Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

Abstract

Background: Although obesity and physical activity influence psychosocial well-being, these effects may vary based on race, gender, and their intersection. Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH).Methods: Data came from waves 7, 8, and 10 (2004–2010) of the Health and Retirement Study (HRS), an ongoing national cohort started in 1992. The study enrolled a representative sample of Americans (n = 19,280) over the age of 50. Latent factors were used to calculate sustained high BMI and physical activity (predictors) and sustained poor SRH and high depressive symptoms (outcomes) based on measurements in 2004, 2006, and 2010. Age, education, and income were confounders. Multi-group structural equation modeling (SEM) was used to test the additive effects of BMI and physical activity on depressive symptoms and SRH, where the groups were defined based on race by gender.Results: Group differences were apparent in the direction and significance of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was positive and significant for White women (B = 0.03, p = 0.007) and non-significant for White men (B = −0.03, p = 0.062), Black men (B = −0.02, p = 0.564) and Black women (B = 0.03, p = 0.110). No group differences were found in the paths from sustained physical activity to depressive symptoms, or from physical activity or BMI to SRH.Conclusion: Sustained high BMI and high depressive symptoms after age 50 are positively associated only for White women. As the association between sustained health problems such as depression and obesity are not universal across race and gender groups, clinical and public health interventions and programs that simultaneously target multiple health problems may have differential effects across race by gender groups.

Depressive Symptoms and Well-being of Individuals with Obesity; Race and Gender Differences

“…Our findings are supported by the literature on race, gender, and race by gender differences in mental health correlates of obesity in general population (1,21,22,25,37,38). Using 6 years of health and retirement survey (HRS), Carter and Assari showed that the association between sustained obesity and depressive symptoms are seen in White women, but not Black men, Black women, or White men (37 Our findings explain why actual weight has a smaller effect on perceived weight and weight control behaviors for Blacks (14,15,(40)(41)(42)(43)(44).…”

“…The study showed major group differences in the direction of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was only significant for White women but not for Black women, Black men and White men (37).…”

“…Using 6 years of health and retirement survey (HRS), Carter and Assari showed that the association between sustained obesity and depressive symptoms are seen in White women, but not Black men, Black women, or White men (37 Our findings explain why actual weight has a smaller effect on perceived weight and weight control behaviors for Blacks (14,15,(40)(41)(42)(43)(44). In a study on a community sample, same amount of increase in obesity was accompanied with a smaller increase in intention for weight loss in Blacks compared to Whites (14).…”

Health Disparities due to Diminished Return among Black Americans: Public Policy Solutions

“…There is also a need to study how culture and individual behaviors explain the effect of poverty and economic disadvantage on health. Culture and social norms may be particularly important in explaining Black-White differences in diet, obesity, and diabetes (Carter & Assari, 2017). Racial and ethnic groups use different coping behaviors that are learned from their culture (LaVeist, Thorpe, Pierre, Mance, & Williams, 2014).…”

Racial Variation in the Association between Educational Attainment and Self-Rated Health

“…For Blacks, having high aspirations that result in educational attainment does not mean they will be rewarded with a high paying job and wealth. Education and class better serves Whites than Blacks in purchasing power and wealth [74][75][76].…”