Molly A. Martin

Feeding her children, but risking her health: The intersection of gender, household food insecurity and obesity

This paper investigates one explanation for the consistent observation of a strong, negative correlation in the United States between income and obesity among women, but not men. We argue that a key factor is the gendered expectation that mothers are responsible for feeding their children. When income is limited and households face food shortages, we predict that an enactment of these gendered norms places mothers at greater risk for obesity relative to child-free women and all men. We adopt an indirect approach to study these complex dynamics using data on men and women of childrearing age and who are household heads or partners in the 1999-2003 waves of the Panel Study of Income Dynamics (PSID). We find support for our prediction: Food insecure mothers are more likely than child-free men and women and food insecure fathers to be overweight or obese and to gain more weight over four years. The risks are greater for single mothers relative to mothers in married or cohabiting relationships. Supplemental models demonstrate that this pattern cannot be attributed to post-pregnancy biological changes that predispose mothers to weight gain or an evolutionary bias toward biological children. Further, results are unchanged with the inclusion of physical activity, smoking, drinking, receipt of food stamps, or Women, Infants and Children (WIC) nutritional program participation. Obesity, thus, offers a physical expression of the vulnerabilities that arise from the intersection of gendered childcare expectations and poverty.

Family Structure and Income Inequality in Families With Children, 1976 to 2000

Using 24 years of data from the March supplements to the Current Population Survey and detailed categories of family structure, including cohabiting unions, I assess the contribution of changes in family structure to the dramatic rise in family income inequality. Between 1976 and 2000, family structure shifts explain 41% of the increase in inequality, but the influence of family structure change is not uniform within this period or across racial-ethnic groups. In general, the estimated role of family structure change is inversely related to the magnitude of the changes in inequality. Furthermore, by including cohabitation, I find lower levels of total inequality and a weaker role for demographic shifts in family structure for trends in income inequality.

Gender and Race/Ethnic Differences in Inaccurate Weight Perceptions Among U.S. Adolescents

PURPOSE Inaccurate weight perceptions may lead to unhealthy weight control practices among normal weight adolescents and to a greater risk of adult obesity and related morbidities for overweight adolescents. To examine which U.S. adolescents are at risk of these outcomes, we examine gender and racial/ethnic differences in weight perception inaccuracy. This is the first study of weight perception inaccuracy to include Latino/a and Asian American adolescents. METHODS Among the 12,789 Wave II participants of the National Longitudinal Study of Adolescent Health, we estimate multivariate models that reveal how gender, race/ethnicity, and clinical weight categories predict weight perception inaccuracy. RESULTS Relative to boys, girls have lower odds of underestimating their weight and greater odds of overestimating their weight. In particular, among overweight and obese adolescents, girls are more accurate than boys, but among normal weight adolescents, boys are more accurate. Compared with Whites, African Americans are more likely to underestimate their weight, particularly among overweight girls and obese boys. Overall and particularly among girls and normal weight adolescents, African Americans are less likely to overestimate their weight than their White counterparts. Finally, Asian American girls are more likely to underestimate their weight than White girls. CONCLUSION These findings have important implications for identifying and intervening with adolescents at the greatest risk of long-term weight problems, weight-related morbidity, and unhealthy weight control practices.

Disparities in the prevalence of cognitive delay: how early do they appear?

