Lauren M Rossen1, Makram Talih2. 1. Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD. Electronic address: lrossen@cdc.gov. 2. Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
Abstract
PURPOSE: To explore whether contextual variables attenuate disparities in weight among 18,639 US children and adolescents aged 2 to 18 years participating in the National Health and Nutrition Examination Survey, 2001 to 2010. METHODS: Disparities were assessed using the Symmetrized Rényi Index, a new measure that summarizes disparities in the severity of a disease, as well as the prevalence, across multiple population groups. Propensity score subclassification was used to ensure covariate balance between racial and ethnic subgroups and account for individual-level and contextual covariates. RESULTS: Before propensity score subclassification, significant disparities were evident in the prevalence of overweight and/or obesity and the degree of excess weight among overweight/obese children and adolescents. After propensity score subclassification, racial/ethnic disparities in the prevalence and severity of excess weight were completely attenuated within matched groups, indicating that racial and ethnic differences were explained by social determinants such as neighborhood socioeconomic and demographic factors. CONCLUSIONS: The limited overlap in covariate distributions between various racial/ethnic subgroups warrants further attention in disparities research. The attenuation of disparities within matched groups suggests that social determinants such as neighborhood socioeconomic factors may engender disparities in weight among US children and adolescents. Published by Elsevier Inc.
PURPOSE: To explore whether contextual variables attenuate disparities in weight among 18,639 US children and adolescents aged 2 to 18 years participating in the National Health and Nutrition Examination Survey, 2001 to 2010. METHODS: Disparities were assessed using the Symmetrized Rényi Index, a new measure that summarizes disparities in the severity of a disease, as well as the prevalence, across multiple population groups. Propensity score subclassification was used to ensure covariate balance between racial and ethnic subgroups and account for individual-level and contextual covariates. RESULTS: Before propensity score subclassification, significant disparities were evident in the prevalence of overweight and/or obesity and the degree of excess weight among overweight/obesechildren and adolescents. After propensity score subclassification, racial/ethnic disparities in the prevalence and severity of excess weight were completely attenuated within matched groups, indicating that racial and ethnic differences were explained by social determinants such as neighborhood socioeconomic and demographic factors. CONCLUSIONS: The limited overlap in covariate distributions between various racial/ethnic subgroups warrants further attention in disparities research. The attenuation of disparities within matched groups suggests that social determinants such as neighborhood socioeconomic factors may engender disparities in weight among US children and adolescents. Published by Elsevier Inc.
Entities:
Keywords:
Epidemiologic methods; Health status disparities; Multilevel analysis; Obesity; Propensity score; Residence characteristics; Social determinants of health
Authors: Sam Harper; Nicholas B King; Stephen C Meersman; Marsha E Reichman; Nancy Breen; John Lynch Journal: Milbank Q Date: 2010-03 Impact factor: 4.911
Authors: Mia A Papas; Anthony J Alberg; Reid Ewing; Kathy J Helzlsouer; Tiffany L Gary; Ann C Klassen Journal: Epidemiol Rev Date: 2007-05-28 Impact factor: 6.222
Authors: Sam Harper; John Lynch; Stephen C Meersman; Nancy Breen; William W Davis; Marsha E Reichman Journal: Am J Epidemiol Date: 2008-03-15 Impact factor: 4.897
Authors: Dolores Acevedo-Garcia; Theresa L Osypuk; Nancy McArdle; David R Williams Journal: Health Aff (Millwood) Date: 2008 Mar-Apr Impact factor: 6.301
Authors: Gabriela R Oates; Janice M Phillips; Lori B Bateman; Monica L Baskin; Mona N Fouad; Isabel C Scarinci Journal: Ethn Dis Date: 2018-02-01 Impact factor: 1.847
Authors: Michael R Kramer; Ilana G Raskind; Miriam E Van Dyke; Stephen A Matthews; Jessica N Cook-Smith Journal: Am J Prev Med Date: 2016-08-21 Impact factor: 5.043
Authors: Omar Nunez Lopez; Daniel C Jupiter; Fredrick J Bohanon; Ravi S Radhakrishnan; Kanika A Bowen-Jallow Journal: J Adolesc Health Date: 2017-09-01 Impact factor: 5.012
Authors: Karina Javalkar; Victoria K Robson; Lukas Gaffney; Amy M Bohling; Puneeta Arya; Sarah Servattalab; Jordan E Roberts; Jeffrey I Campbell; Sepehr Sekhavat; Jane W Newburger; Sarah D de Ferranti; Annette L Baker; Pui Y Lee; Megan Day-Lewis; Emily Bucholz; Ryan Kobayashi; Mary Beth Son; Lauren A Henderson; John N Kheir; Kevin G Friedman; Audrey Dionne Journal: Pediatrics Date: 2021-02-18 Impact factor: 7.124