Coming unmoored: Disproportionate increases in obesity prevalence among young, disadvantaged white women

Authors


  • Funding agencies: WRR: National Cancer Institute (1K01CA172717); we are grateful to the Carolina Population Center (R24 HD050924) for general support; KNK: NIH grant N01-HC-95164; BM: K01-MH093642; MJS: Population Research Training grant (T32 HD007168) and the Population Research Infrastructure Program (R24 HD050924) awarded to the Carolina Population Center.

  • Disclosure: The authors declared no conflict of interest.

Abstract

Objectives

Since the 1980s, older, low-educated White women experienced an unprecedented decrease in life expectancy. We investigated whether a similar phenomenon was evident among younger women for obesity.

Methods

Using the National Health and Nutrition Examination Survey, age-adjusted changes were estimated in the prevalence of overall and abdominal obesity (BMI ≥ 30 kg/m2, waist circumference > 88 cm) between 1988-1994 and 2003-2010 among non-Hispanic White women aged 25-44 years, stratified by educational attainment (<high school (HS), HS, some college, college degree). To address bias from secular increases in educational attainment, White women's changes in obesity prevalence were compared to changes among similarly educated Black women.

Results

Relative increases in overall obesity were disproportionately larger for low-educated (<HS) compared to college-educated White women: 12.3 (95% CI: 3.1, 21.5) percentage points (ppts). For overall and abdominal obesity, general trends indicated dissimilar racial differences by educational attainment. For instance, overall obesity increased more in Blacks than Whites among college-educated (9.9 ppts) but not low-educated (−2.5 ppts) women.

Conclusions

Contemporary young, low-educated White women showed indications of disproportionate worsening of overall obesity prevalence compared to more educated White and similarly educated Black women. Low education levels are more powerful indicators of obesity risk among contemporary White women than 30 years ago.

Ancillary