Urban Neighborhoods and Depressive Symptoms in Late Middle Age

This study examines associations between multiple urban neighborhood characteristics (socioeconomic disadvantage, affluence, and racial/ethnic composition) and depressive symptoms among late middle aged persons and compares findings to those previously obtained for persons age 70 years and older. Survey data are from the Health and Retirement Study (HRS), a U.S. national probability sample of noninstitutionalized persons aged 51 to 61 years in 1992. Neighborhoods are 1990 U.S. census tracts. Hierarchical linear regression is used to estimate multilevel models. Depressive symptoms vary significantly across urban neighborhoods among late middle age persons. Neighborhood socioeconomic disadvantage is significantly associated with depressive symptoms, net of both individual-level sociodemographic and health variables. However, this association is contingent upon individual-level wealth in that persons with low wealth in the most disadvantaged neighborhoods report the most depressive symptoms. Unlike findings for older adults for whom neighborhood effects appear to be entirely compositional in nature, neighborhood context matters to subgroups of late middle age adults.     

The relationship between height and neighborhood context across racial/ethnic groups: A multi-level analysis of the 1999–2004 U.S. National Health and Nutrition Examination Survey

While a growing literature has documented a link between neighborhood context and health outcomes, little is known about the relationship between neighborhood characteristics and height. Using individual data from the 1999-2004 U.S. National Health and Nutrition Examination Survey merged with tract-level data from the U.S. Census, we investigate several neighborhood characteristics, including neighborhood socioeconomic status (NSES), education index of concentration at the extremes (ICE), and population density, as potential predictors of height. Employing a series of two-level random intercept models, we find a one standard deviation increase in NSES to be associated with a 0.6–1.4 cm height advantage for white and foreign-born Mexican-American females and for U.S. born Mexican-American males, net of individual-level controls. Similarly, a 10 point increase in neighborhood education ICE was associated with 0.23–0.32 cm greater height for white and foreign-born Mexican-American females and U.S. born Mexican-American males. Population density was nominally negatively associated with height for foreign-born Mexican-American females. Our findings reveal that lower physical stature for some ethnic and gender groups is clustered within neighborhoods of low SES and education, suggesting that contextual factors may play a role in influencing height above individual-level attributes.     

The price of ultra-processed foods and beverages and adult body weight: Evidence from U.S. veterans

The consumption of ultra-processed foods in the U.S. and globally has increased and is associated with lower diet quality, higher energy intake, higher body weight, and poorer health outcomes. This study drew on individual-level data on measured height and weight from U.S. Department of Veterans Affairs medical records for adults aged 20 to 64 from 2009 through 2014 linked to food and beverage price data from the Council for Community and Economic Research to examine the association between the price of ultra-processed foods and beverages and adult body mass index (BMI). We estimated geographic fixed effects models to control for unobserved heterogeneity of prices. We estimated separate models for men and women and we assessed differences in price sensitivity across subpopulations by socioeconomic status (SES). The results showed that a one-dollar increase in the price of ultra-processed foods and beverages was associated with 0.08 lower BMI units for men (p ≤ 0.05) (price elasticity of BMI of −0.01) and 0.14 lower BMI units for women (p ≤ 0.10) (price elasticity of BMI of -0.02). Higher prices of ultra-processed foods and beverages were associated with lower BMI among low-SES men (price elasticity of BMI of −0.02) and low-SES women (price elasticity of BMI of −0.07) but no statistically significant associations were found for middle- or high-SES men or women. Robustness checks based on the estimation of an individual-level fixed effects model found a consistent but smaller association between the price of ultra-processed foods and beverages and BMI among women (price elasticity of BMI of −0.01) with a relatively larger association for low-SES women (price elasticity of BMI of −0.04) but revealed no association for men highlighting the importance of accounting for individual-level unobserved heterogeneity.     

The bigger the healthier: are the limits of BMI risk changing over time?

