The Health Disadvantages of the Disadvantaged - Research Paper Example

The Health Disadvantages of the Disadvantaged: Effects of the Physical Environment, Socioeconomic Status, and Ethni Race on Obesity University October 9, 2014 Abstract Income gaps and racial and ethnical lines can be risk factors for obesity rates, while obesogenic environmental factors can shape sedentary and food consumption activities that affect obesity too (Lovasi et al., 2009; Sallis & Glanz, 2009; Tandon et al., 2012). A gap in literature underlines the need for summarizing recent studies that understands the relationships among the physical environment, socioeconomic status (SES), and ethnicity/race and its impacts on obesity levels. Knowing about these relationships can help policymakers change the built environment of low SES communities (Lovasi et al., 2009, p. 10). This research aimed to determine if the physical environment, SES, and ethnicity/race affect obesity levels. Secondary research proved the paper’s hypothesis that people with lower socio-economic status and who are from minority ethnic groups are at higher risks of obesity because they tend to live in obesogenic environments and to perform sedentary activities. Table of Contents Abstract 2 Table of Contents 2 Introduction 3 Research Design 4 Research Questions 4 Hypothesis 5 Literature Review 5 Findings 5 Discussion 9 Conclusion 11 References 12 The Health Disadvantages of the Disadvantaged: Effects of the Physical Environment, Socioeconomic Status, and Ethnicity/Race on Obesity Introduction A fat poor person may be an oxymoron because poor financial resources should produce emaciated bodies, but it becomes a real-life-based oxymoron if low-income groups live in communities where fast food restaurants are more accessible than supermarkets and sell cheaper food than healthy food shops, and where they have less access to exercise facilities and safe walkable streets. Income gaps and racial and ethnic lines can contribute to obesity rates, as well as the existence of obesogenic environment factors that encourage sedentary activities (Lovasi et al., 2009; Sallis & Glanz, 2009; Tandon et al., 2012; Wang, 2001; Wang & Beydoun, 2007; Whitt-Glover et al., 2009). A number of past studies focused on obesogenic environments and physical activity, or racial/ethnic correlates of obesity only, thus, a gap in literature stresses the need for summarizing researches that understand the relationships among physical environment, socioeconomic status (SES), ethnicity/race, and obesity levels. Determining these relationships can help policymakers redesign existing low SES communities and justify the need for additional financial resources for these programs (Lovasi et al., 2009, p. 10). This research paper determines if the physical environment, SES, and ethnicity/race affect obesity levels. Research Design The research design of this paper is based on qualitative research. It used secondary research to analyze and synthesize findings from scholarly journals and health reports from 2001 to 2014. The research questions are the following: Research Questions 1) Are people from lower socio-economic status and who are members of minority groups more at risk of developing obesity? 2) Are the factors of obesogenic environments and prevalence of sedentary activities some of the main factors that cause obesity among these at-risk groups? The hypothesis of the paper interconnects the dependent variable of obesity with the independent variables of SES, obesogenic environment characteristics, sedentary behaviors, and race/ethnicity. The hypothesis is below: Hypothesis People with lower socio-economic status and who are from minority ethnic groups are at higher risks of obesity because they tend to live in obesogenic environments and to perform sedentary activities. Literature Review Some studies showed that obesity, ethnicity/race, and socioeconomic status (SES) are related, although their relationships are complex and not frequently explicit in determining causal relationships or correlations (Lovasi et al., 2009; Sallis & Glanz, 2009; Tandon et al., 2012; Wang, 2001; Wang & Beydoun, 2007; Whitt-Glover et al., 2009). High rates of obesity, nevertheless, is usually found among non-white minority groups, especially those who have low incomes and live in neighborhoods that are considered obesogenic because of lack of access to areas that encourage physical activity and to stores and restaurants that sell healthy food (Lovasi et al., 2009; Sallis & Glanz, 2009). These studies underscored that the poor in urban areas live in environments where fast food concentration is high, while supermarket incidence is low (Lovasi et al., 2009; Sallis & Glanz, 2009). There is gap in literature that summarizes research on these relationships for the past decade and that will determine health care issues for these disadvantaged groups through understanding the dominant causes of their obesity. Findings Disadvantaged populations experience health disadvantages because they