Race Differentials in Obesity: The Impact of Place

Abstract

This article reveals race differentials in obesity as both an individual-and neighborhood-level phenomena. Using neighborhood-level data from the 1990-1994 National Health Interview Survey, we find that neighborhoods characterized by high proportions of black residents have a greater prevalence of obesity than areas in which the majority of the residents are white. Using individual-level data, we also find that residents of neighborhoods in which at least one-quarter of the residents are black face a 13 percent increase in the odds of being obese compared to residents of other communities. The association between neighborhood racial composition and obesity is completely attenuated after including statistical controls for the poverty rate and obesity prevalence of respondents' neighborhoods. These findings support the underlying assumptions of both institutional and social models of neighborhood effects.The causes of obesity, including the social relationships that mediate and moderate the relationship between various risk factors and obesity, are complex (Weinsier et al. 1998;Whitaker 2002;Bloomgarden 2002). As research consistently demonstrates that behaviors affecting health are rooted within individuals' social environments (Berkman and Kawachi 2000), it is critical to broaden the scope of inquiry such that health is understood not only as a function of individual traits, but also as related to the environments in which people live (MacIntyre and Ellaway 2003;Robert 1999). These environments include physical space as well as community attitudes and behaviors that characterize these places (Frolich, Corin, and Potvin 2001). Although literature linking residential context to health has increased sharply in recent years (see Kawachi and Berkman 2003 for an overview), little work has examined obesity as an outcome. This article contributes to the growing body of work focusing on the ecological correlates of health and makes a timely contribution to the recent focus on obesity in both academic and popular settings.It is important to fully understand obesity because obesity prevalence among U.S. adults has increased to epidemic levels; has contributed to an increased risk of disease, disability, and death; and has led to an escalation in health care costs (Allison, Zannolli, and Narayan 1999; Wang et al. 2002). Over the last 25 years, the prevalence of adult obesity has more than doubled; in 1976 only 15 percent of the adult population was obese, but by 2000 adult obesity rates surpassed 30 percent (NCHS 2003). This increase is particularly problematic because obesity is associated with an increased risk of serious health problems including type-2 diabetes, gallbladder disease, high blood pressure, and heart disease (Flegal et al. 2002;Calle et al. 2003;Kaplan 2000;Must et al. 1999). More importantly, obesity increases the risk of a number of causes of death and is believed to contribute to approximately 14 and Fontaine et al. 1999;McGinnis and Foege 1993;Rogers, Hummer, and Krueger 2003;Sturm 2002). NI...

Neighborhood context and ethnicity differences in body mass index: A multilevel analysis using the NHANES III survey (1988–1994)

“…Using The Americans' Changing Lives (ACL), Robert and Reither (2004) found that community socioeconomic disadvantage helped explain some of the differences in BMI between Black and White women, above adjustments for individual socioeconomic status. Furthermore, though not a focus in their study, Boardman et al (2005) also found that the BMI difference between Blacks and Whites was attenuated once neighborhood conditions were included in the models. 3 In both studies, substantial differences remained.…”

“…On the other hand, no association between the isolation index and weight was found for Whites. Boardman et al (2005) found neighborhood poverty and obesity prevalence to be independent predictors for being obese. Robert and Reither (2004) found that community socioeconomic disadvantage and community income inequality, as measured by the Gini index, were significantly associated with BMI for women, net of individual socioeconomic adjustments.…”

“…Still fewer studies have used nationally representative data and the few that have did find neighborhood socioeconomic and demographic factors to be associated with BMI (Robert and Reither, 2004;Boardman et al, 2005;Chang, 2006). For example, Chang (2006) found that racial residential segregation, as measured by the isolation index was positively associated with both BMI and greater odds of being overweight for Blacks.…”

“…Beyond the detrimental socioeconomic consequences of racial segregation that may lead to unfavorable health behaviors, the racial concentration of Blacks may engender cultural norms that mitigate the social disapproval of being overweight or obese, thereby decreasing the incentives to lose weight (Robert and Reither, 2004;Boardman et al, 2005). Differences in body image between Blacks and Whites, particularly among women, may be a factor contributing to the higher rates of obesity in Blacks (Flynn and Fitzgibbon, 1998).…”

Weight Status and Restaurant Availability

“…Weight status differs across communities and regions. [20][21][22] For example, areas that are poor and more racially segregated have higher average weight status. 10,20 Recent studies also have focused on how regional differences in weight status may be explained by the contextual restaurant environment.…”