Racial composition of social settings across the life course and adult obesity in women

Background: U.S. racial segregation has shaped access to health promoting resources and services, as well as health practices, which might affect adulthood obesity risk. This study examines the association between self-reported racial composition of social settings (high school and current neighborhood) and obesity in a diverse sample of community health center visitors.

Methods: Data were obtained from two cross-sectional surveys conducted in community health centers serving a medically underserved population. Analysis was limited to female respondents (N = 1,186) that completed surveys in English and self-identified as Non-Hispanic White (37.2%), Non-Hispanic Black (38.0%), or Hispanic (24.8%), who responded to the racial composition question and reported BMI data. Indicators of racial composition were created reflecting the degree of segregation experience (i.e., mostly black vs. not) in each social setting. Linear and logistic regression analyses were conducted to determine if mostly black high school or current neighborhood environments were significantly associated with BMI and obesity, controlling for race, ethnicity, country of birth and age.

Results: Predominately Black racial composition in high school (OR=1.8; p=0.001) and one's current neighborhood (OR=1.4; p=0.048) played a significant role in women's obesity status and BMI after controlling for race, ethnicity, country of birth and age.

Discussion: Racial segregation in high school and current neighborhood settings could be an important social determinant of obesity among females. Future research is needed to understand the mechanisms by which segregation experience impacts access to care, health behaviors and health outcomes.