Elizabeth H. Baker

Epidemiological Paradox or Immigrant Vulnerability? Obesity Among Young Children of Immigrants

According to the “immigrant epidemiological paradox,” immigrants and their children enjoy health advantages over their U.S.-born peers—advantages that diminish with greater acculturation. We investigated child obesity as a potentially significant deviation from this paradox for second-generation immigrant children. We evaluated two alternate measures of mother’s acculturation: age at arrival in the United States and English language proficiency. To obtain sufficient numbers of second-generation immigrant children, we pooled samples across two related, nationally representative surveys. Each included measured (not parent-reported) height and weight of kindergartners. We also estimated models that alternately included and excluded mother’s pre-pregnancy weight status as a predictor. Our findings are opposite to those predicted by the immigrant epidemiological paradox: children of U.S.-born mothers were less likely to be obese than otherwise similar children of foreign-born mothers; and the children of the least-acculturated immigrant mothers, as measured by low English language proficiency, were the most likely to be obese. Foreign-born mothers had lower (healthier) pre-pregnancy weight than U.S.-born mothers, and this was protective against their second-generation children’s obesity. This protection, however, was not sufficiently strong to outweigh factors associated or correlated with the mothers’ linguistic isolation and marginal status as immigrants.

Multiple Imputation For Combined-Survey Estimation With Incomplete Regressors In One But Not Both Surveys.

Within-survey multiple imputation (MI) methods are adapted to pooled-survey regression estimation where one survey has more regressors, but typically fewer observations, than the other. This adaptation is achieved through (1) larger numbers of imputations to compensate for the higher fraction of missing values, (2) model-fit statistics to check the assumption that the two surveys sample from a common universe, and (3) specifying the analysis model completely from variables present in the survey with the larger set of regressors, thereby excluding variables never jointly observed. In contrast to the typical within-survey MI context, cross-survey missingness is monotonic and easily satisfies the missing at random assumption needed for unbiased MI. Large efficiency gains and substantial reduction in omitted variable bias are demonstrated in an application to sociodemographic differences in the risk of child obesity estimated from two nationally representative cohort surveys.

Stigma as a Barrier to Substance Abuse Treatment Among Those With Unmet Need An Analysis of Parenthood and Marital Status

Substance use (SU) stigma is one factor contributing to unmet need for SU treatment. Additionally, theory suggests that women and single parents who use substances experience enhanced stigma because they do not adhere to normative social expectations. This study examines differences in perceived stigma by gender and parenthood among those with unmet need for SU treatment using the 2003-2010 National Survey of Drug Use and Health (N = 1,474). Results indicate that women are more likely to report stigma as a barrier to treatment compared with men, though the interaction between gender and parenthood is not significant. We find that married parents report the highest level of stigma. We situate our findings in past health-related stigma research. We suggest that these results shed a light on stigma, particularly as it relates to family status, as a contributing factor to differences regarding SU treatment utilization. Finally, we raise a provocative question concerning social status and anticipated stigma.

The Role of Perceived Discrimination in Obesity Among African Americans

INTRODUCTION African Americans, especially those in the South, suffer a disproportionate burden of obesity and are at high risk for perceived discrimination (PD). This study investigates the association between PD and weight status among African Americans and clarifies the role of perceived stress and health behaviors in this relationship. METHODS Data came from the Jackson Heart Study, Examination 1 (2000-2004; analyses conducted in 2016 using Stata, version 14). African Americans from Jackson, Mississippi, aged 21-95 years were recruited (N=5,301). Weight status was measured using anthropometric data with BMI; waist circumference (in centimeters); and obesity class (I, II, III). Survey instruments were used to measure PD, perceived global stress, and health behaviors. Multivariate regression was used to model weight status outcomes as a function of PD, perceived stress, and health behaviors. RESULTS After controlling for sociodemographic factors and health status, perceived everyday discrimination was associated with higher BMI (b=0.33, p<0.01); higher waist circumference (b=0.70, p<0.01); and higher relative risk of Class III obesity versus non-obesity (relative risk ratio, 1.18; p<0.001). Global perceived stress was linked to higher BMI (b=0.42, p<0.05) and higher waist circumference (b=1.18; p<0.01) and partially mediated the relationships between PD and these weight status outcomes. Health behaviors led to suppression rather than mediation between PD and weight status and between stress and weight status. CONCLUSIONS PD and perceived stress are potential risk factors for higher weight status. They should be considered as a part of a comprehensive approach to reduce obesity among African Americans.

The role of sex, gender, and education on depressive symptoms among young adults in the United States.

