Journal of Youth and Adolescence

, Volume 35, Issue 4, pp 641–651 | Cite as

Community Influence on Adolescent Obesity: Race/Ethnic Differences

  • K. A. Thulitha Wickrama
  • K. A. S. WickramaEmail author
  • Chalandra M. Bryant

Using a sample of 20,000 adolescents (Add Health data), this study examined the influences of community poverty and race/ethnicity on adolescent obesity. Multilevel analyses revealed strong evidence for the unique influences of community poverty and race/ethnicity on adolescent obesity net of family characteristics. The prevalence of obesity is significantly higher in poor communities than in affluent communities; and it is higher among African Americans, Hispanics and Native Americans than among Whites. The interaction between race/ethnicity and community poverty indicates that race/ethnicity moderates the influence of community poverty on the prevalence of obesity. Although the prevalence of obesity is higher among minorities than among Whites, the influence of community poverty is stronger for Whites than for minorities, suggesting that unlike Whites, most minority groups may not accrue benefits of structural community advantages. The state of being overweight as the outcome variable provided essentially the same findings. The practical implications are discussed.

Key Words

community poverty race adolescent obesity 



This research is based on data from the Add Health project, a program project designed by J. Richard Udry (PI) and Peter Bearman, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding participation by the National Cancer Institute; the National Institute of Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other Communication Disorders; the National Institute on Drug Abuse; the National Institute of General Medical Sciences; the National Institute of Mental Health; the National Institute of Nursing Research; the office of AIDS Research, NIH; the Office of Behavior and Social Science Research, NIH; the Office of the Director, NIH; the Office of Research on Women's Health, NIH; the Office of Population Affairs, DHHS; the National Center for Health Statistics, Centers for Disease Control and Prevention, DHHS; the Office of Minority Health, Centers for Disease Control and Prevention, DHHS; the Office of Minority Health, Office of Public Health and Science, DHHS; the Office of the Assistant Secretary for Planning and Evaluation, DHHS; and the National Science Foundation. Persons interested in obtaining data files from The National Longitudinal Study of Adolescent Health should contact Add Health Project, Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC 27516-3997 (email:


