Ariel L Beccia1, Jonggyu Baek2, William M Jesdale3, S Bryn Austin4, Sarah Forrester5, Carol Curtin6, Kate L Lapane7. 1. Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, United States of America; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America. Electronic address: ariel.beccia@umassmed.edu. 2. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America. Electronic address: jonggyu.baek@umassmed.edu. 3. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America. Electronic address: william.jesdale@umassmed.edu. 4. Division of Adolescent Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, United States of America; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States of America. Electronic address: bryn.austin@childrens.harvard.edu. 5. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America. Electronic address: sarah.forrester@umassmed.edu. 6. Department of Family Medicine & Community Health, E.K. Shriver Center, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, United States of America. Electronic address: carol.curtin@umassmed.edu. 7. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, Massachusetts, 01655, United States of America. Electronic address: kate.lapane@umassmed.edu.
Abstract
BACKGROUND: Gender and racial/ethnic disparities in disordered eating among youth exist, although whether having multiple marginalized identities disproportionately increases risk is unclear. Therefore, we aimed to quantify the risk of disordered eating associated with intersecting gender and racial/ethnic identities of U.S. adolescents. METHODS: We analyzed data from 11,514 U.S. high school students identifying as White, Black/African American, or Hispanic/Latino who participated in the 2013 National Youth Risk Behavior Surveillance System. Age-adjusted relative risks (RR) of purging, fasting, diet pill use, and any disordered eating were estimated using log-binomial models. Relative excess risk due to interaction (RERI) was estimated to evaluate the degree to which the combined effect of marginalized gender and racial/ethnic identity was larger than the sum of their individual effects. RESULTS: Disordered eating was prevalent (girls: 20.4% Black/African American, 29.2% Hispanic/Latina, 21.4% White; boys: 13.4% Black/African American, 12.4% Hispanic/Latino; 8.1% Whites). Girls of all racial/ethnic identities and racial/ethnic minority boys had elevated risks of purging, fasting, and any disordered eating compared to White boys (RR range = 1.57-7.43); Hispanic/Latina and White girls also had elevated risk of diet pill use (RR range = 1.98-3.20). Among Hispanic/Latina girls, positive interaction between gender and race/ethnicity produced excess risk of any disordered eating and purging (RERI: any = 0.42 (95% confidence interval (CI) = -0.02, 0.87); purging = 1.74 (95% CI = 0.06, 3.42). CONCLUSIONS: Findings illustrate the advantages of adopting an intersectional approach to disordered eating research. Future research should investigate the mechanisms of these disparities.
BACKGROUND: Gender and racial/ethnic disparities in disordered eating among youth exist, although whether having multiple marginalized identities disproportionately increases risk is unclear. Therefore, we aimed to quantify the risk of disordered eating associated with intersecting gender and racial/ethnic identities of U.S. adolescents. METHODS: We analyzed data from 11,514 U.S. high school students identifying as White, Black/African American, or Hispanic/Latino who participated in the 2013 National Youth Risk Behavior Surveillance System. Age-adjusted relative risks (RR) of purging, fasting, diet pill use, and any disordered eating were estimated using log-binomial models. Relative excess risk due to interaction (RERI) was estimated to evaluate the degree to which the combined effect of marginalized gender and racial/ethnic identity was larger than the sum of their individual effects. RESULTS:Disordered eating was prevalent (girls: 20.4% Black/African American, 29.2% Hispanic/Latina, 21.4% White; boys: 13.4% Black/African American, 12.4% Hispanic/Latino; 8.1% Whites). Girls of all racial/ethnic identities and racial/ethnic minority boys had elevated risks of purging, fasting, and any disordered eating compared to White boys (RR range = 1.57-7.43); Hispanic/Latina and White girls also had elevated risk of diet pill use (RR range = 1.98-3.20). Among Hispanic/Latina girls, positive interaction between gender and race/ethnicity produced excess risk of any disordered eating and purging (RERI: any = 0.42 (95% confidence interval (CI) = -0.02, 0.87); purging = 1.74 (95% CI = 0.06, 3.42). CONCLUSIONS: Findings illustrate the advantages of adopting an intersectional approach to disordered eating research. Future research should investigate the mechanisms of these disparities.
Authors: Ariel L Beccia; S Bryn Austin; Jonggyu Baek; Madina Agénor; Sarah Forrester; Eric Y Ding; William M Jesdale; Kate L Lapane Journal: Soc Sci Med Date: 2022-04-01 Impact factor: 5.379