| Literature DB >> 30767595 |
Caryn N Bell1,2, Roland J Thorpe2,3.
Abstract
Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive association between marital status and obesity. This study sought to determine how race, income, and marital status interact on obesity among men. Using data from the 2007 to 2014 National Health and Nutrition Examination Survey, obesity was measured as body mass index ≥30 kg/m2 among 6,145 Black and White men. Income was measured by percentage of the federal poverty line and marital status was categorized as currently, formerly, or never married. Using logistic regression and interaction terms, the associations between income and obesity were assessed by race and marital status categories adjusted for covariates. Black compared to White (OR = 1.19, 95% CI [1.03, 1.38]), currently married compared to never married (OR = 1.45, 95% CI [1.24, 1.69]), and high-income men compared to low income men (OR = 1.26, 95% CI [1.06, 1.50]) had higher odds of obesity. A three-way interaction was significant and analyses identified that income was positively associated with obesity among currently married Black men and never married White men with the highest and lowest probabilities of obesity, respectively. High-income, currently married Black men had higher obesity rates and may be at increased risk for obesity-related morbidities.Entities:
Keywords: behavioral issues; marriage; men of color; obesity; psychosocial and cultural issues; special populations
Year: 2019 PMID: 30767595 PMCID: PMC6566485 DOI: 10.1177/1557988319829952
Source DB: PubMed Journal: Am J Mens Health ISSN: 1557-9883
Demographics, Socioeconomic Status, and Obesity Among Men, NHANES 2007–2014.
| Black | White | ||
|---|---|---|---|
| Age (years), mean ± | 44.3 ± 25.0 | 48.4 ± 24.0 | <.001 |
| Insured, | 1,387 (68.8) | 3,520 (85.5) | <.001 |
| Education, | |||
| Less than high school graduate | 507 (24.6) | 751 (11.9) | <.001 |
| High school graduate | 529 (28.5) | 1,071 (23.7) | |
| Some college/associate’s degree | 558 (31.2) | 1,238 (30.6) | |
| Bachelor’s degree or more | 287 (15.7) | 1,204 (33.8) | |
| Fair/poor health, | 458 (21.8) | 759 (13.2) | <.001 |
| Current smoker, | 572 (31.3) | 1,035 (21.7) | <.001 |
| Physically inactive, | 958 (47.3) | 2,045 (42.0) | .006 |
| Marital status, | |||
| Currently | 993 (51.2) | 2,851 (68.6) | <.001 |
| Formerly | 400 (18.1) | 697 (13.0) | |
| Never | 488 (30.7) | 716 (18.4) | |
| Income (federal poverty line), | |||
| <200% FPL | 932 (49.4) | 1,732 (25.9) | <.001 |
| 200%–400% FPL | 534 (28.8) | 1,080 (28.4) | |
| ≥400% FPL | 415 (21.8) | 1,452 (45.7) | |
| Obese, | 707 (37.5) | 1,453 (34.7) | .079 |
Note. Student’s t-test was used to determine the race difference for age. Chi-square tests were used to determine race differences for all other variables.
Association Between Race, Income, and Marital Status With Obesity Among Men, NHANES 2007–2014.
| Model 1 | Model 2 | Model 3 | |
|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Black race | 1.25 [1.10, 1.44] | 1.19 [1.03, 1.38] | |
| Income | |||
| <200% FPL | 1.00 | 1.00 | |
| 200%–400% FPL | 1.22 [1.03, 1.44] | 1.29 [1.09, 1.53] | |
| ≥400% FPL | 1.06 [0.89, 1.27] | 1.26 [1.06, 1.50] | |
| Marital status | |||
| Currently | 1.00 | 1.00 | |
| Formerly | 0.99 [0.80, 1.21] | 0.96 [0.78, 1.20] | |
| Never | 0.72 [0.63, 0.82] | 0.69 [0.59, 0.81] | |
| Race × income × marital status | |||
| White, <200% FPL, currently married | 1.00 | ||
| White, <200% FPL, formerly married | 0.85 [0.61,1.18] | ||
| White, <200% FPL, never married | 0.49 [0.35, 0.69] | ||
| White, 200%–400% FPL, currently married | 1.06 [0.83, 1.36] | ||
| White, 200%–400% FPL, formerly married | 1.67 [1.12, 2.49] | ||
| White, 200%–400% FPL, never married | 0.84 [0.56, 1.25] | ||
| White, ≥400% FPL, currently married | 1.09 [0.86, 1.38] | ||
| White, ≥400% FPL, formerly married | 0.89 [0.57, 1.39] | ||
| White, ≥400% FPL, never married | 0.86 [0.63, 1.17] | ||
| Black, <200% FPL, currently married | 1.00 [0.74, 1.35] | ||
| Black, <200% FPL, formerly married | 0.68 [0.46, 0.99] | ||
| Black, <200% FPL, never married | 0.86 [0.59, 1.26] | ||
| Black, 200%–400% FPL, currently married | 1.46 [1.10, 1.96] | ||
| Black, 200%–400% FPL, formerly married | 0.87 [0.58, 1.28] | ||
| Black, 200%–400% FPL, never married | 0.74 [0.47, 1.15] | ||
| Black, ≥400% FPL, currently married | 1.68 [1.23, 2.30] | ||
| Black, ≥400% FPL, formerly married | 1.35 [0.63, 2.88] | ||
| Black, ≥400% FPL, never married | 1.23 [0.73, 2.05] | ||
Note. Model 1 is adjusted for age. Model 2 adjusts for age, insurance, education, self-rated health, smoking status, and physical inactivity. Wald tests were performed for the three-way interaction term (p value <.001). The following pairwise comparisons of interaction terms were significant: Black, <200% FPL, never married–White, <200% FPL, never married (p = .011); Black, 200%–400% FPL, currently married–White, 200%–400% FPL, currently married (p = .023); Black, ≥400% FPL, currently married–White, ≥400% FPL, currently married (p = .005).
Associations Between Income and Obesity by Race and Marital Status Among Men, NHANES 2007–2014.
| Marital status | |||
|---|---|---|---|
| Never | Formerly | Currently | |
| OR (95% CI) | OR (95% CI) | OR (95% CI) | |
|
| |||
| Income | |||
| <200% FPL | 1.00 | 1.00 | 1.00 |
| 200%–400% FPL | 0.82 [0.52, 1.27] | 1.04 [0.58, 1.88] | 1.38 [1.00, 1.92] |
| ≥400% FPL | 1.19 [0.75, 1.91] | 1.77 [0.69, 4.55] | 1.51 [1.05, 2.18] |
|
| |||
| Income | |||
| <200% FPL | 1.00 | 1.00 | 1.00 |
| 200%–400% FPL | 1.72 [1.07, 2.78] | 1.60 [0.96, 2.67] | 1.09 [0.84, 1.40] |
| ≥400% FPL | 1.86 [1.22, 2.82] | 0.87 [0.50, 1.52] | 1.15 [0.87, 1.52] |
Note. Models adjusted for age, insurance, education, self-rated health, smoking status, and physical inactivity.
Figure 1.Predicted probabilities (95% confidence intervals) of obesity by income and marital status among Black men, NHANES 2007–2014.
Note. Analyses adjusted for age, insurance, education, self-rated health, smoking status, and physical inactivity. Data represent marginal log odds. Statistically significant difference between lowest (reference) and highest income Black men who are currently married.
Figure 2.Predicted probabilities (95% confidence intervals) of obesity by income and marital status among White men, NHANES 2007–2014.
Note. Analyses adjusted for age, insurance, education, self-rated health, smoking status, and physical inactivity. Data represent marginal log odds. Statistically significant difference between lowest (reference), middle, and highest income White men who were never married.