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RUNNING HEAD: OBESITY AND LOW INCOME 1

The Association Between Obesity and Low Income

Cra’Sean T. Carey

The University of North Florida


OBESITY AND LOW INCOME 2

Obesity is a health issue many people face in the United States and is a public health

issue that has become an epidemic over time. Obesity is determined through the body mass

index, or BMI, which is a ratio of the weight and height of an individual. It is used to help report

the health condition of someone being above his or her most suitable weight. If your BMI is 30

or higher, you are considered obese. In the United States, more than one third, about 35%, or

roughly 78 million adults are obese, and another one third of the United States adults are

overweight (AHA, 2016). Results from the 2005-2008 National Health and Nutrition

Examination Survey (NHANES) stated 5.9 percent of the United States adults are extremely

obese which is a BMI above 40 (CDC, 2008). Reports form A National Institution of Health

shows that adults from 20-74 years of age obesity has increased from 13.4 to 35.1 percent from

1976-80 and 2005-2006 (AHA, 2016). Segal, Rayburn, and Martin (2017) found that 45% of

adults in the United States are inactive. In 2011-2014, middle aged Americans (ages 40-59) had

the highest obesity rate than any age group at 41%, followed by seniors (ages 60 and older) at

38.5%, and then younger adults (ages 20-39) at 34.3%.

Segal, Rayburn, and Martin (2016) found individuals with lower income and or education

levels are disproportionately more likely to be obese. Roughly 33 percent of adults who earned

less than 15,000 per year were noted as being obese in comparison with others who made more

than 50,000 a year (Segal et al., 2015). The aim of this review is to determine where there is an

association between low incomes and obesity rates in African American women ages 25-35.

According to Banerjee et al. it is a significant public health concern to find a strategy to help

high risk women find weight loss treatment. If there was higher income in lower income homes,

there wouldn’t be high obesity rates in African American women. My review is being undertaken

to figure out if higher income would lower obesity rates with African American women.
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Throughout my research I have found a positive association between obesity and

insufficient education on healthy eating and regular exercise instead of low income. In the cross-

sectional study conducted by Hartman et al. (2015), they collected data from previous findings

developed by the Emory Prevention Research Center using a community based approach with a

partnership with Cancer Coalition of South Georgia. The study ran was a randomized controlled

intervention designed to test the success of home-based coach to aid healthy home eating and

exercise to prevent weight gain. They had a sample of 198 overweight, or obese, low-income

African American women take a home food environment survey and a dietary assessment. These

surveys were taken twice a week over the phone with trained interview staff using standardized

methods for 6 and 12 months. In this study, they found that demographic characteristics were not

significantly associated with the Healthy Eating Index (HEI) total score, but environmental

determinates were significantly associated with higher quality diets, like shopping and preparing

food. In contrast, environmental determinates were significantly associated with lower quality

diets with eating unhealthy food while watching television. Overall in this study they found that

education on healthier eating and proper food intake would produce the most favorable results

with weight loss and maintaining a healthy diet.

Charlie et al. (2016) ran a cross-sectional study that investigated whether physician-

informed weight status could predict weight self-perception and weight self-regulation strategies

in obese women. They had a convenience sample of 118 low-income African American women

take a survey evaluate demographics, weight regulations for self, and self-perception of weight.

Their BMI was taken and binary logistic regressions were performed to test their hypothesis.

They found a trend that had normalized overweight African American women negatively

affected the intervention effort to reduce obesity. Some women had a misperception of weight
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due to their cultural norms making them perceive their weight as healthy. In contrast some

women knew that they were over-weight but believed their goal weight was unachievable,

discouraging them from acting to live a healthier lifestyle. Researchers found with that

knowledge that educating these women would help reduce obesity as succeed in the experiment.

In this sample 61% had less than 15,000 yearly income, 83% were publicly funded or no health

insurance, 58% had a high school education or less, 16% of the sample had a college degree.

30.5% of the women were not informed of their weight status by their physicians before this

survey. These researchers found that lower socioeconomic status contributes to the increase of

incidence of obesity. Both Hartman et al. (2015) and Charlie et al. (2016) found that education

on heathy life style is significantly associated with obesity while Carlie et al (2016) also found

that income was an associated to obesity.

