Racial discrimination may be ‘significant contributor’ of obesity for youths
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Key takeaways:
- Children and adolescents who reported facing more racial discrimination had a higher BMI and waist circumference.
- Stakeholders must develop strategies to reduce children’s exposure to racial discrimination.
Children and adolescents who face more racial discrimination from peers, teachers, other adults and society have a higher BMI and waist circumference, according to findings published in JAMA Network Open.
“Exposure to racial discrimination is increasingly recognized as a social determinant of health that contributes to health disparities among children and adolescents,” Adolfo Cuevas, PhD, assistant professor in the department of social and behavioral sciences in the School of Global Public Health at New York University, told Healio. “Our study adds to this growing body of evidence by demonstrating that racial discrimination is also a social determinant of obesity and obesity disparities.”
Cuevas and colleagues obtained data from the Adolescent Brain Cognitive Development study, which was designed to examine brain development and associations of various individual, social and familial variables on health outcomes among children and adolescents at 21 sites in the U.S. Participants completed the Perceived Discrimination Scale at baseline from 2017 to 2019 to determine interpersonal racial discrimination. The scale included three questions about how frequently participants were treated unfairly or negatively by peers, teachers and other adults due to their racial or ethnic background, and four questions assessing feelings of unacceptance by society due to race or ethnicity. A higher score indicated greater perceived discrimination. BMI and waist circumference were assessed 1 year after baseline from 2018 to 2020. BMI z scores were calculated using CDC age- and sex-specific reference categories.
There were 6,463 children and adolescents included in the study (mean age, 9.95 years; 47.8% girls), of whom 59.7% identified as white, 18.1% as Hispanic or Latino, 10.5% as Black, 8.6% as multiracial, 2.3% as Asian, Native Hawaiian or Pacific Islander, 0.3% as Native American and 0.5% as other race. Of the study population, 62.1% had healthy weight at baseline, 19.5% had overweight, 11.3% had obesity and 7.1% had underweight.
After adjusting for covariates, children who reported more racial discrimination at baseline had a higher BMI at follow-up (beta = 0.04; 95% CI, 0.01-0.08). Additionally, a greater racial discrimination score was associated with higher waist circumference (beta = 0.24; 95% CI, 0.04-0.44).
“These findings suggest that racial discrimination may be a significant contributor to obesity among youth, and that more research is needed to understand the mechanisms underlying this association,” Cuevas said.
Cuevas said the findings reveal the need for researchers, clinicians, educators, policymakers and health care providers to come together to develop strategies to reduce racial discrimination exposure for children and adolescents. One strategy suggested by the authors was to optimize clinical care among pediatricians.
“Pediatricians can screen patients who report experiencing racism for mental health conditions and integrate positive youth development approaches that focus on identifying strengths and protective factors,” Cuevas said. “For example, pediatricians can work with parents to develop strong social support networks to buffer the effects of discrimination. Additionally, public health scientists can educate and train teachers and administrators on how to enact culturally relevant and inclusive practices in schools. These efforts are essential to ensuring that children receive the needed resources and care to achieve optimal health.”
For more information:
Adolfo Cuevas, PhD, can be reached at adolfo.cuevas@nyu.edu.
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