Perceived discrimination and obesity among African American women in Detroit: Social support and neighborhood characteristics as effect modifiers

The prevalence of obesity, a major risk factor for chronic disease, has increased dramatically in the past three decades, particularly in African American women. Obesity is particularly harmful when fat accumulates in the abdominal region. Psychosocial stress is a potential risk factor for the accumulation of body fat in the abdominal region that has been understudied in African American women. While research is growing on the relationship between perceived discrimination and physical health, there is a dearth of studies that have focused on its relationship to obesity. Among the few studies that have examined this question, Hunte and Williams (2009) found no significant relationship between discrimination and central adiposity in Blacks but an association in ethnic whites (i.e. Jewish and Polish) in a multiethnic population in Chicago. In this study, we will draw upon survey, census and observational data from the Detroit Healthy Environments Partnership, a community-based participatory research partnership, to test the hypothesis that associations between exposure to discrimination and waist circumference may be modified by characteristics of the social and physical environments. We use multivariate regression models to test the hypothesis that relationships between discrimination and waist circumference are modified by social support, and hierarchical linear models to test the hypothesis that these relationships are modified by neighborhood characteristics (e.g., percent poverty, observed neighborhood disorder) that may be conducive to stress. We will discuss implications of our findings for interventions to improve health outcomes, with particular attention to the health of African American women.