Under the same roof: understanding the gender disparity in obesity prevalence in U.S. Black young adults

Background: In the United States, Black women are at much greater risk for obesity than Black men. Little is known about the factors underlying this disparity. Objectives: We explored whether, in U.S. Black young adults, childhood sociodemographic factors (parental education, single-mother household, number of siblings, number of minors in household, birth order, and female caregiver's age) and adolescent behaviors (family dinners, hours of television, playing sports with mother, playing sports with father, bouts of physical activity) were associated with gender disparities in obesity. Methods: Analysis datasets were constructed from the nationally representative National Longitudinal Study of Adolescent Health. The datasets included non-immigrant Black and White youths aged 11 to 19 years in 1994-95. Childhood sociodemographic factors (n=7,747) were assessed in 1994-95. Adolescent behaviors (n=5,955) were assessed in 1994-95 and 1995-96. Obesity was measured in 1995-96 and again in 2001-02. For each assessed childhood sociodemographic factor, we evaluated whether the factor modified the female-male prevalence difference. Second, we evaluated whether standardizing Black males and females to the same distributions of the adolescent behaviors reduced the size of the predicted gender disparity in young Blacks. Results: In unadjusted and multivariable-adjusted models, parental education consistently modified Blacks' gender disparity (p=0.01). The gender gap was largest at low parental education (16.7% men obese vs. 45.4% women obese) and smallest at high parental education (28.5% men obese vs. 31.4% women obese). In Whites, there was little overall gender difference in obesity prevalence. Blacks females reported less leisure-time physical activity and lower likelihood of sport with either parent than did Black males. Standardizing by these behaviors did not reduce the predicted gender disparity in obesity incidence. Discussion: Black young adults' gender disparity in obesity prevalence was concentrated in families with low parental education. Male-female differences in the adolescent behaviors examined did not appear to underlie the obesity gender gap in young U.S. Blacks. Future research should investigate environmental, physiologic, and behavioral factors related to the differential regulation of energy balance in young Black males and females

The spatial distribution of gender differences in obesity prevalence differs from overall obesity prevalence among US adults

While obesity disparities between racial and socioeconomic groups have been well characterized, those based on gender and geography have not been as thoroughly documented. This study describes obesity prevalence by state, gender, and race/ethnicity to (1) characterize obesity gender inequality, (2) determine if the geographic distribution of inequality is spatially clustered and (3) contrast the spatial clustering patterns of obesity gender inequality with overall obesity prevalence

The Role of Adolescent Behaviors in the Female–Male Disparity in Obesity Incidence in US Black and White Young Adults

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93675/1/oby.2009.362.pd

Throwing Out the Baby with the Bathwater?: Comparing 2 Approaches to Implausible Values of Change in Body Size

BACKGROUND: In childhood obesity research, the appearance of height loss, or "shrinkage," indicates measurement error. It is unclear whether a common response--excluding "shrinkers" from analysis--reduces bias. METHODS: Using data from the National Longitudinal Study of Adolescent Health, we sampled 816 female adolescents (≥17 years) who had attained adult height by 1996 and for whom adult height was consistently measured in 2001 and 2008 ("gold-standard" height). We estimated adolescent obesity prevalence and the association of maternal education with adolescent obesity under 3 conditions: excluding shrinkers (for whom gold-standard height was less than recorded height in 1996), retaining shrinkers, and retaining shrinkers but substituting their gold-standard height. RESULTS: When we estimated obesity prevalence, excluding shrinkers decreased precision without improving validity. When we regressed obesity on maternal education, excluding shrinkers produced less valid and less precise estimates. CONCLUSION: In some circumstances, ignoring shrinkage is a better strategy than excluding shrinkers

Learning from LMICs: best practices for leveraging sentinel surveillance systems to track the US COVID-19 pandemic

FRAMING How is the USA like a low-income and middle-income countries (LMICs)? With limited treatment options, no vaccine and a chronically underfunded public health infrastructure, the USA is confronting the COVID-19 pandemic hampered by adversities typically faced by LMICs. In particular, obtaining reliable and timely surveillance data to inform public health policy has been impeded by persistent shortages of testing supplies and inequitable access to testing. SARS-CoV-2 testing in March and April 2020 likely identified only 2%–17% of US infections.

Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993–2001

Black women experience higher rates of hysterectomy than other women in the United States. Although research indicates that premenopausal hysterectomy with bilateral oophorectomy decreases the risk of breast cancer in black women, it remains unclear how hysterectomy without ovary removal affects risk, whether menopausal hormone therapy use attenuates inverse associations, and whether associations vary by cancer subtype. In the population-based, case-control Carolina Breast Cancer Study of invasive breast cancer in 1,391 black (725 cases, 666 controls) and 1,727 white (939 cases, 788 controls) women in North Carolina (1993–2001), we investigated the associations of premenopausal hysterectomy and oophorectomy with breast cancer risk. Compared with no history of premenopausal surgery, bilateral oophorectomy and hysterectomy without oophorectomy were associated with lower odds of breast cancer (for bilateral oophorectomy, multivariable-adjusted odds ratios = 0.60, 95% confidence interval: 0.47, 0.77; for hysterectomy without oophorectomy, multivariable-adjusted odds ratios = 0.68, 95% confidence interval: 0.55, 0.84). Estimates did not vary by race and were similar for hormone receptor–positive and hormone receptor–negative cancers. Use of estrogen-only menopausal hormone therapy did not attenuate the associations. Premenopausal hysterectomy, even without ovary removal, may reduce the long-term risk of hormone receptor–positive and hormone receptor–negative breast cancers. Varying rates of hysterectomy are a potentially important contributor to differences in breast cancer incidence among racial/ethnic groups

Sleep Duration and Obesity among Adolescents Transitioning to Adulthood: Do Results Differ by Sex?

To examine the association between short sleep duration and obesity among adolescents (mean age 16 years) transitioning into young adulthood (mean age 21 years) in the National Longitudinal Study of Adolescent Health (N=10,076)

Where people shop is not associated with the nutrient quality of packaged foods for any racial-ethnic group in the United States

Background: In the literature, it has been suggested that there are race-ethnic disparities in what Americans eat. In addition, some studies have shown that residents of African American and low-income neighborhoods have less access to grocery stores and supermarkets, which tend to stock healthier foods. However, it is unclear whether differences in food shopping patterns contribute to the poorer nutrient profile of food purchases made by racial-ethnic minorities

County-level hurricane exposure and birth rates: application of difference-in-differences analysis for confounding control

Abstract Background Epidemiological analyses of aggregated data are often used to evaluate theoretical health effects of natural disasters. Such analyses are susceptible to confounding by unmeasured differences between the exposed and unexposed populations. To demonstrate the difference-in-difference method our population included all recorded Florida live births that reached 20 weeks gestation and conceived after the first hurricane of 2004 or in 2003 (when no hurricanes made landfall). Hurricane exposure was categorized using ≥74 mile per hour hurricane wind speed as well as a 60 km spatial buffer based on weather data from the National Oceanic and Atmospheric Administration. The effect of exposure was quantified as live birth rate differences and 95 % confidence intervals [RD (95 % CI)]. To illustrate sensitivity of the results, the difference-in-differences estimates were compared to general linear models adjusted for census-level covariates. This analysis demonstrates difference-in-differences as a method to control for time-invariant confounders investigating hurricane exposure on live birth rates. Results Difference-in-differences analysis yielded consistently null associations across exposure metrics and hurricanes for the post hurricane rate difference between exposed and unexposed areas (e.g., Hurricane Ivan for 60 km spatial buffer [−0.02 births/1000 individuals (−0.51, 0.47)]. In contrast, general linear models suggested a positive association between hurricane exposure and birth rate [Hurricane Ivan for 60 km spatial buffer (2.80 births/1000 individuals (1.94, 3.67)] but not all models. Conclusions Ecological studies of associations between environmental exposures and health are susceptible to confounding due to unmeasured population attributes. Here we demonstrate an accessible method of control for time-invariant confounders for future research

Coming unmoored: Disproportionate increases in obesity prevalence among young, disadvantaged white women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109980/1/oby20913.pd