Childhood and adult social context and its association with obesity in a cohort of Baltimore women

Background: Risks for obesity are not distributed equally. We sought to determine whether childhood poverty influenced the likelihood of adult obesity in African-American and White women.

Methods: The Pathways to Adulthood cohort consists of children born in Baltimore from 1960-1965 with follow-up from 1992-1994 at ages 27 to 33. For this study, 989 female respondents were analyzed.

Our outcome was obesity, body mass index>30, which was calculated based on self-reports of height and weight. We used t-tests and chi-square for bivariate comparisons. For multivariate analysis, we used logistic regression clustered on census tract.

Results: The sample was 18% White and 72% African-American; the women had similarly high rates of obesity (25% and 24.5% respectively). Compared to Whites, African-American women were more likely to have completed college, less likely to be married, and had fewer assets (all p<0.05). While the women had similar rates of poverty as children and adults, African-Americans were significantly more likely to have lived in a poor neighborhood as a child or as an adult (p<0.001). Adjusted analyses revealed the interaction of race and marital status; married, African-American women had greater odds of obesity (OR 1.8, p<0.01). As assets increased, obesity decreased (OR 0.86, p<0.01). There was no significant effect of childhood poverty, neighborhood poverty or income.

Conclusion: In this sample of women with high rates of childhood and adulthood poverty, obesity rates were high and was negatively associated with increasing assets. Marriage was associated with increased odds of obesity for African-American women.