The body mass index (BMI) is often used as a predictor of overweight and obesity. There is, however, an important debate among international specialists as to what the risk limits should be, and where the cut-off points should be located. In the United States, for instance, adults with a BMI between 25 and 30 are considered overweight, while adults with a BMI of 30 or higher are considered obese. Nevertheless some researchers, especially in developing countries, claim that the limits established for the US are too permissive, and that the threshold to define obese adults should be set lower for other nationalities and ethnicities. This paper analyzes the mortality risks for different BMI levels of two populations of American adult men. The first population lived during the last quarter of the 19th century and the early 20th century. These men were drawn from a random sample of Union Army veterans who fought during the American Civil War (1861-1865). A contemporary sample of men was drawn from the first wave of the National Health and Nutrition Examination Survey (NHANES I) conducted between 1971 and 1975. The results indicate that the frontier of overweight and obesity are expanding over time, such that the potential risk is nowadays associated with higher levels of BMI. The finding may imply that differences in BMI cut-off points are not only cross ethnic, but also occur for similar ethnicities across time.     

Associations of Family and Neighborhood Socioeconomic Characteristics with Longitudinal Adiposity Patterns in a Biracial Cohort of Adolescent Girls

Although many studies have examined the relationship of adiposity with neighborhood socioeconomic context in adults, few studies have investigated this relationship during adolescence. Using 10-year annual measurements of body mass index, expressed as z-scores (BMIz), obtained from 775 black and white participants of the National Heart, Lung, and Blood Institute Growth and Health Study, a prospective cohort study of girls from pre- to postadolescence, we used multilevel modeling to investigate whether family socioeconomic status (SES) and neighborhood socioeconomic characteristics (measured by census-tract median family income) explain variation in BMIz trajectory parameters. Analyses controlled for pubertal maturation. We found that lower SES was associated with higher overall levels of BMIz for both white and black girls. Additionally, lower-SES black girls had a more sustained increase in BMIz during early adolescence and reached a higher peak compared to higher-SES black girls and to white girls. Neighborhood income was associated with BMIz trajectory for black girls only. Unexpectedly, among black girls, living in higher-income neighborhoods was associated with higher overall levels of BMIz, controlling for SES. Our findings suggest that neighborhood socioeconomic characteristics may affect adolescent BMIz trajectories differently in different racial/ethnic groups.     

Getting Bigger,Quicker? Gendered Socioeconomic Trajectories in Body Mass Index across the Adult Lifecourse: A Longitudinal Study of 21,403 Australians

Do socioeconomic inequities in body mass index (BMI) widen across the adult lifecourse? BMI data for 29,104 male and 32,454 female person-years aged 15 years and older (21,403 persons in total) were extracted from the Household, Income and Labour Dynamics in Australia between 2006 and 2012. Multilevel linear regression was used to examine age and gender specific trajectories in BMI by quintiles of neighborhood socioeconomic circumstance. Models were adjusted for probable sources of confounding, including couple status, number of children resident, if somebody in the household had been pregnant in the last 12 months, the highest level of education achieved, the average household gross income, and the percentage of time in the last year spent unemployed. Approximately 9.6% of BMI variation was observed between neighborhoods. High neighborhood disadvantage was associated with 2.09 kg/m² heavier BMI (95%CI 1.82, 2.36). At age 15-24y, socioeconomic inequity in BMI was already evident among men and women especially (22.6 kg/m² among women in the most affluent areas compared with 25.4 kg/m² among the most disadvantaged). Among women only, the socioeconomic gap widened from 2.8 kg/m² at age 15-24y to 3.2 kg/m² by age 35-44y. Geographical factors may contribute to more rapid weight gain among women living in disadvantaged neighborhoods.     

The Role of Social Contexts in Adolescence: Context Protection and Context Risk in the United States and China

A theoretical framework about protective factors (models protection, controls protection, support protection) and risk factors (models risk, opportunity risk, vulnerability risk) was employed to articulate the content of 4 key contexts of adolescent life—family, peers, school, and neighborhood—in a cross-national study of problem behavior among 7th-, 8th-, and 9th-grade adolescents in the United States (n = 1,596) and the People's Republic of China (n = 1,739). Results were very similar in both samples and across genders. Measures of protection and risk in each of the 4 contexts uniquely contributed to the account of problem behavior involvement even when individual-level measures of protection and risk were controlled. Context protection was also shown to moderate individual-level risk and protection in 1 context moderated risk within that context and in other contexts. Controls protection—protection provided by rules, regulations, and expected sanctions for transgression from adults and peers—was the most important measure of context protection in all but 1 context. The family and peer contexts were the most influential in the U.S. sample, and the peer and school contexts were the most influential in the Chinese sample; the neighborhood context was least influential in both samples.     