live in obesogenic environments. Several studies showed that obesogenic environments have high numbers of fast food stores and low numbers of supermarkets, farmers’ markets, and healthy food stores. Freeman (2007) observed that low-income urban neighborhoods have more fast food stores than supermarket stores. She stressed that poor people of color experience food oppression through living in environments that promote poor nutrition (Freeman, 2007, p. 2222). This study shows how economic inequality results to health oppression too. This article, however, lacks further empirical examination of how and why these environments remain obesogenic despite studies showing that they are harmful to people’s health. Another study confirmed that, at least in the United States, low-income areas had higher obesity rates than high-income areas. Wang (2001) conducted a cross-national comparative study of childhood obesity for the U.S., China, and Russia. He learned that: “the prevalence of obesity and overweight was 11.1% and 14.3%, respectively, in the US, 6.0% and 10.0% in Russia, and 3.6% and 3.4% in China” (Wang, 2001, p. 1131). He added that low-income groups were usually more obese than high-income groups, and that the reverse situation happens in China and Russia where high SES was correlated with obesity. The paper believes that rural areas and low-income areas in these countries do not have the same access to fast food restaurants and have more walkable areas and areas where exercise can be done compared to those in the U.S. Lovasi et al. (2009) conducted a systematic review of literature on scientific studies that examined the relationship between obesogenic environments and obesity rates of people living in low-income communities. They selected 45 studies that were published from 1995 to 2009 and which had at least 100 participants. Their samplings provided information on built environment variables that could be correlated with obesity and other health problems for marginalized sectors and the exposure of these cohorts to built environment characteristics that were potentially obesogenic. Their findings showed that these populations were disadvantaged in terms of access to “food stores, fast food outlets, places to exercise,” and in having poor perceptions of the aesthetic quality and safety of their environments (Lovasi et al., 2009, p. 9). These communities had more fast food stores and fewer places to exercise in than high-income communities. Walkability and sprawling urban communities were not connected to obesity-related health gaps (Lovasi et al., 2009, p. 9). Particular obesegenic-environmental variables that were correlated with high body mass index (BMI) and obesity-related illnesses for these groups were access to supermarkets and exercise facilities and perceptions of neighborhood safety (Lovasi et al., 2009, p. 9). Lovasi et al. (2009) concluded that low-income groups show health disparities with high-income groups because the former live in neighborhoods that have the characteristics of obesogenic environments. These studies indicate that living in low-income communities increases the risk of becoming obese, while also worsening obesity levels because of lack of access to healthy food outlets. Obesogenic environments include the homes of low-income families as well, which affect the health of children from these income levels. Tandon et al. (2012) studied if parental education and income levels determine differences in home activity levels and how home activity processes affect the relationship between household SES and children’s physical activity and sedentary behaviors. Their sampling included 713 child-parent dyads who were part of the Neighborhood Impact on Kids (NIK) Study, a longitudinal, observational group study on children with ages 6 to 11 years old in Seattle and King County in WA and San Diego County, CA. Parents completed online or pen-and-paper surveys at home. Children wore an Actigraph accelerometer for 7 days to measure their physical activity. Their findings showed that children in low SES households had more access to electronic media devices in their bedrooms, but lower access to portable playing tools; parents with low SES were more restrictive of their children’s physical activity; children’s screen time was higher for low-income children; parents of lower SES watched with their children more than those with high SES; and SES was not correlated with physical activity and sedentary behaviors (Tandon et al., 2012, pp. 6-7). These authors concluded that parents contribute to the obesogenic environment if they believe that safety level is a large concern enough to restrict their children’s physical activity, if they have less time to supervise their children, and if they have fewer recreational options for their kids (Tandon et al., 2012, p. 7). This study remarks on the role of the family environment in obesity. Obesogenic environments themselves are not the only causes or contributors of obesity but also the physical aspects of the environment