Social context may be a better indicator of obesity disparities than race

The results are featured in the May 2010 issue of the Journal of Epidemiology and Community Health.

"In a national sample not accounting for race differences in social context, black women had twice the chance of being obese as compared to white women," Sara Bleich, PhD, lead author and assistant professor in the Bloomberg School's Department of Health Policy and Management. "To date, efforts to explain the disparity in obesity prevalence have primarily focused on individual level factors and little research has focused on social context as a possible explanation. When we examined poor, urban women exposed to the same environment, race disparities in obesity virtually disappeared."

Bleich, along with colleagues from the Hopkins Center for Health Disparities Solutions examined race disparities in obesity among black and white women living in the same social context with similar income in Baltimore. Using the data from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) study, a cross-sectional face-to-face survey of the adults ages 18 and older, researchers compared estimates to national data from the National Health Interview Survey (NHIS) to determine if the race disparity in obesity was attenuated among women living in the same social context. Obesity was calculated from self-reported height and body weight and logistic regression was used to examine the association between race and obesity.

"Accurately accounting for social and environmental exposures is particularly important for the study of obesity disparities given the growing literature linking individual body weight to a host of environmental factors, both positively and negatively associated with body mass index," said Thomas LaVeist, PhD, senior author of the study and director of the Bloomberg School's Hopkins Center for Health Disparities Solutions. "Developing policies that focus on modifying social aspects of the environment may reduce disparities in obesity among low-income women living in urban communities."

The research was supported by The National Center on Minority Health and Health Disparities (NCMHD) of the National Institutes of Health (NIH), Pfizer, the National Heart Lung and Blood Institute and the Health Disparities Loan Repayment Program.