Trends in U.S. food prices, 1950-2007

The potential effect that food prices may have on the health of the U.S. population needs to be further explored, particularly in light of the rising food prices currently being observed. Declining food prices over time have been singled out as a main contributor, for example, to the rising trend in obesity. In this paper we use data from the Bureau of Labor Statistics, the American Chamber of Commerce Researchers Association, the Consumer Expenditure Survey, and the United States Department of Agriculture to analyze trends in various types of food prices, to create a food price index, and to estimate the price of a calorie. Results may be used by future researchers in estimating the health implications of these trends. We find that while the general trend in food prices has been declining, that of restaurant meal prices and prices of fruits and vegetables has risen over time. It is doubtful that the decline in food prices has been sufficiently large to account for the large increase in caloric intake that is said to have contributed to the obesity epidemic in the U.S.     

"Drink Milk for Fitness": The Cultural Politics of Human Biological Variation and Milk Consumption in the United States

Cow's milk is accorded a high cultural value in the contemporary United States. Its white color, association with the maternal and the pastoral, and repeated mention in the Bible add positive symbolic weight to this major national agricultural commodity. Thus, it comes as no surprise that influential policy-making institutions in the United States recommend milk consumption for all U.S. groups. This is despite variation in adult populations' abilities to digest milk, which has been documented by biological anthropologists. This article assesses various U.S. "stories" about milk consumption and its relationship to biological variation against the biological anthropological explanation of variation in lactase activity/lactose tolerance. Many of these serve as normalizing discourses that ultimately pathologize biological difference and may undermine the dietary traditions of some ethnic groups. In particular, the close relationship between government and the dairy industry leads to policies that fail to seriously consider variation in digestive physiology among the diverse U.S. populations.     

Leveraging genetic ancestry to study health disparities

Research to understand human genomic variation and its implications in health has great potential to contribute in the reduction of health disparities. Biological anthropology can play important roles in genomics and health disparities research using a biocultural approach. This paper argues that racial/ethnic categories should not be used as a surrogate for sociocultural factors or global genomic clusters in biomedical research or clinical settings, because of the high genetic heterogeneity that exists within traditional racial/ethnic groups. Genetic ancestry is used to show variation in ancestral genomic contributions to recently admixed populations in the United States, such as African Americans and Hispanic/Latino Americans. Genetic ancestry estimates are also used to examine the relationship between ancestry-related biological and sociocultural factors affecting health disparities. To localize areas of genomes that contribute to health disparities, admixture mapping and genome-wide association studies (GWAS) are often used. Recent GWAS have identified many genetic variants that are highly differentiated among human populations that are associated with disease risk. Some of these are population-specific variants. Many of these variants may impact disease risk and help explain a portion of the difference in disease burden among racial/ethnic groups. Genetic ancestry is also of particular interest in precision medicine and disparities in drug efficacy and outcomes. By using genetic ancestry, we can learn about potential biological differences that may contribute to the heterogeneity observed across self-reported racial groups.     

Obesity and labour market success in Finland: The difference between having a high BMI and being fat

This paper examines the relationship between obesity and labour market success in Finland, using various indicators of individual body composition along with body mass index (BMI). Weight, height, fat mass and waist circumference are measured by health professionals. We find that only waist circumference has a negative association with wages for women, whereas no obesity measure is significant in the linear wage models for men. However, all measures of obesity are negatively associated with women's employment probability and fat mass is negatively associated with men's employment probability. We also find that the use of categories for waist circumference and fat mass has a substantial influence on the results. For example, the category for high fat mass is associated with roughly 5.5% lower wages for men. All in all, the results indicate that in the absence of measures of body composition, there is a risk that labour market penalties associated with obesity are measured with bias.     

Intergenerational persistence of health: Do immigrants get healthier as they remain in the U.S. for more generations?

