The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents.

OBJECTIVE To examine the extent to which race/ethnic differences in income and education account for sex-specific disparities in overweight prevalence in white, African American, Hispanic, and Asian U.S. teens. RESEARCH METHODS AND PROCEDURES We used nationally representative data collected from 13113 U.S. adolescents enrolled in the National Longitudinal Study of Adolescent Health. Logistic regression models were used to examine the relationship of family income and parental education to overweight prevalence (body mass index >or= 85th percentile of age and sex-specific cutoff points from the 2000 Centers for Disease Control and Prevention/National Center for Health Statistics growth charts). In addition, we used coefficients from our logistic regression models to project the effects on overweight prevalence of equalizing the socioeconomic status (SES) differences between race/ethnic groups. RESULTS Keeping adolescents in their same environments and changing only family income and parental education had a limited effect on the disparities in overweight prevalence. Ethnicity-SES-overweight differences were greater among females than males. Given that overweight prevalence decreased with increasing SES among white females and remained elevated and even increased among higher SES African-American females, African-American/white disparity in overweight prevalence increased at the highest SES. Conversely, disparity was lessened at the highest SES for white, Hispanic, and Asian females. Among males, disparity was lowest at the average SES level. DISCUSSION One cannot automatically assume that the benefits of increased SES found among white adults will transfer to other gender-age-ethnic groups. Our findings suggest that efforts to reduce overweight disparities between ethnic groups must look beyond income and education and focus on other factors, such as environmental, contextual, biological, and sociocultural factors.