Obesity in Minority Populations
SHIRIKI K. KUMANYIKA
There is particular concern about obesity in both children and adults in minority populations. This will intensify as the proportion of minorities in the U.S. population increases.
Three “racial” classifications (black or African American, Asian or Pacific Islander American, American Indian or Alaska Native) and one ethnic classification (Hispanic or Latino) are used to describe U.S. minority populations. These ethnic groups vary among themselves, and in relation to the nonminority (white) population, in the percentage who are immigrants, duration of residence within the United States, fertility rates, family structures, living arrangements, poverty, wealth, educational attainment, occupation, and residence distribution across U.S. regions and in inner-city, suburban, and rural areas. In spite of this diversity, when compared to non-Hispanic whites, minorities are more socially disadvantaged and have worse health profiles. This is least applicable to Asian Americans. Aggregate data for Asian Americans mask the presence of a bipolar distribution of socioeconomic status, with substantial proportions of both advantaged and disadvantaged individuals.
Table 79.1 shows obesity prevalence estimates for adults in several minority populations—taken, of necessity, from various sources and with some differences in age groupings, cutoffs, and time lines. In spite of the recognized ethnic differences in percentage body fat and regional distribution of body fat at any given body mass index (BMI) level, a single set of cutoffs (e.g., BMI ≥ 25 kg/m2 for overweight and ≥ 30 kg/m2 for obesity) is considered advantageous when comparing across populations. However, the standard