Racial and ethnic disparities: An examination of social control and contagion mechanisms linking neighborhood disadvantage and young adult obesity

Despite increasing wealth and improvements in overall health worldwide, striking disparities remain in the burden of illness and death, including obesity. As rates of obesity have increased, inequalities in childhood and adult obesity have strengthened, with highest rates among the poor, minority groups and women. The rapid increase in the prevalence of disparities in obesity in the U.S. and worldwide may suggest that adverse environmental factors as opposed to genes, for instance, are one of the key sources of obesity and obesity-related health problems. The challenge then of this dissertation is twofold: to determine how differences in where we live contribute to and perpetuate the obesity epidemic and to understand the processes involved. Results need to inform policy in ways that can minimize inequalities.

This dissertation investigates the racial and ethnic disparities in young adult obesity during the transition to adulthood among males and females, the extent to which the presence of early life neighborhood disadvantage impacts young adult obesity, the functional form of this relationship (i.e., linear or curvilinear) and the processes by which disadvantage may impact obesity. Social control and contagion models, incorporated with a life course perspective serve as the foundations for the conceptual framework. This research incorporates social control, social contagion, and life course perspectives in order to better suggest policy interventions aimed at reducing environmental causes and processes involved in the development of obesity.

Using multilevel statistical models and data from three waves of the National Longitudinal Study of Adolescent Health, findings indicate that adolescent neighborhood disadvantage partially explains racial and ethnic disparities in the transition from being a healthy weight adolescent to an obese young adult, for females. I find that adolescent neighborhood disadvantage increases the risk of obesity for White, Black, and Hispanic females in a curvilinear form, but does not significantly differ across groups. I do not find that neighborhood disadvantage increases the risk of obesity for males, regardless of race. Neighborhood disadvantage increases the risk of early school dropout and fear of victimization among males and females in a positive and curvilinear leveling-off form. Neighborhood disadvantage also increases risk of early childbearing among females, and early childbearing explains part of the effect of neighborhood disadvantage on obesity. Finally, interesting results are found with respect to the relationships among neighborhood disadvantage, fear and obesity. Among males the effect of neighborhood disadvantage on fear is positive and levels off, while a j-shaped curve is found among Blacks and Hispanics. Among females, the effect of fear on obesity is moderated by level of disadvantage. Implications for obesity prevention efforts are discussed.