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Published Online First: 31 October 2008. doi:10.1136/jech.2008.075721
Journal of Epidemiology and Community Health 2009;63:133-139
Copyright © 2009 by the BMJ Publishing Group Ltd.

RESEARCH REPORTS

Obesity, race/ethnicity and life course socioeconomic status across the transition from adolescence to adulthood

M Scharoun-Lee1,2, J S Kaufman2,3, B M Popkin1,2 and P Gordon-Larsen1,2

1, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
2, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
3, Department of Epidemiology, School of Public Health; University of North Carolina at Chapel Hill, Chapel Hill, USA

Correspondence to:
Dr P Gordon-Larsen, Carolina Population Center, University of North Carolina at Chapel Hill, University Square, 123 West Franklin Street, Chapel Hill, NC 27516-3997, USA; gordon_larsen{at}unc.edu

Background: Differences in the association of socioeconomic status (SES) with obesity may underlie the racial/ethnic disparities in obesity that increase dramatically across the transition to adulthood in the United States. The aim of this study was to examine racial/ethnic differences in the influence of life course SES on longitudinal obesity patterns from adolescence to adulthood.

Methods: Latent class analysis was used on a nationally representative, diverse sample of 12 940 adolescents followed into young adulthood (mean age = 21.7 years) to identify life course SES group profiles based on SES data in adolescence and young adulthood. Gender-stratified multinomial logistic regression models estimated the association of SES groups with obesity incidence and persistence versus staying non-obese.

Results: No significant interactions with race/ethnicity were observed, although racial/ethnic minorities had the highest obesity risk across SES groups. Racial/ethnic-pooled associations between disadvantaged SES exposure and higher obesity risk were strong but differed by gender. Males with a disadvantaged background who experienced early transitions into the labour force, marriage and residential independence had the highest risk of obesity incidence (relative risk ratio (RRR) = 1.64; 95% confidence interval (CI) 1.12 to 2.40), while females exposed to persistent adversity were at highest risk (RRR = 3.01, 95% CI 1.95 to 4.66). In general, SES group membership had a stronger relationship with obesity persistence than incidence.

Conclusions: The relationship between SES and obesity patterns is similar across race/ethnicity and differs by gender during the transition to adulthood. However, stronger associations with obesity persistence and enduring racial/ethnic disparities in obesity risk across SES groups suggest that these social factors play a larger role in disparities earlier in the life course.


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