Understanding the role of structural racism and intergenerational wealth on obesity outcome

项目摘要/摘要 肥胖是可预防的早期死亡原因，并对公共卫生和 医疗保健系统。肥胖增加了几种慢性疾病的风险，包括肾脏疾病， 高血压、糖尿病、心血管疾病、骨关节炎、中风和可预防的癌症。在以下方面存在差距 种族主义群体的肥胖是显著的，然而只有一小部分文献询问了 结构性种族主义在造成肥胖差距方面的作用。这项研究旨在确定合理的因果关系 这种结构性种族主义的一种形式--“红线”，或将社区归类为基于种族的过程 煽动歧视性抵押贷款做法的信贷风险水平-在造成财富不平等和 肥胖在一生中的差异。利用房主贷款公司的地域性质 (HOLC)种族主义的抵押贷款信用风险类别(例如，红线区域)为良好的 评估邻里水平表现的合理因果影响的自然实验 结构性种族主义及其长期后果。我们的具体目标是：1)确定 邻里层面的结构性种族主义和代际财富积累；2)测试 关于多代人肥胖的结构性种族主义；以及3)测试代际之间的中介作用 关于结构性种族主义和成年人肥胖结果之间的因果关系的财富。我们最重要的是 假设是，联邦政府支持的种族主义“红线”政策有效地禁止了美国黑人 在他们的家中积累财富，导致数十年来在以黑人为主的社区撤资， 促进肥胖环境的发展，并最终在一生中存在肥胖风险。 我们利用收入动态小组研究(PSID)的纵向性质来实施生命过程 评估世代财富不平等和肥胖差距的方法，并使用准实验 避免使用随机分配曝光变量的设计。AIMS 1和2将使用 “红线”社区的实际边界，以进行地理回归间断(GRD) 它通过指定空间或地理边界来解决邻域特征的内生性 以一个明显的门槛分裂。目标3将调查每一代财富的间接影响 社区层面结构性种族主义和身体质量指数(BMI)结果的积累。结果将 通过确定为什么种族主义少数族裔社区存在健康差距，有助于理解 特定的途径通过结构性种族主义在肥胖结果中制造种族主义的不平等。 这项研究的影响将有助于确定结构性种族主义的后果，并有助于导致充分的 核算影响，以及确定解决以下问题的纠正经济和卫生政策干预措施 中年人的财富不平等和肥胖差距。

PROJECT SUMMARY/ABSTRACT Obesity is a preventable cause of early mortality and poses a significant cost burden to public health and health care systems. Obesity increases risk for several chronic conditions including kidney disease, hypertension, diabetes, cardiovascular disease, osteoarthritis, stroke, and preventable cancers. Disparities in obesity by racialized groups are marked, yet only a small body of literature has interrogated the role of structural racism in the creation of obesity disparities. This research aims to determine the plausible causal role that one form of structural racism—“redlining”, or the process of categorizing neighborhoods into race-based credit risk levels instigating discriminatory mortgage lending practices–plays in creating wealth inequality and obesity disparities over the life course. Using the geographical nature of Home Owners’ Loan Corporation (HOLC) racialized mortgage credit risk categories (e.g., redlined areas) provides an opportunity for a good natural experiment to evaluate the plausible causal impacts of the manifestation of neighborhood-level structural racism and its long-term consequences. Our specific aims are: 1) To identify the impact of neighborhood-level structural racism and intergenerational wealth accumulation; 2) To test the effect of structural racism on obesity over multiple generations; and 3) To test the mediating role of intergenerational wealth on the causal relationship between structural racism and obesity outcomes in adults. Our overarching hypothesis is that federally supported racialized “redlining” policies effectively prohibited Black Americans from building wealth in their homes, leading to decades of divestment in predominately Black neighborhoods and contributing to the development of obesogenic environments, and ultimately obesity risk over the life course. We leverage the longitudinal nature of the Panel Study for Income Dynamics (PSID) to implement a life course approach for assessing generational wealth inequality and obesity disparities and use a quasi-experimental design which circumvents the use of random assignment of the exposure variable. Aims 1 and 2 will use the actual boundaries of the “redlined” neighborhoods to conduct a geographical regression discontinuity (GRD) which addresses endogeneity of neighborhood characteristics by specifying a spatial or geographical boundary split with a marked threshold. Aim 3 will investigate the indirect effects of each generation of wealth accumulation on neighborhood-level structural racism and body mass index (BMI) outcomes. Results will contribute to understanding why health disparities exist for racialized minority communities by identifying how specific pathways operate through structural racism to create racialized inequities in obesity outcomes. Implications from this research will help identify consequences of structural racism and can help to lead to full accounting of the impacts, as well as identify corrective economic and health policy interventions that address inequalities in wealth and obesity disparities in middle-aged adults.