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标题：Life-Course Socioeconomic Position and Obesity in African American Women: The Pitt County Study
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作者：Sherman A. James ; Angela Fowler-Brown ; Trevillore E. Raghunathan 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2006
卷号：96
期号：3
页码：554-560
DOI：10.2105/AJPH.2004.053447
语种：English
出版社：American Public Health Association
摘要：Objectives . We studied obesity in African American women in relationship to their socioeconomic position (SEP) in childhood and adulthood. Methods . On the basis of parents’ occupation, we classified 679 women in the Pitt County (North Carolina) Study into low and high childhood SEP. Women’s education, occupation, employment status, and home ownership were used to classify them into low and high adulthood SEP. Four life-course SEP categories resulted: low childhood/low adulthood, low childhood/high adulthood, high childhood/low adulthood, and high childhood/high adulthood. Results . The odds of obesity were twice as high among women from low versus high childhood SEP backgrounds, and 25% higher among women of low versus high adulthood SEP. Compared to that in women of high SEP in both childhood and adulthood, the odds of obesity doubled for low/low SEP women, were 55% higher for low/high SEP women, and were comparable for high/low SEP women. Conclusions . Socioeconomic deprivation in childhood was a strong predictor of adulthood obesity in this community sample of African American women. Findings are consistent with both critical period and cumulative burden models of life-course socioeconomic deprivation and long-term risk for obesity in African American women. Obesity is an increasingly prevalent condition in the United States, particularly among African American women, who currently have the highest prevalence of obesity of any US demographic group. According to the 1999–2002 National Health and Nutrition Examination Survey, 49% of African American women are obese, compared to 38.4% of Mexican American women and 30.7% of White women. 1 The development of obesity is multifactorial, resulting from an interaction between an individual’s genetic makeup and his/her health behaviors (e.g., diet, physical activity, smoking), with the latter being strongly patterned by one’s access to both individual and neighborhood-level socioeconomic resources over the entire life course. 2 ^– 6 Indeed, a life-course perspective on the problem of adulthood obesity is receiving increased attention from public health researchers in Europe, 6 ^– 9 the United States, 10 and Latin America, 11 with most studies indicating that low SEP in childhood, like low SEP in adulthood, is associated with increased risk for adulthood obesity. A life-course perspective on socioeconomic conditions and obesity would seem to be especially important in the case of African American women, a group known to be at increased risk for lifelong poverty 12 ^, 13 as well as for adulthood obesity. 1 ^, 14 To date, however, inconsistent findings characterize the handful of studies investigating the association between childhood SEP and future risk of obesity in African American women. For example, in a study from the National Longitudinal Survey of Youth, 15 researchers found that parental education was inversely associated with risk of adulthood obesity in African American women. Another study of African American and White adults in 4 US cities found that for White women, but not African American women, parental education was inversely associated with mean body mass index (BMI), independent of adulthood SEP. 10 A Philadelphia-based study that followed a group of African Americans from birth to young adulthood likewise failed to observe an inverse association between maternal education and adult adiposity. 16 Finally, although associations between intergenerational social mobility or the movement from one SEP level in childhood to another in adulthood have been studied in European populations, 7 ^, 8 we found no similar studies of African Americans. Given the growing public health interest in how socioeconomic deprivation over the life course might accelerate deterioration in health by early/middle adulthood and the limited research of this kind focusing specifically on the excess risk for obesity in African American women, additional studies are clearly needed. Our aims were 2-fold: (1) examine the independent associations between childhood and adulthood SEP and risk for obesity in adulthood in a community probability sample of southern, African American women and (2) examine the degree to which the trajectories of obesity risk initiated in childhood are altered by differential changes in women’s relative access to socioeconomic resources between childhood and adulthood.