BACKGROUND Men are less likely to experience depression and both women and men who self-assess as high in traits associated with masculinity are less likely to experience depression. Recent theoretical developments stress that the context of gender construction varies by other aspects of social status such as education. METHODS Data come from the National Longitudinal Study of Adolescent Health Wave III, romantic relationship sub-sample, a nationally representative sample of middle and high school students in the U.S. in 1997. Wave III data were collected in 2001-2002 when they are ages 18-26. A subsample of individuals who were or currently are in a romantic relationship (N=4302) were administered the Bem Sex Role Inventory (BSRI). RESULTS We find that femininity, not masculinity, results in less depressive symptoms among women regardless of education. Femininity is associated with less depressive symptoms among college educated men, but masculinity is associated with less depressive symptoms among non-college educated men. Sex differences in the association between gender traits and depression symptoms are smaller among those who have attended college. CONCLUSIONS Results stress the importance of context for understanding the relationship between sex, gender, and depression. Individuals benefit more from both masculinity and femininity with increased education. Conversely, those with less education may be penalized for sex-gender incongruent traits in terms of mental health. LIMITATIONS These analyses are cross-sectional, making causal inference impossible. This sample is limited to young adults who were or had been in a romantic relationship at the time of the survey.

Athletic Participation and Intimate Partner Violence Victimization Investigating Sport Involvement, Self-Esteem, and Abuse Patterns for Women and Men

This study used representative, quantitative data from The National Longitudinal Study of Adolescent Health (Add Health) and explored the relationship between young adults’ sport participation and experiences of intimate partner violence victimization (IPVV) for both women and men. Past research has suggested that sports participation, especially among women, results in increased self-esteem, a prominent protective factor against experiencing IPVV. We found that sports participation was associated with a lower prevalence of experiencing IPVV, but only for women. In addition, this pattern held after controls for race, mother’s education, age, number of relationships, and the hypothesized pathways of self-esteem and alcohol consumption. However, controls for the young adult’s own education completely mediated the association between sports participation and IPVV. Additional analyses indicated that higher education reduced the risk of experiencing IPVV and increased the likelihood of sports participation. Nonetheless, even among women with the highest educational attainment, sports participation was associated with lower prevalence of experiencing IPVV.

A pilot study to promote walking among obese and overweight individuals: walking buses for adults

publisher: Elsevier articletitle: A pilot study to promote walking among obese and overweight individuals: walking buses for adults journaltitle: Public Health articlelink: http://dx.doi.org/10.1016/j.puhe.2015.03.021 content_type: article copyright: Copyright

Short CommunicationA pilot study to promote walking among obese and overweight individuals: walking buses for adults

publisher: Elsevier articletitle: A pilot study to promote walking among obese and overweight individuals: walking buses for adults journaltitle: Public Health articlelink: http://dx.doi.org/10.1016/j.puhe.2015.03.021 content_type: article copyright: Copyright

Perinatal Maternal Stress and Susceptibility to Infectious Diseases in Later Childhood: An Early Life Programming Perspective

Abstract There is evidence of transmission of stress-related dysregulation from parents to offspring during early developmental stages, leading to adverse health outcomes. This study investigates whether perinatal stress is linked to the risk of infectious diseases in children aged 7–11 years. We hypothesize that stress exposure during pregnancy and the first 6 months after birth independently predict common infectious diseases. Data are obtained from ELSPAC-CZ, a prospective birth cohort. Maternal stress, operationalized as the number of life events, is examined for pregnancy and the first 6 months postpartum. Children’s diseases include eye infection, ear infection, bronchitis/lung infection, laryngitis, strep throat, cold sores, and flu/flu-like infection. More prenatal and postnatal life events are both independently linked to a higher number of infectious diseases between the ages of 7–11 years. The effect is larger for postnatal vs. prenatal events, and the effect of prenatal events is attenuated after maternal health in pregnancy is controlled. The results suggest that perinatal stress is linked to susceptibility to infectious diseases in school-age children. Interventions to address stress in pregnant and postpartum women may benefit long-term children’s health.

Overweight and Obesity: Prevention and Weight Management

Overweight/obesity represents a global public health problem as prevalence has reached alarmingly high levels in developed countries and continues to increase in developing countries. This article explores obesity trends and the causes of obesity focusing on the social environment, but also reviewing the evidence concerning biology and recent research detailing the importance of the fetal environment. A review of recent prevention efforts is provided focusing on population level interventions such as changes in nutrition labeling, subsidies for healthy eating, and school-based interventions.