Cognitively delayed children are at risk for poor mental and physical health throughout their lives. The economically disadvantaged and some race/ethnic groups are more likely to experience cognitive delay, but the age at which delays first emerge and the underlying mechanisms responsible for disparities are not well understood. The objective of this study was to determine when sociodemographic disparities in cognitive functioning emerge, and identify predictors of low cognitive functioning in early childhood. Data were from 7308 singleton and 1463 multiple births in the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative cohort of children born in the USA in 2001. Multiple logistic regression analyses examined associations between sociodemographic characteristics and low cognitive functioning at 9 and 24 months, and tested whether gestational and birth-related factors mediate these associations. Sociodemographic characteristics were statistically significant predictors of low cognitive functioning among singletons at 24 months, including the three lowest quintiles of socio-economic status [lowest quintile, odds ratio (OR) = 2.7, 95% confidence interval [CI][1.7, 4.1]], non-white race/ethnicity (African American OR = 1.8 [95% CI 1.3, 2.5], Hispanic OR = 2.3 [95% CI 1.6, 3.2]), and gender (male OR = 2.1, [95% CI 1.7, 2.5]). Gestational and birth characteristics associated with low cognitive function at 9 months included very low and moderately low birthweight (OR = 55.0 [95% CI 28.3, 107.9] and OR = 3.6 [95% CI 2.6, 5.1]), respectively, and very preterm and moderately preterm delivery (OR = 3.6 [95% CI 2.0, 6.7] and OR = 2.4 [95% CI 1.7, 3.5]), respectively, but they had weaker effects by 24 months (ORs for birthweight: 3.7 [95% CI 2.3, 5.9] and 1.8 [95% CI 1.4, 2.3]; ORs for preterm: 1.8 [95% CI 1.1, 2.9] and 0.9 [95% CI 0.7, 1.3]). Results for multiple births were similar. Sociodemographic disparities in poor cognitive functioning emerged by 24 months of age, but were not mediated by gestational or birth characteristics. Further investigation of processes whereby social disadvantage adversely affects development prior to 24 months is needed.

THE IMAGE IN THE MIRROR AND THE NUMBER ON THE SCALE: WEIGHT, WEIGHT PERCEPTIONS, AND ADOLESCENT DEPRESSIVE SYMPTOMS

Double jeopardy and health congruency theories suggest that adolescents’ joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study of Adolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.

Equal weights but different weight perceptions among US adolescents.

We investigate sex and race/ethnic differences in adolescents’ perceptions of the same objectively measured weight in a nationally representative US sample. At the same BMI z-score, girls perceive themselves as heavier than boys. Regardless of sex and relative to Whites, African-Americans perceive the same BMI z-score as leaner and Native Americans are more likely to perceive objectively heavier weights as ‘about the right weight’. Asian boys consider a narrower weight range to be ‘about the right weight’ relative to White boys, and Asian girls are less likely than White girls to perceive objectively lower weights as ‘about the right weight’.

Is socioeconomic incorporation associated with a healthier diet? Dietary patterns among Mexican-origin children in the United States.

With each successive generation in the United States, Mexican-origin families lose their initial dietary advantages. Focusing on childrens diets, we ask whether greater socioeconomic status (SES) can help buffer Mexican-origin children in immigrant families from negative dietary acculturation or whether it exacerbates these dietary risks. Pooling data from the 1999 to 2009 waves of the continuous National Health and Nutrition Examination Survey, we test whether the association between generational status and Mexican-origin childrens nutrition varies by the familys SES. When predicting childrens overall dietary quality using the Healthy Eating Index (2010) and predicting unhealthy dietary patterns, we find stronger evidence of segmented assimilation, whereby greater family average SES is associated with better diets across generations of Mexican-origin children. High-status Mexican-origin parents appear able to buffer their children against generational dietary declines documented in the acculturation literature.

Race, Immigration, and Exogamy among the Native-born Variation across Communities

Did rising immigration levels change racial and ethnic exogamy patterns for young adults in the United States? Adding local demographics to Qian and Lichter’s national results, the authors examine the relationship between the sizes of the local immigrant populations in urban and rural areas and U.S.-born individuals’ exogamy patterns in heterosexual unions, controlling for the areas’ racial compositions. Using 2000 census race, ethnicity, and nativity data and log-linear models, the authors test hypotheses about the relationship between high levels of immigration from Asia and Latin America and endogamy rates for U.S.-born Latino/as and Asians. They find that U.S.-born Latino/as and Asians are not consistently more endogamous in high-immigrant areas once population composition differences across local areas are controlled. Surprisingly, U.S.-born Blacks and Native Americans are significantly less endogamous in areas with more immigrants.

The health significance of families seen through the recent measles outbreak.

The recent rise of measles demonstrates the importance of our families’ social characteristics for a host of infectious and non-infectious diseases. We need to recognize that families are more than their shared genes; families are distinctive health environments and our family relationships affect our health and health behaviors. Although families are a relatively understudied health context, I recommend several avenues by which we can grow this exciting field within social epidemiology. With a greater understanding of how families’ social characteristics influence health, we can inform clinical and public health practices and better meet our public health goals.