Disparities and Obesity Trends

Black-White Disparities in Trends of Obesity and Overweight by Level of Education in the United States 

Abstract

This research paper examined the differences between Whites and Black in the recent trends of obesity and overweight by their educational level. The paper adopted a three-pronged probability and stratified cluster sampling research design in collecting data from the research subjects drawn from African Americans, Caribbean Blacks, and Caucasian households. The study was based on a three-year National Survey of American Life (NSAL) that was carried out in the U.S. between January 2015 and December 2018. Both probability and stratified sampling were used to gather the necessary data from a sample of 900 Caucasians and 3,500 African Americans. The study sought to unearth any significant difference between Caucasians and their Black counterparts in terms of trends in obesity and overweight, with educational attainment playing a mediating role. The data was analyzed using both ANOVA and Chi-Square test of independence, negating the null hypothesis. The findings reveal that education accomplishment is a key predictor of being obese and overweight and that Blacks are more disadvantaged than Whites in terms of obesity and overweight prevalence. These results call for more awareness and educational programs for the Blacks.        

Keywords

Obesity, overweight, Caribbean Blacks, African Americans

Black-White Disparities in Trends of Obesity and Overweight by Level of Education in the United States 

 Both obesity and overweight represent chronic health conditions that affect both adults and children across the United States. They are linked with enormous health consequences since they act as risk factors for the development of various other chronic illnesses, including cardiovascular disease, Type 2 diabetes, and hypertension. Obesity has a disproportionate effect on the population belonging to lower socioeconomic status groups, women, and ethnic minorities (Abraham, Kazman, Zeno, & Deuster, 2013). Specifically, obesity and its related chronic conditions disproportionately affect African Americans (AAs) more that the rest of the populations within the country. It has also been revealed that Black women are at an elevated risk of developing this chronic condition compared to their Caucasian (CA) counterparts (Abraham, Kazman, Zeno, & Deuster, 2013). While it is suggested that education attainment is one of the most social determinants of health, little is known regarding its specific influence on the development of obesity/overweight among different ethnic groups in the United States. The purpose of the current research paper is to examine the disparities between Whites and Black in the recent trends of obesity and overweight by their educational level.    

Research Questions

The current study was guided by two major research questions:

1. Is there a significant difference between African Americans’ and Caucasian’s obesity and overweigh trends in the United States?
2. Is there a significant correlation between one’s educational attainment and the risk of developing of being obese or overweight?

Null and Alternate Hypotheses

 The null and alternate hypotheses for the first research question are:

H₀: There are no significant disparities between African Americans’ and Caucasian’s obesity and overweigh trends in the United States based on their respective levels of education.

H₁: There are significant disparities between African Americans’ and Caucasian’s obesity and overweigh trends in the United States based on their respective levels of education.

 The null and alternate hypotheses for the second research question are:  

H₀: There is no significant correlation between one’s educational attainment and the risk of developing of being obese or overweight.

H₁: There is a significant correlation between one’s educational attainment and the risk of developing of being obese or overweight.

Addressed Research Question

 The research addressed the first question that sought to empirically determine whether there was any significant disparity between Caucasians’ and African Americans’ obesity and overweight trends in the country on the basis of the two ethnic groups’ levels of educational attainments. The independent or predictor variables in this research question were African Americans (AA), Caucasians (CA), and educational levels. On the other hand, the dependent single dependent variable was obesity/overweight trends. With regard to variable type, both CA and AA fall under the category of nominal scale because such variables lack any quantitative value. Obesity/overweight trends fall under numerical category because they can be quantified to determine their exact values. Nevertheless, the independent variable, educational attainment/level falls under ordinal category.  

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Methodology

Recruitment of the Research Subjects

 The current study was based on the so-called National Survey of American Life (NSAL) with a probability sample consisting of 900 Caucasians and 3,500 African Americans recruited between January 2015 and December 2018. The study focused on adults aged between 25 years and 60 years. Within NSAL’s core major sampling elements, there were 30 and 60 self-representing metropolitans statistical regions (MSRs) and primary sampling regions (PSRs), respectively. Out of all PSRs, 10 of them were selected from the United States’ southern region in order to effectively reflect African Americans’ national distribution.

