title: Reducing racial disparities in obesity: simulating the effects of improved education and social network influence on diet behavior.
abstract: OBJECTIVE
  Understanding how to mitigate the present black-white obesity disparity in the United States is a complex issue, stemming from a multitude of intertwined causes. An appropriate but underused approach to guiding policy approaches to this problem is to account for this complexity using simulation modeling.
  
  
  METHODS
  We explored the efficacy of a policy that improved the quality of neighborhood schools in reducing racial disparities in obesity-related behavior and the dependence of this effect on social network influence and norms. We used an empirically grounded agent-based model to generate simulation experiments. We used a 2 × 2 × 2 factorial design that represented the presence or absence of improved neighborhood school quality, the presence or absence of social influence, and the type of social norm (healthy or unhealthy). Analyses focused on time trends in sociodemographic variables and diet quality.
  
  
  RESULTS
  First, the quality of schools and social network influence had independent and interactive effects on diet behavior. Second, the black-white disparity in diet behavior was considerably reduced under some conditions, but never completely eliminated. Third, the degree to which the disparity in diet behavior was reduced was a function of the type of social norm that was in place; the reduction was the smallest when the type of social norm was healthy.
  
  
  CONCLUSIONS
  Improving school quality can reduce, but not eliminate racial disparities in obesity-related behavior, and the degree to which this is true depends partly on social network effects.
authors.affiliation: Social and Decision Analytics Laboratory-Virginia Bioinformatics Institute, Virginia Polytechnic Institute and State University, Arlington, VA. Electronic address: morr9@vbi.vt.edu.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Orr
authors.affiliation: Department of Epidemiology, Columbia University, New York, NY.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Decision and Information Science, Argonne National Laboratory, Lemont, IL.
authors.forename: Matt
authors.initials: M
authors.lastname: Riddle
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, MI.
authors.forename: George A
authors.initials: GA
authors.lastname: Kaplan
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D003198:Computer Simulation; D004032:Diet / Q000208:ethnology*; D004779:Environment Design; D005523:Food Supply; D015438:Health Behavior / Q000208:ethnology*; D006266:Health Education / Q000379:methods / Q000592:standards; D054624:Health Status Disparities; D006801:Humans; D008962:Models, Theoretical; D009765:Obesity / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D012111:Residence Characteristics; D012574:Schools / Q000592:standards* / Q000706:statistics & numerical data; D066262:Social Norms / Q000208:ethnology; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D016138:Walking; D044465:White People / Q000706:statistics & numerical data
keywords: Agent-based modeling; Complex systems; Health disparities; Obesity; Simulation