Effects of Increasing Economic Resources and Obesity: A Quasi-Experimental Study

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Project Summary Obesity is a leading cause of morbidity and mortality and is inversely associated with economic resources in the US. Despite the well-documented correlation between decreased individual- and community-level eco- nomic resources and increased obesity, few existing studies have been capable of attributing a causal impact to the effect of economic resources on obesity, particularly among children. Determining the extent to which economic resources are causal antecedents to weight-related health outcomes is vitally important for informing structural approaches for improving population health. I am seeking the Pathway to Independence Award in order to gain the additional training required to accomplish my career goal: to establish an independent pro- gram of research that rigorously investigates socioeconomic inputs to health and productively bridges epidemi- ology, nutrition, public health, economics, and social psychology. The training portion of this project includes formal courses, directed readings, attendance of scholarly seminars, apprenticeships, and mentored career building activities to gain skills in the following key areas: 1) economics and econometrics, 2) social psycho- logical theories of SES-health relationships, 3) primary data collection and qualitative data analysis. The newly acquired knowledge and skills will be applied in the research component of the project. The research compo- nent of this project proposes a quasi-experimental approach to examine the extent to which increased eco- nomic resources are associated with maternal weight gain and childhood obesity. I propose that the introduc- tion of casino-style gaming to American Indian tribal lands offers a unique opportunity to determine how an ex- ogenous, sustained influx of economic resources to American Indian communities impacts population health. We will leverage existing geographically-linked vital records and school fitness testing records in combination with space-time variation in casino openings in the state of California to accomplish the following specific aims: 1) Determine the extent to which an exogenous increase in economic resources affects: a) excessive gesta- tional weight gain, b) large-for-gestational-age infant birth weight, and c) child obesity; 2) Assess how eco- nomic resources stemming from casinos may affect weight-related health through the collection of formative, qualitative data; 3) Collect quantitative data in order to assess mediating or moderating mechanisms between exogenous economic resources and weight-related health. The training and research activities will feed into publications and conference presentations, and will prepare me to compete successfully for R01 funding during the R00 phase of the project.