Recent Developments and New Directions

Ellen GranbergClemson University, Clemson SC

Counts of articles from major sociology journals: ASR, JHSB, SPQ, Soc of Education, Sociology of Health and Illness, Social Science and Medicine using search terms: BMI, overweight, and obes*

Consequences of ObesitySociological research on obesity has typically

focused on the consequences of excessive weight rather than the causes. Emphasized obesity as a stigmatized status

characteristic.Explored differential treatment and differential

distribution of valued social resources on the basis of body weight.

Findings reinforce the contingent nature of obesity’s associations and the power of social context to shield overweight persons from stigma.

The Rise of a New “Issue”

African American Adolescents and ObesityAge adjusted obesity rate among African

American women is 48.8% whereas the rate among European American women is about 37% (CDC 2005).

Prevalence of morbid obesity among adult black women has doubled since 1988 (CDC 2005).

Proportion of overweight black adolescents has increased 120% since 1980, about double that of white teens (Swallen et al. 2005).

Underlying contributors are not well understood.

Theoretical Perspectives on Social Location and HealthSocial conditions influence health outcomes

and mortality. (Link and Phelan 1995; Lutfey and Freese 2005).Probability of disease risk factors (e.g., diet,

activity, smoking).Fundamental causes of health and illness.

Structure versus CultureCultural explanations for health disparities

often mask underlying structure causes (Williams and Collins 2001).

Family and Community Health Study -- FACHSFour wave panel study of the social,

emotional, and physical health of African American children and their parents.900 families – 1 target child age 10, 1 older

sibling, 1 primary caregiver, 1 secondary caregiver (if present in the home).

Experience of African American adolescents growing up outside the urban inner city core. Families originally lived in rural and suburban Iowa

and Georgia.Included an oversample of middle and upper

middle class black families.

Family and Community Health Study

Data collected over four waves: 1997 (10-11), 1999 (12-14); 2001 (14-16); 2004 -

2005(17-20). Included mental health, family function, and

neighborhood function measures. 2004 wave included a GIS component. Two additional waves planned.

Health Data: Self report BMI available in waves 1, 2, and 4. Dietary intake, physical activity, and sedentary

activity measures included in waves 3 and 4. GIS data being expanded to include access to

healthy and unhealthy food resources.

Average BMI Across Waves

Cultural Contributors to ObesityNo longitudinal associations between racial socialization

and BMI. Cross-sectional associations show a negative

relationship between cultural education and BMI, for girls only.

Among girls positive ethnic identity at ages 10-12 & 12-14 is negatively associated with obesity at age 17-19 net of BMI at age 10-12.

Among boys, positive ethnic identity at ages 12-14 is positively associated with BMI at age 17-19. Relationships

disappears after BMI at age 12-14 included. Table 1: Association between Ethnic Identity in

early adolescence and BMI at age 17:

Wave 1 (10-12)

Wave 2 (12-14)

Boys No Association Positive

Girls Negative Negative

Possible Structural Contributors to ObesityPotential structural contributors to obesity

among AA teens:Individual socioeconomic statusNeighborhood socioeconomic statusNeighborhood racial compositionNeighborhood resourcesExposure to racial discrimination

Conceptualizing Structural Contributors to Obesity2004 FACHS added a GIS component.

Modeling community context using census data but centered at respondent’s residence.

Obtained residential data from U.S. Bureau of the Census & Department of Health and Human Services. Modeled a “buffer” around the target’s residence that

incorporates multiple block groups.Obtained counts of commercial food establishments

around each target residence. Distance measured from each target residence to each

commercial concern. Counts of commercial establishments within a specific

distance from residence (<.10 miles, <.75 miles, <1.5 miles, etc.)

Structural Contributors to ObesityFew correlations within the full sample

between neighborhood advantage or neighborhood racial composition and body size. Due to the transience in this age group.Isolated the sample to respondents who had

not moved since the previous wave. Full Sample:

% white – positively associated with BMI % Black – negatively associated with BMI Count of convenience stores with .75 miles

marginally associated with overweight.

Structural Contributors to ObesityAmong boys:

Proportion of unemployed males positively associated with BMI and morbid obesity.

Urbanization negatively associated with BMI and overweight.

Per capita income negatively associated with morbid obesity.

Among girls:Percent white positively associated with BMI.Per capita income positively associated with

BMI and morbid obesity.

Structural Contributors to ObesityWave 4, Girls, N: 230; Standardized Regr. Coeff.

1 2 3

4

5

BMI 99 .449*** .453*** .449*** .440*** .415***

% White .137+ .112+ .113+ .107

Cond Dis

.101 .085 .109

Discrim. .091 .096 .096

Parenting

-.072 -.068

Ethnic ID

-.174**

Adj R-Sq

.21 .23 .23 .23 .25

Structural Contributors to Obesity Wave 4, Girls, N: 230; Standardized Regr. Coeff.

1 2 3 4 5

BMI99 .449*** .449*** .446*** .436*** .409***

Per Cap Inc

.125+ .120+ .126+ .144*

Cond Dis .106 .088 .133+

Discrim. .104 .110+ .110+

Parenting -.080 -.077

Ethnic ID -.191*

Adj R-Sq .20 .21 .23 .23 .26

Concluding ThoughtsNext steps:

Examine the influence of residential racial composition and per capita income across time.

Consider neighborhood food resources as a mediator of this relationship. Food deserts versus Food oases.

Reconsider the question of “culture” as an explanatory mechanism. Gender culture versus raceculture. Favorite “hang out”

Neighborhood Contexts and Obesity – FACHS (2004)