Contributions of the Social Environment to Central Adiposity: Results from Etiologic and Intervention Studies.

Abstract

Evidence is building regarding the relationship of the social environment to central adiposity risk. Proxies of the social environment include indicators of psychosocial stress, such as neighborhood poverty, perceived discrimination, and family stress. While some research has theorized that psychosocial stress influences central adiposity indirectly through poor health behaviors, other studies have theorized that psychosocial stress directly influences central adiposity via biophysiological pathways. However, these pathways have rarely been examined. The purpose of this dissertation is to examine both direct and indirect pathways that psychosocial stress may influence central adiposity. First, I examine several direct pathways that psychosocial stress (i.e. perceived discrimination, family stress, and cumulative stress index) may influence changes in central adiposity over time; and ways that neighborhood poverty, may influence changes in central adiposity through both direct and mediating pathways. Next, I examine indirect pathways that psychosocial stress may effect central adiposity. I examined a sample of 386 Non-Hispanic Black, Non-Hispanic White, and Hispanic adults of waves I and II of the Healthy Environments Partnership community surveys 2002-2003 and 2008, respectively. In addition, I analyzed an intervention study of 473 adults who were predominately NHB and Hispanic women. Results include 1) a positive association between perceived discrimination and central adiposity over time; 2) in general, a null association between multiple indicators of psychosocial stress and changes in central adiposity over time, with the exception of family stress; 3) a positive association between cumulative stress index (i.e. composite measure of psychosocial stress) at baseline changes in central adiposity over time; 4) neighborhood economic composition did not mediate the association between cumulative stress index and changes in central adiposity over time; and 5) a null association between perceived safety and participation in the physical-activity-intervention; 6) perceived safety modified the associations between participation and physical activity; however, perceived safety did not modify the association between physical activity and central adiposity. The understanding of these factors may help to elucidate the direct and indirect pathways between psychosocial stress and central adiposity, which may help public health professionals target interventions more effectively towards the factors that drives these changes.PHDHealth Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/107144/1/jamilah_1.pd