Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition

Abstract

Obesity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007–2014 County Health Rankings and 2012–2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES.

Wealth and Obesity Among U.S. Adults Entering Midlife

“…While this result supports research on obesogenic environments and property value (12,37), we found little evidence of a similar association between housing wealth and obesity among Black women and men. This finding could be the result of discriminatory practices at multiple stages of purchasing a home that constrain Black families from moving into more desirable-and less obesogenicneighborhoods (10,12). Thus, future research should extend this study by considering how residential quality and racial segregation moderate the relationship between housing wealth and obesity.…”

“…Housing wealth is the largest contributor to net worth and grows as a financial resource in midlife (4,10). With respect to obesity, prior research has found that obesogenic environments (e.g., areas perceived as proximate to crime, heavy traffic, liquor stores, and fast food) are associated with lower property values, and property values are negatively associated with obesity and BMI (11)(12)(13). Rehm et al (13) examined the assessed value of homes in a Washington county and found that women with property in the bottom quartile were 3.4 times more likely to experience obesity than women in the top quartile.…”

Wealth and Obesity Among US Adults Entering Midlife

“…Home value had a particularly large association with obesity for white women and men. Although this result supports research on obesogenic environments and property value , we found little evidence of a similar association between home value and obesity among black women and men. This finding could be the result of discriminatory practices at multiple stages of purchasing a home that constrain black families from moving into more desirable (and less obesogenic) neighborhoods .…”

“…Although this result supports research on obesogenic environments and property value , we found little evidence of a similar association between home value and obesity among black women and men. This finding could be the result of discriminatory practices at multiple stages of purchasing a home that constrain black families from moving into more desirable (and less obesogenic) neighborhoods . Thus, future research should extend this study by considering how residential quality and racial segregation moderate the relationship between home value and obesity.…”

“…Housing wealth is the largest contributor to net worth and grows as a financial resource in midlife . With respect to obesity, prior research has found that obesogenic environments (e.g., areas proximate to crime, heavy traffic, liquor stores, and fast food) are associated with lower property values, and property values are, in turn, negatively associated with obesity and BMI . Rehm et al examined the assessed value of homes in a Washington State county and found that women with property in the bottom quartile were 3.4 times more likely to experience obesity than women in the top quartile.…”