Racial disparities in obesity for males & females in three southern states in the US, across SES categories

Abstract

Objectives: Obesity rates in US are substantially higher among African-Americans than Whites. Racial disparities in obesity are sometimes ascribed to racial differences in socio-economic-status (SES). We used data from three states in the southern region of the US with high rates of obesity, to examine the extent of racial disparities within SES categories, particularly examining whether disparities grow smaller at higher levels of income and education. Methods: We used data (2001-2009) from the Behavioral Risk Factor Surveillance System (BRFSS) for 79,676 respondents, African-American and white, from Mississippi, Alabama, and Louisiana. Multivariate logistic regressions were estimated. Analyses were conducted separately for males and females, for the full sample and by levels of education, income and aggregate SES. Risk-differences (RD), and Relative-Risk-Ratios (RR) were reported to enable inspection of magnitudes of racial gaps, which more conventional odds-ratios does not allow researchers to do. Results: The obesity-gap between African-Americans and Whites is larger for females than males. For males the gap becomes smaller and insignificant in higher education and income categories. For females, the gap remains statistically significant and is of comparable magnitude across all education and income categories. Conclusions: Racial disparities in obesity among males can be largely attributed to SES differences. However, racial disparities among females cannot simply be attributed to racial disparities in SES. Thus, reducing racial differences in income and education may not help reduce disparities in obesity risk among White and African-American females. Further research is required to understand why racial disparities in obesity exist within specific SES categories for females.