  1. Acton, K. J., Burrows, N. R., Moore, K., and Querec, L. (2002). Trends in diabetes prevalence among American Indian and Alaska native children, adolescents, and young adults. Am. J. Public Health 92: 1485.PubMedGoogle Scholar
  2. Allison, D. B., and Pi-Sunyer, F. X. (1995). Obesity treatment. New York: Plenum Press.Google Scholar
  3. Armstrong, J., et al. (2003). Coexistence of social inequalities in under nutrition and obesity in preschool children population based cross sectional study. Arch. Dis. Child 88: 671–675.CrossRefPubMedGoogle Scholar
  4. Auchincloss, A. H., and Hadden, W. (2002). The health effects of rural-urban residence and concentrated poverty. J. Rural Health 18(2), 319–336.PubMedCrossRefGoogle Scholar
  5. Auge, K. (2003). Obesity's effects vary by race, studies show. The Denver Post, A-01. January, 8Google Scholar
  6. Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  7. Baum, C. G., and Forehand, R. (1984). Social factors associated with adolescent obesity. J. Pediatr. Psychol. 9(3): 293–302.PubMedCrossRefGoogle Scholar
  8. Berg, F. M. (1993). Health risks of obesity (2nd edn.). Hettinger, ND: Graphic Designs and Printing.Google Scholar
  9. Black, S. A. (2002). Diabetes, diversity, and disparity: What do we do with the evidence? Am. J. Public Health 92(4): 543548.PubMedGoogle Scholar
  10. Blazer, D. G., Moody-Ayers, S., Craft-Morgan, J., and Burchett, B. (2002). Depression in diabetes and obesity, racial/ethnic/gender issues in older adults. J. Psychosom. Res. 53: 91916.CrossRefGoogle Scholar
  11. Brooks-Gunn, J., Duncan, G. J., Klebanov, P. K., and Sealand, N. (1993). Do neighborhood influence child and adolescent development? Am. J. Sociol. 99: 353395.CrossRefGoogle Scholar
  12. Bouchard, C. (2000). Physical activity and obesity. Champaign, IL: Human Kinetics Publishers.Google Scholar
  13. British nutritional foundation. (1999). Obesity: The report of the British nutrition foundation task force. Oxford, England: Blackwell Science Ltd.Google Scholar
  14. Browning, C. R., and Cagney, K. A., (2004). Moving beyond poverty: Neighborhood structure, social processes, and health. J. Health Soc. Behav. 44: 552–571.CrossRefGoogle Scholar
  15. Carrol, G. (1998). Mundane extreme environmental stress and African American Families: A case for recognizing different realities. J. Comp. Fam. Stud. 29(2): 271–284.Google Scholar
  16. Center for disease control. (2003). Black or African American populations. Retrieved from Scholar
  17. Coile, R. C., Jr. (2001). Competing in a consumer choice market. J. Healthc. Manag. 465(5): 297300.Google Scholar
  18. Cristol, H. (2003). Predicting obesity. The Futurist 37(1): 10–12.Google Scholar
  19. Crosnoe, R., and Muller, R. (2005). Body Mass Index, Academic Achievement and School Context: Examining the Educational Experience of Adolescents at Risk of Obesity. J. Health and Soc. Behav. 45: 393–407.CrossRefGoogle Scholar
  20. Duncan, G. J., Brooks-Gunn, J., and Klebanov, P. (1994). Economic deprivation and early childhood development. Child Dev. 65: 296318.PubMedCrossRefGoogle Scholar
  21. Duncan, G. J., Connell, J. P., and Klebanov, P. K. (1997). Conceptual and methodological issues in estimating causal effects of neighborhoods and family conditions on individual development. In J. Brooks-Gunn, G. J. Duncan, and J. L. Aber (eds.). Neighborhood poverty: Contextual and consequences for children. New York: Russel Sage (pp. 219–250).Google Scholar
  22. Ferraro, K. F. and Kelly-Moore, J. A. (2003). Cumulative disadvantage and health: Long-term consequences of obesity. Am. Sociol. Rev. 68: 702729.CrossRefGoogle Scholar
  23. Fitzgivvon, M. L., Spring, B., Avellone, M. E., Blackman, L. R., Pingitore, R., and Stolley, M. R. (1997). Correlates of binge eating in Hispanic, Black, and White Women. Int. J. Eat. Disord. 24: 4352.CrossRefGoogle Scholar
  24. Gordon-Larsen, P., McMurray, R. G., and Popkin, B. M. (1999). Adolescent physical activity and inactivity vary by ethnicity: The national longitudinal study of adolescent health. J. Pediatr. 135(3): 301–306.CrossRefPubMedGoogle Scholar
  25. Kaplan, G. A. (1995). Where do shared pathways lead? Some reflections on a research agenda. Psychosom. Med. 57: 208212.PubMedGoogle Scholar
