Claire E. Altman

Competitive Food Sales in Schools and Childhood Obesity A Longitudinal Study

The vast majority of American middle schools and high schools sell what are known as “competitive foods,” such as soft drinks, candy bars, and chips, to children. The relationship between consumption of sugar-sweetened drinks and snacks and childhood obesity is well established, but it remains unknown whether competitive food sales in schools are related to unhealthy weight gain among children. The authors examined this association using data from the Early Childhood Longitudinal Study, Kindergarten Class. Employing fixed effects models and a natural experimental approach, they found that children’s weight gain between fifth and eighth grades was not associated with the introduction or the duration of exposure to competitive food sales in middle school. Also, the relationship between competitive foods and weight gain did not vary significantly by gender, race/ethnicity, or family socioeconomic status, and it remained weak and insignificant across several alternative model specifications. One possible explanation is that children’s food preferences and dietary patterns are firmly established before adolescence. Also, middle school environments may dampen the effects of competitive food sales because they so highly structure children’s time and eating opportunities.

What Does Self-rated Health Mean? Changes and Variations in the Association of Obesity with Objective and Subjective Components Of Self-rated Health

There are concerns about the meaning of self-rated health (SRH) and the factors individuals consider. To illustrate how SRH is contextualized, we examine how the obesity–SRH association varies across age, periods, and cohorts. We decompose SRH into subjective and objective components and use a mechanism-based age–period–cohort model approach with four decades (1970s to 2000s) and five birth cohorts of National Health and Nutrition Examination Survey data (N = 26,184). Obese adults rate their health more negatively than non-obese when using overall SRH with little variation by age, period, or cohort. However, when we decomposed SRH into objective and subjective components, the obesity gap widened with increasing age in objective SRH but narrowed in subjective SRH. Additionally, the gap narrowed for more recently born cohorts for objective SRH but widened for subjective SRH. The results provide indirect evidence that the relationship between obesity and SRH is socially patterned according to exposure to information about obesity and the availability of resources to manage it.

Migrant youth’s emerging dietary patterns in Haiti: the role of peer social engagement

OBJECTIVE The present study examines whether rural-to-urban migrant youth consume a greater diversity of high-sugar beverages and fried snacks (HSBFS) compared with their peers who remain in rural areas. It also tests whether the association between migration and HSBFS diversity is moderated by migrant youths social engagement with their peers. DESIGN Participants were recruited in August and September 2011 following the completion of primary school (6th grade) and shortly before many rural youth migrate to urban areas. Participants were re-interviewed six months later. HSBFS diversity was assessed at follow-up; analyses control for baseline and follow-up characteristics. SETTING Baseline interviews occurred in rural Southeast Haiti. Follow-up interviews of migrants occurred at urban destinations in Haiti. SUBJECTS The sample includes 215 youth (mean age 15.9 years; 43.3 % female; 21.9 % rural-to-urban migrants) who were interviewed at baseline and follow-up. RESULTS Rural-to-urban migrant youth consumed a greater diversity of HSBFS products at follow-up than their rural counterparts (b=0.70, P≤0.05). Moreover, we found that this relationship varied by level of peer social engagement. Youth who migrated and had a high degree of peer social engagement consumed 2.2 additional types of HSBFS products daily than their counterparts who remained in rural areas and had low peer social engagement. CONCLUSIONS Higher HSBFS diversity among migrant youth is consistent with the patterns proposed by the nutrition transition. Interactions with peers may have an important influence as migrant youth adopt new dietary preferences. Emerging dietary patterns among youth migrants have important implications for health trajectories and the development of degenerative diseases.

Gender migration and perceptions of HIV risk in Mexico.

Abstract This study examines the role that duty plays in men’s and women’s perceptions of HIV-related risk in Mexico, and how gender and migration influence these perceptions. We draw on qualitative data from the 2014 Study of Health and Migration in Mexico (SHMM), which included 24 in-depth interviews with migrant men and non-migrant women living in a medium-sized city in Guanajuato, Mexico. While men report migrating out of responsibility to provide for their families, this sense of duty also had implications for their sexual health behaviours. Duty permeates how residents in this migrant-sending community described their perceptions of HIV risk, with men and women drawing consistently on three aspects of duty: fidelity, gendered sexual expectations, and the burden of HIV prevention. We argue that a strong sense of duty can prompt gender role expansion for migrant men and limit gender role expansion for non-migrant women.

Becoming Overweight without Gaining a Pound: Weight Evaluations and the Social Integration of Mexicans in the United States

Mexican women gain weight with increasing duration in the United States. In the United States, body dissatisfaction tends to be associated with depression, disordered eating, and incongruent weight evaluations, particularly among white women and women of higher socioeconomic status. However, it remains unclear how being overweight and obesity are interpreted by Mexican women. Using comparable data of women aged 20–64 from both Mexico (the 2006 Encuesta Nacional de Salud y Nutricion; N = 17,012) and the United States (the 1999–2009 National Health and Nutrition Examination Surveys; N = 8,487), we compare weight status evaluations among Mexican nationals, Mexican immigrants, US-born Mexicans, US-born non-Hispanic whites, and US-born non-Hispanic blacks. Logistic regression analyses, which control for demographic and socioeconomic variables and measured body mass index and adjust for the likelihood of migration for Mexican nationals, indicate that the tendency to self-evaluate as overweight among Mexicans converges with levels among non-Hispanic whites and diverges from blacks over time in the United States. Overall, the results suggest a US integration process in which Mexican-American womens less critical self-evaluations originate in Mexico but fade with time in the United States as they gradually adopt US white norms for thinner body sizes. These results are discussed in light of prior research about social comparison and negative health assimilation.

Healthy Eating among Mexican Immigrants: Migration in Childhood and Time in the United States

Past research on immigrant health frequently finds that the duration of time lived in the United States is associated with the erosion of immigrants’ health advantages. However, the timing of U.S. migration during the life course is rarely explored. We draw from developmental and sociological perspectives to theorize how migration during childhood may be related to healthy eating among adult immigrants from Mexico. We test these ideas with a mechanism-based age-period-cohort model to disentangle age, age at arrival, and duration of residence. Results show that immigrants who arrived during preschool ages (2–5 years) and school ages (6–11 years) have less healthy diets than adult arrivals (25+ years). After accounting for age at arrival, duration of residence is positively related to healthy eating. Overall, the findings highlight the need to focus more research and policy interventions on child immigrants, who may be particularly susceptible to adopting unhealthy American behaviors during sensitive periods of childhood.

The mental well-being of Central American transmigrant men in Mexico

ABSTRACT To understand the mental health status of Central American migrant men travelling through Mexico to the U.S., we analysed the association between migration-related circumstances/stressors and psychological disorders. In-person interviews and a psychiatric assessment were conducted in 2010 and 2014 with 360 primarily Honduran transmigrant young adult males. The interviews were conducted at three Casas del Migrante (or migrant safe houses) in the migration-corridor cities of Monterrey, and Guadalupe, Nuevo Leon; and Saltillo, Coahuila. The results indicated high levels of migration-related stressors including abuse and a high prevalence of major depressive episodes (MDEs), alcohol dependency, and alcohol abuse. Nested logistic regression models were used to separately predict MDEs, alcohol dependency, and alcohol abuse, assessing their association with migration experiences and socio-demographic characteristics. Logistic regression models showed that characteristics surrounding migration (experiencing abuse, migration duration, and attempts) are predictive of depression. Alcohol dependency and abuse were both associated with marital status and having family/friends in the intended U.S. destination, while the number of migration attempts also predicted alcohol dependency. The results provide needed information on the association between transit migration through Mexico to the U.S. among unauthorised Central American men and major depressive disorder and alcohol abuse and dependency.