Contribution of Social, Behavioral, and Contextual Exposures to Black-White Disparities in Incident Obesity: The CARDIA Study

Citation

Song, Christopher; Bancks, Michael P.; Whitaker, Kara M.; Wong, Mandy; Carson, April P.; Dutton, Gareth R.; Goff, David C., Jr.; Gordon-Larsen, Penny; Gunderson, Erica P.; & Jacobs, David R., Jr., et al. (2023). Contribution of Social, Behavioral, and Contextual Exposures to Black-White Disparities in Incident Obesity: The CARDIA Study. Obesity, 31(5), 1402-1414. PMCID: PMC10191978

Abstract

OBJECTIVE: The aim of this study was to quantify the contributions of socioeconomic, psychosocial, behavioral, reproductive, and neighborhood exposures in young adulthood to Black-White differences in incident obesity.
METHODS: In the Coronary Artery Risk Development in Young Adults (CARDIA) study, 4488 Black or White adults aged 18 to 30 years without obesity at baseline (1985-1986) were followed over 30 years. Sex-specific Cox proportional hazard models were used to estimate Black-White differences in incident obesity. Models were adjusted for baseline and time-updated indicators.
RESULTS: During follow-up, 1777 participants developed obesity. Black women were 1.87 (95% CI: 1.63-2.13) times more likely and Black men were 1.53 (95% CI: 1.32-1.77) times more likely to develop obesity than their White counterparts after adjusting for age, field center, and baseline BMI. Baseline exposures explained 43% of this difference in women and 52% in men. Time-updated exposures explained more of the racial difference in women but less for men, compared with baseline exposures.
CONCLUSIONS: Adjusting for these exposures accounted for a substantial but incomplete proportion of racial disparities in incident obesity. Remaining differences may be explained by incomplete capture of the most salient aspects of these exposures or potential variation in the impact of these exposures on obesity by race.

URL

http://dx.doi.org/10.1002/oby.23698

Reference Type

Journal Article

Year Published

2023

Journal Title

Obesity

Author(s)

Song, Christopher
Bancks, Michael P.
Whitaker, Kara M.
Wong, Mandy
Carson, April P.
Dutton, Gareth R.
Goff, David C., Jr.
Gordon-Larsen, Penny
Gunderson, Erica P.
Jacobs, David R., Jr.
Kiefe, Catarina I.
Lewis, Cora E.
Lloyd-Jones, Donald M.
Shikany, James M.
Kershaw, Kiarri N.

Article Type

Regular

PMCID

PMC10191978

Data Set/Study

Coronary Artery Risk Development in Young Adults (CARDIA) Study

Continent/Country

United States of America

State

Nonspecific

Race/Ethnicity

Black
White

ORCiD

Gordon-Larsen - 0000-0001-5322-4188