  26. Karlsen, S., and Nazroo, J. Y. (2002). Relation between racial discrimination, social class, and health among ethnic minority groups. Am. J. Public Health 92(4): 624631.PubMedGoogle Scholar
  27. Kawachi, I., and Berkman, L. F., (2000). Social cohesion, social capital, and health In: L. F. Berkman and I. Kawachi (Eds.), Social Epidemiology. Oxford: Oxford University Press.Google Scholar
  28. Kowaleski-Jones, L. (2000). Staying out of trouble: Community resource and problem behavior among high-risk adolescents. J. Marriage Fam. 62: 449464.CrossRefGoogle Scholar
  29. Krivo, L. J., and Petterson, R. (2000). The structural context of homicide: Accounting for racial differences in process. Am. Sociol. Rev. 65: 547559.CrossRefGoogle Scholar
  30. Kuczmarski, R. J., Flegal, K. M., Campbell, S. M., and Johnson, C. L. (1994). Increasing prevalence of overweight among U.S. adults: The national health and nutrition examination surveys, 1960 to 1991. J. Am. Med. Assoc. 272: 205211.CrossRefGoogle Scholar
  31. Lau, R. R., Quadrel, J. M., and Hartman, A. K. (1990). Development and change of young adults’ preventive health beliefs and behavior: Influence from parents and peers. J. Health Soc. Behav. 31: 240259.CrossRefGoogle Scholar
  32. Little, R. C., Milliken, G. A., Stroup, W. W., and Wolfinger, R. D. (1996). SAS System for mixed models. NC: SAS Institute Inc.Google Scholar
  33. Maes, H. H. M., Neale, M. C., and Eaves, L. J. (1997). Genetic and environmental factors in relative body weight and human adiposity. Behav. Genet. 27: 325–351.CrossRefPubMedGoogle Scholar
  34. Massey, D. S. (1998). Back to future: The rediscovery of neighborhood context. Contemp. Sociol. 27: 570572.CrossRefGoogle Scholar
  35. Mays, M. V., Yancey, A. K., Cochran, S. D., Weber, M., and Fielding, J. E. (2002). Heterogeneity of health disparities among African American, Hispanic, and Asian American Women: Unrecognized influences of sexual orientation. Am. J. Public Health 92(4): 632–639.PubMedGoogle Scholar
  36. Meyers, I. H. (1993). Prejudice and pride: Minority stress and mental health in gay men. Doctoral dissertation, Division of Sociomedical Sciences, School of Public Health, Columbia University, New York, NY.Google Scholar
  37. Morland, K., Wing, S., Roux, A. D., and Poole, C. (2002). Neighborhood characteristics associated with the location of food stores and food service places. Am. J. Prev. Med. 22(1): 23–29.CrossRefPubMedGoogle Scholar
  38. Ogden, C. L., Flegal, K. M., Carrol, M. D., and Johnson, C. L. (2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288: 1728–1732.CrossRefPubMedGoogle Scholar
  39. Perrin, F. V. (1991). Diabetes hits Hispanics hard: Pharmacists can help. Drug topics 135(1): 13.Google Scholar
  40. Pine, D. S., Cohen, P., Brook, J., and Coplan, J. D. (1997). Psychiatric symptoms in adolescence as predictors of obesity in early adulthood: A longitudinal study. Am. J. Public Health 87(8).Google Scholar
  41. Raudenbush, S. W., and Bryk, S. A. (2002). Hierarchical linear models. Thousands Oaks, CA: Sage.Google Scholar
  42. Robbins, J. M., Vaccarino, V., Zhang, H., and Kasl, S. V. (2001). Socioeconomic status and type 2 diabetes of African American and non-Hispanic White Women and Men: Evidence from the third national healthy and nutrition examination survey. Am. J. Public Health 91(1): 7683.PubMedGoogle Scholar
  43. Ross, C. E., and Mirowsky, J. (2001). Neighborhood disadvantage, disorder, and health. J. Health Soc. Behav. 42: 258276.CrossRefGoogle Scholar
  44. Sampson, R. J., Raudenbush, S. W., and Earls, F. (1997). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science 227: 918–923.CrossRefGoogle Scholar
  45. Sanjay, K. (2000). Deprivation and childhood obesity: A cross sectional study of 20973 children in Plymouth, United Kingdom. J. Epidemiol. Community Health 54: 456–460.CrossRefPubMedGoogle Scholar
  46. Smith, G. D. (2000). Learning to live with complexity: Ethnicity, socioeconomic position, and health in Britain and the United States. Am. J. Public Health. 90(11): 16941698.PubMedGoogle Scholar
