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Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey

BACKGROUND: Racial health disparities in obesity and obesity-related conditions and behaviors are well documented, although a small body of research suggests that geographic factors (e.g., socioeconomic status [SES] and rural/urban status) may alter the magnitude of these disparities. METHODS: This...

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Autores principales: Cohen, Steven A., Nash, Caitlin C., Byrne, Erin N., Mitchell, Lauren E., Greaney, Mary L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985531/
https://www.ncbi.nlm.nih.gov/pubmed/35402770
http://dx.doi.org/10.1089/heq.2021.0149
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author Cohen, Steven A.
Nash, Caitlin C.
Byrne, Erin N.
Mitchell, Lauren E.
Greaney, Mary L.
author_facet Cohen, Steven A.
Nash, Caitlin C.
Byrne, Erin N.
Mitchell, Lauren E.
Greaney, Mary L.
author_sort Cohen, Steven A.
collection PubMed
description BACKGROUND: Racial health disparities in obesity and obesity-related conditions and behaviors are well documented, although a small body of research suggests that geographic factors (e.g., socioeconomic status [SES] and rural/urban status) may alter the magnitude of these disparities. METHODS: This study explored how rurality moderates black/white health disparities using a nationally representative sample from the 2012 Behavioral Risk Factor Surveillance System (n=359,157). Respondents' county of residence was linked to the U.S. Census information to obtain the county-level Index of Relative Rurality (IRR). Weighted logistic regression was used to model obesity, diabetes, and lack of physical activity (PA) on race (black/white), IRR, and an interaction term of race and IRR, including covariates (age, sex, education, marital status, employment, and income). RESULTS: Blacks were significantly more likely to have obesity, diabetes, and a lack of PA compared with whites. Irrespective of race, rural respondents were significantly more likely to have obesity (odds ratio [OR] 1.035, confidence interval [95% CI] 1.028–1.043) and a lack of PA (OR 1.045, 95% CI 1.038–1.053) than respondents in more urban areas. For obesity and diabetes, the interaction term for black×IRR quintile was significant and positive, indicating an increase in the magnitude of the black/white disparity with increasing rurality. DISCUSSION: These findings underscore the need for policies and programs aimed to reduce racial disparities in obesity and related conditions to consider the geographic context in which these outcomes occur.
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spelling pubmed-89855312022-04-07 Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey Cohen, Steven A. Nash, Caitlin C. Byrne, Erin N. Mitchell, Lauren E. Greaney, Mary L. Health Equity Original Research BACKGROUND: Racial health disparities in obesity and obesity-related conditions and behaviors are well documented, although a small body of research suggests that geographic factors (e.g., socioeconomic status [SES] and rural/urban status) may alter the magnitude of these disparities. METHODS: This study explored how rurality moderates black/white health disparities using a nationally representative sample from the 2012 Behavioral Risk Factor Surveillance System (n=359,157). Respondents' county of residence was linked to the U.S. Census information to obtain the county-level Index of Relative Rurality (IRR). Weighted logistic regression was used to model obesity, diabetes, and lack of physical activity (PA) on race (black/white), IRR, and an interaction term of race and IRR, including covariates (age, sex, education, marital status, employment, and income). RESULTS: Blacks were significantly more likely to have obesity, diabetes, and a lack of PA compared with whites. Irrespective of race, rural respondents were significantly more likely to have obesity (odds ratio [OR] 1.035, confidence interval [95% CI] 1.028–1.043) and a lack of PA (OR 1.045, 95% CI 1.038–1.053) than respondents in more urban areas. For obesity and diabetes, the interaction term for black×IRR quintile was significant and positive, indicating an increase in the magnitude of the black/white disparity with increasing rurality. DISCUSSION: These findings underscore the need for policies and programs aimed to reduce racial disparities in obesity and related conditions to consider the geographic context in which these outcomes occur. Mary Ann Liebert, Inc., publishers 2022-03-03 /pmc/articles/PMC8985531/ /pubmed/35402770 http://dx.doi.org/10.1089/heq.2021.0149 Text en © Steven A. Cohen et al., 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Cohen, Steven A.
Nash, Caitlin C.
Byrne, Erin N.
Mitchell, Lauren E.
Greaney, Mary L.
Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title_full Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title_fullStr Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title_full_unstemmed Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title_short Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey
title_sort black/white disparities in obesity widen with increasing rurality: evidence from a national survey
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985531/
https://www.ncbi.nlm.nih.gov/pubmed/35402770
http://dx.doi.org/10.1089/heq.2021.0149
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