Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the USA

ObjectiveTo evaluate COVID-19 infection and mortality disparities in ethnic and racial subgroups in a state-wise manner across the USA.MethodsPublicly available data from The COVID Tracking Project at The Atlantic were accessed between 9 September 2020 and 14 September 2020. For each state and the District of Columbia, % infection, % death, and % population proportion for subgroups of race (African American/black (AA/black), Asian, American Indian or Alaska Native (AI/AN), and white) and ethnicity (Hispanic/Latino, non-Hispanic) were recorded. Crude and normalised disparity estimates were generated for COVID-19 infection (CDI and NDI) and mortality (CDM and NDM), computed as absolute and relative difference between % infection or % mortality and % population proportion per state. Choropleth map display was created as thematic representation proportionate to CDI, NDI, CDM and NDM.ResultsThe Hispanic population had a median of 158% higher COVID-19 infection relative to their % population proportion (median 158%, IQR 100%–200%). This was followed by AA, with 50% higher COVID-19 infection relative to their % population proportion (median 50%, IQR 25%–100%). The AA population had the most disproportionate mortality, with a median of 46% higher mortality than the % population proportion (median 46%, IQR 18%–66%). Disproportionate impact of COVID-19 was also seen in AI/AN and Asian populations, with 100% excess infections than the % population proportion seen in nine states for AI/AN and seven states for Asian populations. There was no disproportionate impact in the white population in any state.ConclusionsThere are racial/ethnic disparities in COVID-19 infection/mortality, with distinct state-wise patterns across the USA based on racial/ethnic composition. There were missing and inconsistently reported racial/ethnic data in many states. This underscores the need for standardised reporting, attention to specific regional patterns, adequate resource allocation and addressing the underlying social determinants of health adversely affecting chronically marginalised groups.

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BEWARE OF BEING UNAWARE: RACIAL/ETHNIC DISPARITIES IN CHRONIC ILLNESS IN THE USA

Health Economics ◽

10.1002/hec.2856 ◽

2012 ◽

Vol 21 (9) ◽

pp. 1040-1060 ◽

Cited By ~ 8

Author(s):

Pinka Chatterji ◽

Heesoo Joo ◽

Kajal Lahiri

Keyword(s):

Chronic Illness ◽

Ethnic Disparities ◽

The Usa ◽

Racial Ethnic

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Multimorbidity Accumulation by Race or Ethnicity and Body-Weight Status Among Middle-Aged and Older Americans

Innovation in Aging ◽

10.1093/geroni/igaa057.822 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 256-256

Author(s):

Anda Botoseneanu ◽

Sheila Markwardt ◽

Heather Allore ◽

Corey Nagel ◽

Jason Newsom ◽

...

Keyword(s):

Ethnic Groups ◽

Weight Status ◽

Minority Groups ◽

Ethnic Disparities ◽

Overweight And Obesity ◽

Middle Aged ◽

Older Americans ◽

Black And White ◽

Body Weight Status ◽

Racial Ethnic

Abstract Obesity and multimorbidity are more prevalent among U.S. racial/ethnic minority groups. Evaluating racial/ethnic disparities in multimorbidity accumulation according to body-mass index (BMI) may guide interventions to reduce multimorbidity burden in vulnerable racial/ethnic groups. Data from the 1998-2016 Health & Retirement Study (N=8,106, 51-55 years at baseline) and generalized estimating equations models with inverse probability weights estimated the accumulation of seven chronic diseases (arthritis, cancer, diabetes, heart disease, hypertension, lung disease, and stroke) between racial/ethnic groups [Non-Hispanic White (reference; 64.2%), Non-Hispanic Black (21.6%), Hispanic (14.2%)]. Overweight and obesity were more prevalent in Black (82.3%) and Hispanic (78.9%) than White (70.9 %) participants at baseline. Initial burden of morbidity was higher among Black participants [risk ratio (RR) =1.3, p<0.001] but similar among Hispanic compared with White participants; and higher in overweight or greater BMI categories compared with normal BMI (RR=1.07, 1.15, 1.22, p<0.001, for overweight, obese 1, and obese 2/3 BMI, respectively). Disease accumulation did not differ among racial/ethnic groups. Higher BMI was associated with less disease accumulation compared with the normal BMI category (RR=0.99, 0.98, 0.97, all p<0.001, for overweight, obese 1, and obese 2/3 BMI, respectively, per two-year interval). Black participants crossed the threshold of multimorbidity (≥2 diseases) 4-6 years earlier than White and Hispanic participants. There are substantial differences in initial disease burden between Black and White middle-aged/older adults, but not in the accumulation of disease, suggesting the need to intervene prior to entering middle age to reduce disparities in the burden of multimorbidity among vulnerable racial minorities.

