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人际歧视、邻里不平等与儿童身体质量指数:描述性、横断面分析。

Interpersonal Discrimination, Neighborhood Inequities, and Children's Body Mass Index: A Descriptive, Cross-Sectional Analysis.

机构信息

Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (Dr Kunin-Batson); Department of Epidemiology and Biostatistics, University of Georgia, Athens (Mr Carr and Dr Tate); Department of Family Medicine and Community Health, University of Minnesota, Minneapolis (Ms Trofholz and Dr Berge); Children's Minnesota, Minneapolis (Dr Troy); Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis (Dr Hardeman); and Center for Antiracism Research for Health Equity, University of Minnesota, Minneapolis (Dr Hardeman).

出版信息

Fam Community Health. 2023;46(Suppl 1):S30-S40. doi: 10.1097/FCH.0000000000000372.

Abstract

Psychosocial stressors have been implicated in childhood obesity, but the role of racism-related stressors is less clear. This study explored associations between neighborhood inequities, discrimination/harassment, and child body mass index (BMI). Parents of children aged 5-9 years from diverse racial/ethnic backgrounds (n = 1307), completed surveys of their child's exposure to discrimination/harassment. Census tract data derived from addresses were used to construct an index of concentration at the extremes, a measure of neighborhood social polarization. Child's height and weight were obtained from medical records. Multiple regression and hierarchical models examined child's BMI and racism at the individual and census tract levels. Children residing in the most Black-homogenous census tracts had 8.2 percentage units higher BMI percentile (95% confidence interval, 1.5-14.9) compared with white-homogenous tracts (P = .03). Household income and home values were lower, poverty rates higher, and single parent households more common among Black-homogeneous census tracts. Almost 30% of children experienced discrimination/harassment in the past year, which was associated with a 5.28-unit higher BMI percentile (95% confidence interval, 1.72-8.84; P = .004). Discrimination and racial/economic segregation were correlated with higher child BMI. Longitudinal studies are needed to understand whether these factors may be related to weight gain trajectories and future health.

摘要

心理社会压力与儿童肥胖有关,但种族相关压力因素的作用尚不清楚。本研究探讨了邻里不平等、歧视/骚扰与儿童体重指数(BMI)之间的关系。来自不同种族/族裔背景的 5-9 岁儿童的父母(n=1307)完成了孩子遭受歧视/骚扰情况的调查。根据地址得出的普查区数据用于构建极端集中指数,这是衡量邻里社会两极分化的一个指标。从医疗记录中获取儿童的身高和体重。多变量回归和分层模型分别在个体和普查区层面上检验了儿童的 BMI 和种族。与白人聚居的普查区相比,居住在黑人聚居的普查区的儿童 BMI 百分位高出 8.2 个百分点(95%置信区间,1.5-14.9)(P=0.03)。黑人聚居的普查区的家庭收入和房屋价值较低,贫困率较高,单亲家庭更为常见。近 30%的儿童在过去一年中经历过歧视/骚扰,这与 BMI 百分位高出 5.28 个单位(95%置信区间,1.72-8.84;P=0.004)有关。歧视和种族/经济隔离与儿童 BMI 较高有关。需要进行纵向研究,以了解这些因素是否与体重增加轨迹和未来健康有关。

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