title: A longitudinal study of structural risk factors for obesity and diabetes among American Indian young adults, 1994-2008.
abstract: BACKGROUND
  American Indian young adults have higher rates of obesity and type 2 diabetes than the general US population. They are also more likely than the general population to have higher rates of structural risk factors for obesity and diabetes, such as poverty, frequent changes of residence, and stress. The objective of this study was to investigate possible links between these 2 sets of problems.
  
  
  METHODS
  Data from the American Indian subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine potential links between obesity and type 2 diabetes and structural risk factors such as neighborhood poverty, housing mobility, and stress. We used logistic regression to explore explanatory factors.
  
  
  RESULTS
  American Indians in the subsample had higher rates of poor health, such as elevated hemoglobin A1c levels, self-reported high blood glucose, self-reported diabetes, and overweight or obesity. They also had higher rates of structural risk factors than non-Hispanic whites, such as residing in poorer and more transient neighborhoods and having greater levels of stress. Self-reported stress partially mediated the increased likelihood of high blood glucose or diabetes among American Indians, whereas neighborhood poverty partially mediated their increased likelihood of obesity.
  
  
  CONCLUSIONS
  Neighborhood poverty and stress may partially explain the higher rates of overweight, obesity, and type 2 diabetes among American Indian young adults than among non-Hispanic white young adults. Future research should explore additional neighborhood factors such as access to grocery stores selling healthy foods, proximity and safety of playgrounds or other recreational space, and adequate housing.
authors.affiliation: Arizona State University, Tempe, Arizona.
authors.forename: Tennille L
authors.initials: TL
authors.lastname: Marley
authors.affiliation: Washington University in St Louis, George Warren Brown School of Social Work, One Brookings Dr, Campus Box 1196, St Louis, MO 63130. Email: mmetzger22@wustl.edu.
authors.forename: Molly W
authors.initials: MW
authors.lastname: Metzger
mesh_terms: D000293:Adolescent; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000502:physiology; D015438:Health Behavior / Q000208:ethnology; D006798:Housing / Q000592:standards; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology*; D050177:Overweight / Q000208:ethnology; D011203:Poverty / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D057566:Self Report; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin