American Journal of Epidemiology Advance Access originally published online on March 18, 2009
American Journal of Epidemiology 2009 169(9):1102-1112; doi:10.1093/aje/kwp027
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ORIGINAL CONTRIBUTIONS |
Do Socioeconomic Gradients in Body Mass Index Vary by Race/Ethnicity, Gender, and Birthplace?
Correspondence to Dr. Emma V. Sánchez-Vaznaugh, Department of Health Education, College of Health and Human Services, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132 (e-mail: emmav{at}sfsu.edu).
Received for publication April 28, 2008. Accepted for publication January 8, 2009.
Despite the well-documented negative socioeconomic status (SES) gradient in body mass index (BMI; weight (kg)/height (m)2) among women in developed societies, the presence and strength of the gradient is less consistent among men. Far less clear is the SES patterning of BMI among racial/ethnic minorities and immigrants. Using data from the 2001 California Health Interview Survey, a cross-sectional representative sample of California adults, the authors examined whether the SES patterning of BMI varied across 4 major US racial/ethnic groups (n = 37,150) by gender and birthplace. The shape and strength of the relation between SES and BMI differed markedly by race/ethnicity; and within racial/ethnic groups, it varied by gender. Irrespective of race/ethnicity, there were negative income and education gradients in BMI among women; however, there was considerable variation among men. The effect of education on BMI differed by birthplace in some groups. A clear education gradient in BMI was found among all US-born participants, a quadratic education pattern in BMI was found among foreign-born Asian men, a flat pattern was found among foreign-born Asian women, and no clear pattern was found in the remaining foreign-born groups. There is substantial heterogeneity in the contemporaneous SES gradient in BMI. US social disparities in BMI require simultaneous consideration of race/ethnicity and SES, but also birthplace.
body mass index; continental population groups; emigrants and immigrants; ethnic groups; obesity; population groups; sex factors; social class
Abbreviations: BMI, body mass index; NHANES, National Health and Nutrition Examination Survey; SES, socioeconomic status