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Racial/Ethnic Disparities in the Prevalence and Trends of Autism Spectrum Disorder in US Children and Adolescents

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.0771 ◽

2021 ◽

Vol 4 (3) ◽

pp. e210771

Author(s):

Jing Yuan ◽

Minghui Li ◽

Z. Kevin Lu

Keyword(s):

Autism Spectrum Disorder ◽

Children And Adolescents ◽

Ethnic Disparities ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Us Children ◽

Racial Ethnic

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Racial/Ethnic Disparities in Opioid-Related Mortality in the USA, 1999–2019: the Extreme Case of Washington DC

Journal of Urban Health ◽

10.1007/s11524-021-00573-8 ◽

2021 ◽

Author(s):

Mathew V. Kiang ◽

Alexander C. Tsai ◽

Monica J. Alexander ◽

David H. Rehkopf ◽

Sanjay Basu

Keyword(s):

Ethnic Disparities ◽

Extreme Case ◽

Washington Dc ◽

The Usa ◽

Racial Ethnic ◽

Related Mortality

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RACIAL-ETHNIC DIFFERENCES IN MULTIMORBIDITY PROGRESSION ACCORDING TO BODY-WEIGHT STATUS AMONG OLDER U.S. ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1163 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S318-S319

Author(s):

Anda Botoseneanu ◽

Sheila Markwardt ◽

Heather Allore ◽

Corey Nagel ◽

Jason T Newsom ◽

...

Keyword(s):

Ethnic Groups ◽

Weight Status ◽

Minority Groups ◽

Negative Binomial ◽

Ethnic Disparities ◽

Overweight And Obesity ◽

Black And White ◽

Body Weight Status ◽

Racial Ethnic ◽

Retirement Study

Abstract Obesity and multimorbidity are more prevalent among underrepresented U.S. racial/ethnic minority groups. Evaluating whether racial/ethnic disparities in multimorbidity accumulation vary according to body-mass index (BMI) may guide interventions aimed at reducing multimorbidity burden in vulnerable racial/ethnic groups. We used 1998-2014 data from the Health & Retirement Study (N=8,635 participants, age 51-55 years old at baseline) and negative binomial models stratified by BMI category to evaluate differences in rates of accumulation of seven chronic conditions (arthritis, cancer, diabetes, heart disease, hypertension, lung disease, and stroke), focusing on differences between racial/ethnic groups [White (reference; 64.7%), Black (21.5%), Hispanic (13.8%)]. Overweight and obesity were more prevalent in Black (80.9%) and Hispanic (78.6%) than White (69.9%) participants at baseline; in all BMI categories, Black participants had higher rates of multimorbidity compared with White participants (normal BMI:β=0.304, p<0.001; overweight:β=0.243,p<0.001; and obese:β=0.135,p=0.013); initial burden of disease was similar between Whites and Hispanics in the normal and overweight categories, but significantly lower among Hispanics (vs. Whites) in the obese category (β= -0.180,p=0.017). We found no significant differences in rates of disease accumulation between the racial/ethnic groups in any of the BMI categories. There are substantial differences in initial disease burden between Black and White middle-aged/older adults, but not in the rate of accumulation of disease between the race/ethnic groups in the 3 main BMI categories. These findings suggest an opportunity to reduce racial disparities in multimorbidity by intervening early in the lifecourse to reduce the burden of chronic disease among vulnerable racial minorities prior to entering middle-age.

