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Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition

1
Department of African American Studies, University of Maryland, College Park, MD 20724, USA
2
School of Public Health, University of Maryland, College Park, MD 20724, USA
3
Department of Health Studies, American University, Washington, DC 20016, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(5), 861; https://doi.org/10.3390/ijerph16050861
Received: 31 December 2018 / Revised: 14 February 2019 / Accepted: 28 February 2019 / Published: 9 March 2019
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PDF [328 KB, uploaded 9 March 2019]

Abstract

Obesity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007–2014 County Health Rankings and 2012–2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES. View Full-Text
Keywords: obesity; obesogenic environments; structural racism; racial composition obesity; obesogenic environments; structural racism; racial composition
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Bell, C.N.; Kerr, J.; Young, J.L. Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition. Int. J. Environ. Res. Public Health 2019, 16, 861.

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