Assari Shervin
Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
BRITE Center, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
Children (Basel). 2018 Jun 10;5(6):73. doi: 10.3390/children5060073.
Although the protective effects of socioeconomic status (SES) on obesity and cardiovascular disease are well established, these effects may differ across racial and ethnic groups. Using a national sample, this study investigated racial variation in the association between family income and childhood obesity in White and Black families. This cross-sectional study used data from the National Survey of Children’s Health (NSCH), 2003⁻2004, a nationally representative survey in the United States. This analysis included 76,705 children 2⁻17 years old who were either White ( = 67,610, 88.14%) or Black ( = 9095, 11.86%). Family income to needs ratio was the independent variable. Childhood obesity was the outcome. Race was the focal moderator. Logistic regression was used for data analysis. Overall, higher income to needs ratio was protective against childhood obesity. Race, however, interacted with income to needs ratio on odds of childhood obesity, indicating smaller effects for Black compared to White families. Race stratified logistic regressions showed an association between family income and childhood obesity for White but not Black families. The protective effect of income against childhood obesity is smaller for Blacks than Whites. Merely equalizing population access to SES and economic resources would not be sufficient for elimination of racial disparities in obesity and related cardiovascular disease in the United States. Policies should go beyond access to SES and address structural barriers in the lives of Blacks which result in a diminished health return of very same SES resources for them. As the likely causes are multi-level barriers, multi-level interventions are needed to eliminate racial disparities in childhood obesity.
尽管社会经济地位（SES）对肥胖和心血管疾病的保护作用已得到充分证实，但这些作用在不同种族和族裔群体中可能存在差异。本研究使用全国性样本，调查了白人和黑人家庭中家庭收入与儿童肥胖之间关联的种族差异。这项横断面研究使用了2003 - 2004年美国全国儿童健康调查（NSCH）的数据，该调查具有全国代表性。该分析纳入了76705名2至17岁的儿童，其中白人儿童67610名（占88.14%），黑人儿童9095名（占11.86%）。家庭收入需求比为自变量，儿童肥胖为结果变量，种族为核心调节变量。数据分析采用逻辑回归。总体而言，较高的收入需求比对儿童肥胖具有保护作用。然而，种族与收入需求比在儿童肥胖几率上存在交互作用，这表明与白人家庭相比，黑人家庭的影响较小。按种族分层的逻辑回归显示，白人家庭的家庭收入与儿童肥胖之间存在关联，而黑人家庭则不然。收入对黑人儿童肥胖的保护作用小于白人。仅仅使人口平等获取SES和经济资源，不足以消除美国肥胖及相关心血管疾病方面的种族差异。政策应超越获取SES的范畴，解决黑人生活中的结构性障碍，这些障碍导致相同的SES资源给他们带来的健康回报减少。由于可能的原因是多层次的障碍，因此需要多层次的干预措施来消除儿童肥胖方面的种族差异。