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Trends in racial/ethnic disparities in overweight self-perception among US adults, 1988–1994 and 1999–2008

Public Health Nutrition ◽

10.1017/s1368980014002560 ◽

2014 ◽

Vol 18 (12) ◽

pp. 2115-2125 ◽

Cited By ~ 19

Author(s):

Brent A Langellier ◽

Deborah Glik ◽

Alexander N Ortega ◽

Michael L Prelip

Keyword(s):

Ethnic Groups ◽

Mexican Americans ◽

Weight Status ◽

White Women ◽

Mexican Immigrants ◽

Ethnic Disparities ◽

Self Perceptions ◽

The Usa ◽

Time Periods ◽

Racial Ethnic

AbstractObjectiveWeight self-perceptions, or how a person perceives his/her weight status, may affect weight outcomes. We use nationally representative data from 1988–1994 and 1999–2008 to examine racial/ethnic disparities in weight self-perceptions and understand how disparities have changed over time.DesignUsing data from two time periods, 1988–1994 and 1999–2008, we calculated descriptive statistics, multivariate logistic regression models and predicted probabilities to examine trends in weight self-perceptions among Whites, Blacks, US-born Mexican Americans and Mexican immigrants to the USA.SettingNational Health and Nutrition Examination Survey (NHANES) III (1988–1994) and continuous NHANES (1999–2008).SubjectsAdult NHANES participants aged 18 years and older (n 37 050).ResultsThe likelihood of self-classifying as overweight declined between 1988–1994 and 1999–2008 among all US adults, despite significant increases in mean BMI and overweight prevalence. Trends in weight self-perceptions varied by gender and between racial/ethnic groups. Whites in both time periods were more likely than racial/ethnic minorities to perceive themselves as overweight. After adjustment for other factors, disparities in weight self-perceptions between Whites and Blacks of both genders grew between survey periods (P<0·05), but differences between overweight White women and Mexican immigrants decreased (P<0·05).ConclusionsWeight self-perceptions have changed during the obesity epidemic in the USA, but changes have not been consistent across racial/ethnic groups. Secular declines in the likelihood of self-classifying as overweight, particularly among Blacks, are troubling because weight self-perceptions may affect weight-loss efforts and obesity outcomes.

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Multimorbidity Accumulation among Middle-Aged Americans: Differences by Race/Ethnicity and Body-Mass Index

The Journals of Gerontology Series A ◽

10.1093/gerona/glab116 ◽

2021 ◽

Author(s):

Anda Botoseneanu ◽

Sheila Markwardt ◽

Corey L Nagel ◽

Heather G Allore ◽

Jason T Newsom ◽

...

Keyword(s):

Body Mass Index ◽

Chronic Diseases ◽

Body Mass ◽

Minority Groups ◽

Ethnic Disparities ◽

Later Life ◽

Overweight And Obesity ◽

Obese Class ◽

Class 1 ◽

Racial Ethnic

Abstract BACKGROUND Obesity and multimorbidity are more prevalent among U.S. racial/ethnic minority groups. Evaluating racial/ethnic disparities in disease accumulation according to body-mass index (BMI) may guide interventions to reduce multimorbidity burden in vulnerable racial/ethnic groups. METHODS We used data from the 1998-2016 Health & Retirement Study on 8,106 participants aged 51-55 at baseline. Disease burden and multimorbidity (≥2 co-occurring diseases) were assessed using seven chronic diseases: arthritis, cancer, heart disease, diabetes, hypertension, lung disease, and stroke. Four BMI categories were defined per convention: normal, overweight, obese class 1, and obese class 2/3. Generalized estimating equations models with inverse probability weights estimated the accumulation of chronic diseases. RESULTS Overweight and obesity were more prevalent in non-Hispanic Black (82.3%) and Hispanic (78.9%) than non-Hispanic White (70.9 %) participants at baseline. The baseline burden of disease was similar across BMI categories, but disease accumulation was faster in the obese class 2/3 and marginally in the obese class 1 categories compared with normal BMI. Black participants across BMI categories had a higher initial burden and faster accumulation of disease over time, while Hispanics had a lower initial burden and similar rate of accumulation, compared with Whites. Black participants, including those with normal BMI, reach the multimorbidity threshold 5-6 years earlier compared with White participants. CONCLUSIONS Controlling weight and reducing obesity early in the lifecourse may slow the progression of multimorbidity in later life. Further investigations are needed to identify the factors responsible for the early and progressing nature of multimorbidity in Blacks of non-obese weight.

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