It is well known that a substantial part of income and education is passed on from parents to children, generating substantial persistence in socioeconomic status across generations. In this paper, we examine whether another form of human capital, health, is also largely transmitted from generation to generation. Using data from the NLSY, we first present new evidence on intergenerational transmission of health outcomes in the U.S., including weight, height, the body mass index (BMI), asthma and depression for both natives and immigrants. We show that between 50% and 70% of the mothers’ health status persists in both native and immigrant children, and that, on average, immigrants experience higher persistence than natives in BMI. We also find that the longer immigrants remain in the U.S., the less intergenerational persistence there is and the more immigrants look like native children. Unfortunately, the more generations immigrant families remain in the U.S., the more children of immigrants resemble natives’ higher BMI.     

Decomposing body mass index gaps between Mediterranean countries: A counterfactual quantile regression analysis

Wide cross-country variation in obesity rates has been reported between European Union member states. Although the existing cross-country differences have not been analyzed in depth, they contain important information on health production determinants. In this paper we apply a methodology for conducting standardized cross-country comparisons of body mass index (BMI). We draw on estimations of the marginal density function of BMI for Italy and Spain in 2003, two countries with similar GDP and socio-economic conditions. We produce different counterfactual distribution estimates using covariates (health production inputs) specified in a quantile regression. Our findings suggest that Spain-to-Italy BMI gaps among females are largely explained by cross-country variation in the returns to each covariate, especially for younger women. We find that adverse underlying determinants do not explain the gap observed in particular between younger Spanish females and their Italian counterfactuals; behavioural differences appear to be the key. We tentatively conclude that Spanish policy on obesity should target mainly younger females.     

Relationship between perceptions about neighborhood environment and prevalent obesity: data from the dallas heart study

Objectives:

Although psychosocial stress can result in adverse health outcomes, little is known about how perceptions of neighborhood conditions, a measure of environment‐derived stress, may impact obesity. The association between perceptions of neighborhood environment and obesity (defined as body mass index [BMI] ≥ 30 kg/m²) among 5,907 participants in the Dallas Heart Study, a multi‐ethnic, probability‐based sample of Dallas County residents was examined.

Design and Methods:

Participants were asked to respond to 18 questions about perceptions of their neighborhood. Factor analysis was used to identify three factors associated with neighborhood perceptions: neighborhood violence, physical environment, and social cohesion. Logistic regression analyses were performed to determine the relationship between each factor (higher quintile = more unfavorable perceptions) and the odds of obesity.

Results:

Decreasing age, income, and education associated with unfavorable overall neighborhood perceptions and unfavorable perceptions about specific neighborhood factors (P trend <0.05 for all). Increasing BMI was associated with unfavorable perceptions about physical environment (P trend <0.05) but not violence or social cohesion. After adjustment for race, age, sex, income, education, and length of residence, physical environment perception score in the highest quintile remained associated with a 25% greater odds of obesity (OR 1.25, [95% CI 1.03‐1.50]). Predictors of obesity related to environmental perceptions included heavy traffic (OR 1.39, [1.17‐1.64]), trash/litter in neighborhood (OR 1.27, [1.01‐1.46]), lack of recreational areas (OR 1.21, [1.01‐1.46]), and lack of sidewalks (OR 1.25, [95% CI 1.04‐1.51]).

Conclusions:

Thus, unfavorable perceptions of environmental physical conditions are related to increased obesity. Efforts to improve the physical characteristics of neighborhoods, or the perceptions of those characteristics, may assist in the prevention of obesity in this community.     

Association between VDR ApaI Polymorphism and Hip Bone Mineral Density Can Be Modified by Body Mass Index： A Study on Postmenopausal Chinese Women

Osteoporosis is a major public health problem for old people. Genetic factors are considered to be major contributors to the pathogenesis of postmenopausal osteoporosis. The vitamin D receptor (VDR) gene is a prominent candidate gene for the regulation of postmenopausal bone mass; however, despite extensive studies, controversy remains regarding its association with postmenopausal body mineral density (BMD) variation. In this study, a total of 260 healthy postmenopausal Chinese women were genotyped at the VDR ApaI locus using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Raw hip BMD was significantly associated with VDR ApaI polymorphism with and without adjusting for age (P=0.015 and 0.040, respectively). This genetic effect can explain 3.32% of hip BMD variation. However, the significant association vanished after correcting for both age and body mass index (BMI) (P=0.169). In addition, we observed a significant association between VDR ApaI polymorphism with unadjusted BMI(P=0.042) or BMI adjusted for age (P=0.049). The raw hip BMD was also found to be significantly correlated with BMI (r=0.517, P=0.0001), with BMI explaining 26.35% of the variation of hip BMD. All of these facts prompt us to conclude that the significant association between the VDR ApaI genotype and hip BMD may be modified by BMI in postmenopausal Chinese women. Our findings may partially explain the earlier inconsistent association results concerning the VDR gene and BMD, and highlight the importance of incorporating covariates such as BMI into osteoporosis association studies.     

