middle-Aged Women: A Population Study.
Relationship of Socioeconomic Status Indicators to Obesity in Hispanic and Non-Hispanic White Middle-Aged Women: A Population Study.
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DOI：
10.23937/2474-1353/1510090
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发表时间：
2019-01-01
期刊：
影响因子：
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通讯作者：
Patrick, Donald L
中科院分区：
文献类型：
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作者：
Beresford, Shirley Aa;Bowen, Deborah J;Patrick, Donald L
背景：在美国，西班牙裔和白色（非西班牙裔）女性的肥胖率不同，西班牙裔女性的肥胖率更高。社会经济进程在个人和环境两个层面上造成了这种差距。要理解这些复杂的关系，就需要对共同环境中的妇女群体进行多层次的分析。在人口为基础的样本，西班牙裔和白色（非西班牙裔）妇女从相同的社区，我们在每个种族群体内进行评估a）的协会的个人层面的社会经济地位（SES）与身体质量指数（BMI）;和B）的额外贡献的邻里水平的措施SES.METHODS：使用人口为基础的多阶段抽样方法，我们过采样低SES和西班牙裔块组。在家庭筛查期间，我们确定了30至50岁的妇女。在白色女性中，我们特别对教育水平低的女性进行了过度抽样。515名西班牙裔和503名白色女性完成了基线。测量身高和体重。西班牙文和英文的基线调查包括四项社会经济地位的衡量标准。对地区一级社会经济地位的三项措施进行了审查。分析loge BMI对每个SES措施使用线性混合模型，纳入design effects.RESULTS：在白色妇女，低教育，社会地位，和邻里SES与较高的BMI（p < 0.001，p < 0.0001，和p < 0.05，分别），独立于其他SES措施。虽然西班牙裔队列中教育、收入和主观社会地位的最高分组类别具有最低的平均估计BMI，但各类别的点估计值并不单调，并且具有较宽的置信区间。其结果是，相反的研究结果之间的白色妇女，没有统计学上显着的关联被发现之间的BMI和措施的SES among Hispanic women.Discussion：邻里和个人措施的SES不同的操作在西班牙裔相比，白色妇女。我们假设我们所包括的措施是最突出的，对两组妇女的作用相似。相反，西班牙裔妇女的突出因素尚未确定。进一步的了解可能最终为文化相关的多层次肥胖预防策略的设计提供信息。
BACKGROUND: Obesity rates differ between Hispanic and White (non-Hispanic) women in the United States, with higher rates among Hispanic women. Socioeconomic processes contribute to this disparity both at the individual and the environmental level. Understanding these complex relationships requires multilevel analyses within cohorts of women that have a shared environment. In population-based samples of Hispanic and White (non-Hispanic) women from the same neighborhoods, we evaluated within each ethnic group a) The association of individual-level socioeconomic status (SES) with body mass index (BMI); and b) The additional contribution of neighborhood-level measures of SES.METHODS: Using population-based multi-stage sampling methods, we oversampled low SES and Hispanic block groups. During household screening, we identified women aged 30 to 50 years. Among White women, we specifically oversampled women with low educational levels. 515 Hispanic and 503 White women completed baseline. Height and weight were measured. Baseline surveys, in Spanish and English, included four measures of SES. Three measures of area-level SES were examined. Analysis of loge BMI on each SES measure used linear mixed models, incorporating design effects.RESULTS: Among White women, low education, social status, and neighborhood SES were associated with higher BMI (p < 0.001, p < 0.0001, and p < 0.05, respectively), independent of other SES measures. Although the highest grouped category of education, income and subjective social status within the Hispanic cohort had the lowest mean estimated BMI, the point estimates across categories were not monotonic, and had wide confidence intervals. As a result, in contrast to the findings among White women, no statistically significant associations were found between BMI and measures of SES among Hispanic women.DISCUSSION: Neighborhood and individual measures of SES operate differently in Hispanic compared with White women. We had assumed the measures we included to be most salient and operate similarly for both groups of women. Rather the salient factors for Hispanic women have yet to be identified. Improved understanding may ultimately inform the design of culturally-relevant multilevel obesity prevention strategies.