 The NSAL Caribbean Black sample was obtained through over-sampling of households within geographic regions that had higher densities of individuals belonging to the Caribbean origin. On the other hand, the NSAL Caucasian sample was obtained through stratified sampling of Caucasian adults living in households within block groups and census tracts derived from the African American segments.

Research Design

 NSAL is a nationwide representative survey that employed a three-pronged probability and stratified cluster sampling research design in conducting in-person, face-to-face interviews with the research subjects. Both the probability and stratified samples of households were subject to the interview process highly trained personnel. With the help of the computer assisted personal interviewing (CAPI), the personnel drawn from the Bureau of Census conducted in-depth interviews with the subjects with the view of obtaining the necessary information regarding the subjects’ health and other social determinants of health. Some of the critical information gathered during the study included the subjects’ use of and access to health care services, health insurance coverage, injuries, activity limitations, social indicators of health, sociodemographic characteristics, and household composition. 

Statistical Analyses

 The data obtained was codified and analyzed using IBM SPSS® statistical software. Specifically, the researchers performed a two-way analysis of variance (ANOVA) on the data to with the view of affirming or rejecting the null hypothesis. The two-way ANOVA was preferred over one-way ANOVA because the independent (predictor) variables were more than one. There results revealed a positive and significant disparity between the two ethnic groups’ obesity and overweight trends, with educational attainment playing a mediating role.

 The researchers also performed a Chi-Square test of independence on the data to determine whether or not educational attainment was significantly related with obesity and overweight trends. In this regard, educational attainment was treated as predictor variable and trends of obesity and overweight as dependent variable. The results of the test negated the null hypothesis.

Ethical Considerations

 A number of ethical issues were taken into account given that the research involved the use of human research subjects. One of the ethical considerations was that the participant’s anonymity was upheld by not attaching their names or any personally identifying information on the data collected. The information collected was kept private and confidential in order to prevent unauthorized parties from getting access to it. In addition, the researchers sought the participants’ informed consent before conducting the research. The data collected was used for this research purpose only and no nay other use. 

Implications of Findings for Clinical Practice

 The results derived from the study showed that African Americans are at disproportionately higher risk of becoming obese or overweight than their Caucasian counterparts. These findings corroborate a prior study by Lincoln, Abdou, and Lloyd (2014) who found that both the Caribbean Blacks and African Americans are disproportionately affected by co-occurring depression and obesity than non-Hispanic Whites. However, the prior study utilized socioeconomic differences between the two ethnic groups as a key predictor of obesity. In contrast, the current study utilized educational attainment in place of socioeconomic status. This study’s findings imply that healthcare practitioners need to focus more on the Black populations when creating awareness regarding obesity and overweight. Jackson, Szklo, Yeh, Wang, and Dray-Spira et al. (2013) found that both Whites and Blacks with lower educational attainments were more likely to be obese/overweight than those with higher education levels. These findings were also replicated in the current research, and they underscore the need for the development of health programs specifically focused on individuals with lower education levels. Overall, individuals with lower education levels are less likely to have adequate access to resources to enable them live healthy lifestyles. 

References

• Abraham, P. A., Kazman, J. B., Zeno, S. A., & Deuster, P. A. (2013). Obesity and African Americans: Physiological and behavioral pathways. ISRN Obesity, 1-8.
• Jackson, C. L., Szklo, M., Yeh, H-C., Wang, N-Y., Dray-Spira, R., Thorpe, R., & Brancati, F. L. (2013). Black-White Disparities in overweight and obesity trends by educational attainment in the United Sates, 1997-2008. Journal of Obesity, 1-9.  
• Lincoln, K. D., Abdou, C. M., & Lloyd, D. (2014). Race and socioeconomic differences in obesity and depression among black and non-Hispanic White Americans. J Health Care Poor Underserved, 25(1), 257-275.