  47. Sorensen, G., Emmons, K., Hunt, M. K., and Johnston, D. (1998). Implications of the results of community intervention trials. Ann. Rev. Public Health 19: 379416.CrossRefGoogle Scholar
  48. Sobal, J., and Stunkard, A. J. (1989). Socioeconomic status and obesity: a review of the literature. Psychol. Bull. 105:260–275.CrossRefPubMedGoogle Scholar
  49. South, S. J., and Kyle Crowder, D. (1999). Neighborhood effects on family formation: Concentrated poverty. Am. Sociol. Rev. 64: 113132.CrossRefGoogle Scholar
  50. Spencer, M. B. (2001). Resiliency and frailty factors associated with the contextual experiences of low resource urban African male youth and families. In A. Booth and A. C. Crouter (Eds.) Does it take a village? Community effects on children, adolescents, and families (pp. 51–77). New Jersey: Lawrence Erlbaum Associates.Google Scholar
  51. Striegel-Moore, H. R., Schreiber, B. G., Lo, A., Crawford, P., Obarzanek, E., and Rodin, J. (2000). Eating disorder symptoms in a cohort of 11 to 16-year-old Black and White girls: The NHLBI growth and health study. Int. J. Eat. Disord. 27(1): 4966.CrossRefPubMedGoogle Scholar
  52. Stunkard, A. J., and Sorenson, T. I. A. (1993). Obesity and socioeconomic status: a complex relation. N. Engl. J. Med. 329: 1036–1037.CrossRefPubMedGoogle Scholar
  53. Sucoff, C. A., and Upchurch, D. M. (1998). Neighborhood context and the risk of childbearing among metropolitan-area Black adolescents. Am. Sociol. Rev. 63: 571585.CrossRefGoogle Scholar
  54. Surgeon General Report. (2001). Overview of cultural diversity and mental health issues: A report of the surgeon General. From health/chapter2/sec8.Google Scholar
  55. Taylor, J., and Turner, P. J. (2002). Perceived discrimination, social stress, and depression in the transition to adulthood: Racial contrasts. Soc. Psychol. Q, 65: 213325.CrossRefGoogle Scholar
  56. Thornton, B., Gibbons, F. X., and Gerrard, M. (2002). Risk perception and prototype perception: Independent processes predicting risk behavior. Pers. Soc. Psychol. Bull. 28(7).Google Scholar
  57. Tucker, K. L., and Odilia, I. B. (2000). Type 2 diabetes is prevalent and poorly controlled among Hispanic elders of Caribean origin. Am. J. Public Health. 90(8): 12881293.PubMedGoogle Scholar
  58. Wadden, T. A., Sarwer, D. B., Womble, L. G., Foster, G. D., McGuckin, B. G., and Schimmel, A. (2001). Psychosocial aspects of obesity and obesity surgery. Surg. Clin. North Am. 81(5): 1001–1024.CrossRefPubMedGoogle Scholar
  59. Wang, Y. (2001). Cross-national comparison of childhood obesity: The epidemic and the relationships between obesity and socioeconomic status. Int. J. Epidemiol. 30:1129–1136.CrossRefPubMedGoogle Scholar
  60. Watson, D., and Pennebaker, J. A. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol. Rev. 96: 234–254.CrossRefPubMedGoogle Scholar
  61. Wickrama, K. A. S., and Bryant, C. M. (2003). The community context of social resources and adolescent mental health. J. Marriage Fam. 65: 850–866.CrossRefGoogle Scholar
  62. Wickrama, K. A. S., Conger, R. D., Wallace, L. E., and Elder, G. H., Jr. (1999). The intergenerational transmission of health-risk behaviors: Adolescent lifestyles and gender moderating effects. J. Health and Soc. Behav. 40: 258272.CrossRefGoogle Scholar
  63. Wheaton, B., and Clarke, P. (2003). Past vs. Present Neighborhood Disadvantage and Early Adult Mental Health. Am. Sociol. Rev. 68(5): 680–706.CrossRefGoogle Scholar
  64. Wolf, A. M., Gortmaker, S. L., Cheung, L., Gray, H. M., Herzog, D. B., and Colditz, G. (1993). Activity, inactivity, and obesity: Racial, ethnic, and age differences among school girls. Am. J. Public Health 83(11): 16251627.PubMedGoogle Scholar
  65. Young, L. R., and Nestle, M. (2002). The contribution of expanding portion sizes to the US obesity Epidemic. Am. J. Public Health 92: 246249.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • K. A. Thulitha Wickrama
    • 1
  • K. A. S. Wickrama
    • 2
    • 3
    Email author
  • Chalandra M. Bryant
    • 1
  1. 1.Human Development and Family StudiesThe Pennsylvania State UniversityUniversity ParkUSA
  2. 2.Institute for Social and Behavioral ResearchAmesUSA
  3. 3.Human Development and Family Studies at Iowa State UniversityAmesUSA

Personalised recommendations