Obesity, race/ethnicity and life course socioeconomic status across the transition from adolescence to adulthood.
BACKGROUND
Differences in the association of socioeconomic status (SES) with obesity may underlie the racial/ethnic disparities in obesity that increase dramatically across the transition to adulthood in the United States. The aim of this study was to examine racial/ethnic differences in the influence of life course SES on longitudinal obesity patterns from adolescence to adulthood.


METHODS
Latent class analysis was used on a nationally representative, diverse sample of 12 940 adolescents followed into young adulthood (mean age = 21.7 years) to identify life course SES group profiles based on SES data in adolescence and young adulthood. Gender-stratified multinomial logistic regression models estimated the association of SES groups with obesity incidence and persistence versus staying non-obese.


RESULTS
No significant interactions with race/ethnicity were observed, although racial/ethnic minorities had the highest obesity risk across SES groups. Racial/ethnic-pooled associations between disadvantaged SES exposure and higher obesity risk were strong but differed by gender. Males with a disadvantaged background who experienced early transitions into the labour force, marriage and residential independence had the highest risk of obesity incidence (relative risk ratio (RRR) = 1.64; 95% confidence interval (CI) 1.12 to 2.40), while females exposed to persistent adversity were at highest risk (RRR = 3.01, 95% CI 1.95 to 4.66). In general, SES group membership had a stronger relationship with obesity persistence than incidence.


CONCLUSIONS
The relationship between SES and obesity patterns is similar across race/ethnicity and differs by gender during the transition to adulthood. However, stronger associations with obesity persistence and enduring racial/ethnic disparities in obesity risk across SES groups suggest that these social factors play a larger role in disparities earlier in the life course.
Scharoun-Lee
M
M
Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516-3997, USA.
Kaufman
J S
JS
Popkin
B M
BM
Gordon-Larsen
P
P
D000293:Adolescent; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009765:Obesity / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D012737:Sex Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology