Stepanikova Irena, Baker Elizabeth H, Simoni Zachary R, Zhu Aowen, Rutland Sarah B, Sims Mario, Wilkinson Larrell L
Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama; Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czech Republic.
Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama.
Am J Prev Med. 2017 Jan;52(1S1):S77-S85. doi: 10.1016/j.amepre.2016.07.034.
African Americans, especially those in the South, suffer a disproportionate burden of obesity and are at high risk for perceived discrimination (PD). This study investigates the association between PD and weight status among African Americans and clarifies the role of perceived stress and health behaviors in this relationship.
Data came from the Jackson Heart Study, Examination 1 (2000-2004; analyses conducted in 2016 using Stata, version 14). African Americans from Jackson, Mississippi, aged 21-95 years were recruited (N=5,301). Weight status was measured using anthropometric data with BMI; waist circumference (in centimeters); and obesity class (I, II, III). Survey instruments were used to measure PD, perceived global stress, and health behaviors. Multivariate regression was used to model weight status outcomes as a function of PD, perceived stress, and health behaviors.
After controlling for sociodemographic factors and health status, perceived everyday discrimination was associated with higher BMI (b=0.33, p<0.01); higher waist circumference (b=0.70, p<0.01); and higher relative risk of Class III obesity versus non-obesity (relative risk ratio, 1.18; p<0.001). Global perceived stress was linked to higher BMI (b=0.42, p<0.05) and higher waist circumference (b=1.18; p<0.01) and partially mediated the relationships between PD and these weight status outcomes. Health behaviors led to suppression rather than mediation between PD and weight status and between stress and weight status.
PD and perceived stress are potential risk factors for higher weight status. They should be considered as a part of a comprehensive approach to reduce obesity among African Americans.
非裔美国人，尤其是南方的非裔美国人，承受着不成比例的肥胖负担，且面临较高的感知歧视（PD）风险。本研究调查了非裔美国人中感知歧视与体重状况之间的关联，并阐明了感知压力和健康行为在这种关系中的作用。
数据来自杰克逊心脏研究，第一次检查（2000 - 2004年；2016年使用Stata 14版本进行分析）。招募了来自密西西比州杰克逊市年龄在21 - 95岁的非裔美国人（N = 5301）。使用人体测量数据测量体重状况，包括体重指数（BMI）、腰围（厘米）和肥胖等级（I、II、III级）。使用调查工具测量感知歧视、感知整体压力和健康行为。多元回归用于将体重状况结果建模为感知歧视、感知压力和健康行为的函数。
在控制了社会人口学因素和健康状况后，日常感知歧视与较高的BMI（b = 0.33，p < 0.01）、较高的腰围（b = 0.70，p < 0.01）以及III级肥胖相对于非肥胖的较高相对风险（相对风险比，1.18；p < 0.001）相关。整体感知压力与较高的BMI（b = 0.42，p < 0.05）和较高的腰围（b = 1.18；p < 0.01）相关，并部分介导了感知歧视与这些体重状况结果之间的关系。健康行为导致感知歧视与体重状况之间以及压力与体重状况之间的关系受到抑制而非中介作用。
感知歧视和感知压力是体重增加的潜在风险因素。应将它们视为减少非裔美国人肥胖综合方法的一部分。