Unlike the other articles reviewed in Irene, A., and Lauren, H. (2013) cross-sectional

convenience nonrandom sample of 364 women 92 were African American women and 272 were

Hispanic. They found that majority of African American women had some knowledge of healthy

eating and healthier life style. Irene et al. (2013) noticed African Americans attitudes towards

food was directly related to BMI as well as food security level to diet intake. African American

women were compared to Hispanic women and researchers found that African American women

had higher income and still had higher obesity rates than Hispanic women. Cost was still labeled

as a barrier for both groups. Vedovato et al. conducted a research on food insecurity, overweight

and obesity among low-income African American families in Baltimore City, MD. It was a cross-

sectional survey taken in 14 low-income neighborhoods by 298 adults caregivers. In this study

food insecurity and obesity was noticed in low-income settings as well as in the Irene, A., and

Lauren, H. study.
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Banerjee et al. (2018) found their study to be consistent with Bennet et al, patients need

proper education, a plan, and accountability. In this study education of proper diet and exercise

helped women lose weight successfully like all the other reviewed articles there was a

disproportionally association with low income and obesity in the African American women.

This review was being undertaken to figure out if higher income would lower obesity

rates with African American women. Based on the supporting evidence presented in this review

income was disproportionally association with African American women. I found that there

should be more educational interventions with low income families and communities to promote

a healthier lifestyle. While insufficient funds were a barrier so was education. In Irene, A., and

Lauren, H. research it showed African American women to have more income than a Hispanic

women and Hispanic women still had lower rates of obesity. I firmly believe income might be an

issue, but education on a healthy diet is significantly associated with obesity.

Public health practitioners could use my study to acknowledge that there are income

barriers but they are disproportionately insignificant associated with obesity in African American

women. These practitioners should educate the individuals and communities that they interact

with to promote a healthier lifestyle to reduce the obesity rates, because education was the main

barrier to living a healthier life within the African American community. So, the best foot

moving forward would be to educate through interventions, create pamphlets, and health fairs.
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References

American Heart Association (2016, March 09). Understanding the American Obesity Epidemic.
Retrieved April 1, 2018.

American Heart Association (2018, February 16). Weight Management. Retrieved April 1, 2018.

Banerjee, E. S., Herring, S. J., Hurley, K. E., Puskarz, K., Yebernetsky, K., & LaNoue, M.

(2018). Overcoming Obesity: A Mixed Methods Study of the Impact of Primary Care

Physician Counseling on Low-Income African American Women Who Successfully Lost

Weight. American Journal Of Health Promotion, 32(2), 374-380.

Charlie L., H., Gregory, S., Sandra, M., Brian, G., & Michelle Y., M. (2016). Perceived

Physician-informed Weight Status Predicts Accurate Weight Self-Perception and Weight

Self-Regulation in Low-income, African American Women. (3), 1441.

doi:10.1353/hpu.2016.0140

Hartman, T. J., Haardörfer, R., Whitaker, L. L., Addison, A., Zlotorzynska, M., Gazmararian, J.

A., & ... Haardörfer, R. (2015). Dietary and Behavioral Factors Associated with Diet

Quality among Low-income Overweight and Obese African American Women. Journal

Of The American College Of Nutrition, 34(5), 416-424.

Irene, A., & Lauren, H. (2013). Are Nutrition Knowledge, Attitudes, and Beliefs Associated with

Obesity among Low-Income Hispanic and African American Women Caretakers?.

Journal Of Obesity, Vol 2013 (2013), doi:10.1155/2013/123901

National Center for Health Statistics. (2009, December 23). Retrieved April 1, 2018

Segal, L. M., Rayburn, J., & Martin, A. (n.d.). Obesity Rates & Trends. (2016, March) Retrieved
April 1, 2018.
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Segal, L. M., Rayburn, J., & Martin, A. (n.d.).Obesity Rates & Trends. (2017, August). Retrieved
March 13, 2018.

Vedovato, G. M., Surkan, P. J., Jones-Smith, J., Steeves, E. A., Eunkyung, H., Trude, A. B., & ...

Trude, A. C. (2016). Food insecurity, overweight and obesity among low-income African-

American families in Baltimore City: associations with food-related perceptions. Public

Health Nutrition, 19(8), 1405. doi:10.1017/S1368980015002888