Obesity and labor market outcomes in Denmark

This paper analyzes the relationship between body mass index (BMI) and employment status and wages. The analysis uses a unique data set from a Danish panel survey from 1995 and 2000, combined with administrative registers, covering 8000 individuals. Results show a negative effect of BMI on employment for women and an inverted u-shaped effect for men. Results further indicate that in the private sector BMI has a negative effect on wages for women but an inverted u-shaped effect on wages for men, whereas results from the public sector show that BMI has no influence on wages for either men or women.     

Obesity and time preference: the health consequences of discounting the future

Much focus has been placed on the obesity epidemic due to its high prevalence and the costs it imposes on society. Using 2004 data from the Roper Center, complemented with 2003 data from the Behavioural Risk Factor Surveillance System, this study analyses the possible effect that time preference has on health in the United States, as measured by the body mass index. After controlling for a variety of covariates and correcting for potential selectivity, some evidence of a positive association between time preference for the present and the body mass index can be found, particularly for males. Research in this area has policy implications in terms of creating incentives for those who lack self-control through the use of pre-commitment devices. Measures addressing self-control issues may be more effective in reducing the rising obesity rates across the world.     

In urban South Africa, 16 year old adolescents experience greater health equality than children

Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n = 346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9–10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9–10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.     

Association between VDR Apal Polymorphism and Hip Bone Mineral Density Can Be Modified by Body Mass Index:A Study on Postmenopausal Chinese Women

Osteoporosis is a major public health problem for old people.Genetic factors are considered tobe major contributors to the pathogenesis of postmenopausal osteoporosis.The vitamin D receptor(VDR)gene is a prominent candidate gene for the regulation of postmenopausal bone mass;however,despite exten-sive studies,controversy remains regarding its association with postmenopausal body mineral density(BMD)variation.In this study,a total of 260 healthy postmenopausal Chinese women were genotyped at the VDRApaI locus using polymerase chain reaction(PCR)-restriction fragment length polymorphism (RFLP).Rawhip BMD was significantly associated with VDR ApaI polymorphism with and without adjusting for age(P=0.015 and 0.040,respectively).This genetic effect can explain 3.32% of hip BMD variation.However,the significant association vanished after correcting for both age and body mass index(BMI)(P=0.169).Inaddition,we observed a significant association between VDR ApaI polymorphism with unadjusted BMI(P=0.042)or BMI adjusted for age(P=0.049).The raw hip BMD was also found to be significantly corre-lated with BMI(r=0.517,P=0.0001),with BMI explaining 26.35% of the variation of hip BMD.All of thesefacts prompt us to conclude that the significant association between the VDR ApaI genotype and hip BMDmay be modified by BMI in postmenopausal Chinese women.Our findings may partially explain the earlierinconsistent association results concerning the VDR gene and BMD,and highlight the importance of incorpo-rating covariates such as BMI into osteoporosis association studies.     

Socioeconomic status, height, and obesity in children

The substantial increase in the prevalence of child obesity over recent decades and its association with a number of negative health and economic outcomes suggests its strong potential as an influence on the lifecourse development of health and productivity. This paper evaluates interactive effects between family socioeconomic status (SES) and height on child obesity in the United States. Using the 1999-2006 National Health and Nutrition Examination Surveys (NHANES), the results of this paper confirm previous findings that taller children exhibit greater propensity towards obesity as measured by body mass index (BMI) and that obesity is inversely related to family SES as measured by poverty status. The analysis adds to the existing literature by showing that the magnitude of the SES-obesity association is larger in taller children. Age and sex patterns are evaluated that suggest the SES-height interaction persists through childhood and adolescence in males but is only evident in females during adolescence. Interaction effects are also shown to be most evident in white males and Hispanic females. Policy implications are discussed and directions for future work are suggested.