Obesity, race/ethnicity and life course socioeconomic status across the transition from adolescence to adulthood

Abstract

Background Differences in the association of socioeconomic status (SES) with obesity may underlie racial/ethnic disparities in obesity that increase dramatically across the transition to adulthood in the US. Objective To examine racial/ethnic differences in the influence of life course SES on longitudinal obesity patterns from adolescence to adulthood. Methods Latent class analysis was used on a nationally representative, diverse sample of 12,940 adolescents followed into young adulthood (mean age=21.7 years) to identify life course SES group profiles based on SES data in adolescence and young adulthood. Gender-stratified multinomial logistic regression models estimated the association of SES groups with obesity incidence and persistence versus staying non-obese. Results No significant interactions with race/ethnicity were observed, though racial/ethnic minorities had the highest obesity risk across SES groups. Racial/ethnic-pooled associations between disadvantaged SES exposure and higher obesity risk were strong but differed by gender. Males with a disadvantaged background who experienced early transitions into the labor force, marriage and residential independence had the highest risk of obesity incidence (RRR=1.64; 95%CI: 1.12, 2.40), while females exposed to persistent adversity were at highest risk (RRR=3.01, 95%CI: 1.95, 4.66). In general, SES group membership had a stronger relationship with obesity persistence than incidence. Conclusions The relationship between SES and obesity patterns is similar across race/ethnicity and differs by gender during the transition to adulthood. However, stronger associations with obesity persistence and enduring racial/ethnic disparities in obesity risk across SES groups suggest that these social factors play a larger role in disparities earlier in the life course.

Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the USA

“…This interaction could help to explain some of the complex SES gradients in risk of obesity by race and ethnicity that have been reported in previous studies5 9 55 where there are ‘diminishing returns’ of the effect of increasing individual SES on health outcomes for racial and ethnic subpopulations as compared to non-Hispanic white individuals 56. For example, previous studies have found that the inverse association between income and obesity is stronger for white children than for black children and that for some subgroups income is positively associated with obesity 5 9 55. These studies have not examined neighbourhood deprivation or SES in the context of these patterns.…”

Life stage and sex specificity in relationships between the built and socioeconomic environments and physical activity

“…Socioeconomic position in young adulthood can be characterised by a complex array of behaviours and achievements,36 37 so we used parent income and education to indicate socioeconomic position in both waves.…”

Accumulation of childhood poverty on young adult overweight or obese status: race/ethnicity and gender disparities

“…Specifically, poverty and multidimensional measures of SES have a positive association with obesity for adolescent women, but not men, during the transition to adulthood 5 8. Further, adolescent women exposed to persistent economic adversity are at a greater risk for obesity in adulthood 3. Although the prevalence of overweight status for Black adolescent women remains high even after household SES increases,9 several studies find an inverse association between SES and overweight9 and obesity1 among non-Hispanic white adolescent women.…”