Targeting Interventions for Ethnic Minority and Low-Income Populations

By Kumanyika, Shiriki; Grier, Sonya | The Future of Children, Spring 2006 | Go to article overview

Targeting Interventions for Ethnic Minority and Low-Income Populations


Kumanyika, Shiriki, Grier, Sonya, The Future of Children


Summary

Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers-and thus contribute to disparities in obesity rates.

The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment-breast-feeding, television viewing, and parental behaviors-that may contribute to childhood obesity but be amenable to change through targeted intervention.

Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical environments in which these communities exist.

Rates of childhood obesity, now far too high among all U.S. children, are even higher among the nation's ethnic minority and low-income children. (1) These ethnic and socioeconomic disparities in childhood obesity rates present yet another challenge for researchers, policymakers, and practitioners who are focusing on obesity prevention.

In this article, we present and summarize data from multiple sources on racial, ethnic, and related socioeconomic correlates of obesity. We document differences in child obesity across race and ethnic groups and between low- and high-income children. We then consider which obesity-promoting factors might be more prevalent or more intensified among low-income and ethnic minority children than among the general population, with an eye toward identifying modifications that would do the most to prevent obesity. We try to highlight issues for diverse minority populations, but because far more information is available about African Americans and Hispanic Americans than about other groups, the discussion focuses mostly on these two populations. (2)

Obesity Prevalence among Minority and Low-Income Children

No single data source provides information on trends in child obesity for all the major racial and ethnic groups in the United States. The National Health and Nutrition Examination Survey (NHANES), a nationally representative survey that has been conducted periodically since the early 1970s, has large enough samples of white, African American, and (since 1982) Mexican American children to estimate obesity rates within racial and ethnic groups at different points in time. Table 1, which is based on NHANES data, shows rates of obesity for white, African American, and Mexican American boys and girls in two age groups, ages six to eleven and twelve to nineteen, for three time periods since the mid-1970s. Although obesity rates have increased for boys and girls within each ethnic and racial group, they have increased more for African American and Mexican American children. …

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