that promote sedentary living. Sallis and Glanz (2009) confirmed the results of the study of Lovasi et al. (2009) through their own literature review on the role of obesogenic environments and physical activity in the incidence of obesity. Sallis and Glanz (2009) stressed that communities that lack physical activity facilities are often low-income communities where racial and ethnic minorities live. Tandon et al. (2012) showed that SES and sedentary behaviors interact in shaping obesity. They hypothesized that low-income communities tend to have high crime rates and/or low access to physical activity facilities, so parents would rather have their children stay at home and spend time watching TV or playing on computers and other media devices (Tandon et al., 2012, p. 7). Whitt-Glover et al. (2009) described gaps in physical activity patterns and sedentary behaviors for American children and adolescents. They used behavioral data that they attained from the accelerometer results of the National Health and Nutrition Examination Survey (NHANES). They noted that non-Hispanic blacks were more physically active than non-Hispanic whites at young age levels, but physical activity declined for all across ages (Whitt-Glover et al., 2009, p.s313). They also found some studies that correlated low access to safe physical activity centers with sedentary behaviors and high BMI (Whitt-Glover et al., 2009, pp.s331-s322). Low SES communities usually had the least access to physical-activity recreational facilities, based on quality and number of the latter, that can explain their obesity-level gap (Whitt-Glover et al., 2009, pp.s331-s322). Some low-income areas may have higher acreage for physical activity, but they may not necessarily be safe and appealing to the youth (Whitt-Glover et al., 2009, p.s322). Finally, studies showed that low-income groups and racial and ethnic factors intersect in influencing obesogenic environments’ impact on obesity rates. Wang (2001) learned from his cross-cultural study that ethnicity and race increased risks for obesity. He noted that, in the U.S., blacks and Hispanic children and adolescents with low SES were at higher risk for obesity and overweight problems than whites with high SES (Wang, 2001, p. 1133). Sallis and Glanz (2009) verified in their study that low-income communities and areas where colored groups usually live have less access to public and private physical activity areas (p. 133). Wang and Beydoun (2007) studied the obesity epidemic in America. They learned that obesity worsened by increasing from 13% to 32% prevalence in the 1960s to 66% prevalence of obesity among adults in 2004 (Wang & Beydoun, 2007, p. 22). In addition, their findings showed that SES and ethnicity/race intersected in showing large obesity disparities. Wang and Beydoun (2007) stated: Some minority and low-SES groups such as non-Hispanic Black women and children, Mexican-American women and children, low-SES Black men and White women and children, Native Americans, and Pacific Islanders are disproportionally affected (p. 22). Gender, race, ethnicity, and SES are factors that affect obesity prevalence too. Being white and poor increases the risks for obesity. Likewise, being colored and poor increases the risks for obesity. Their study lacks qualitative and quantitative aspects in understanding the factors that influenced the growth of obesity rates in their cohorts, however. Discussion These findings from secondary research prove that people with lower socio-economic status and who are from minority ethnic groups are at higher risks of obesity because they tend to live in obesogenic environments and to perform sedentary activities. First, people from lower socio-economic status and who are members of minority groups are more at risk of being obese because they live in obesogenic environments where safety concerns can impact walkability and physical activity behaviors (Tandon et al., 2012, pp. 6-7). In addition, these environments have higher fast food restaurants per community than supermarkets and healthy food shops (Freeman, 2007, p. 2222; Lovasi et al., 2009, p. 9). The poor, especially those who come from minority groups, are fatter and at risks of being obese and overweigh because of an environment that reduces opportunities for a physically active and healthy diet. Moreover, since poverty is more prevalent among colored groups, ethnicity and race can be considered as obesity risk factors (Wang, 2001, p. 1133). However, parents and cultures that encourage physical activity can be buffers from these risks (Whitt-Glover et al., 2009, p.s323). Second, the factors of obesogenic environments and prevalence of sedentary activities are some of the main factors that cause obesity among these at-risk groups. Being poor increases the risk for obesity if low-income groups live in obesogenic environments that lack access to physical activity facilities (Lovasi et al., 2009, p. 9). Those that have environments and homes that facilitate and promote physical activity, nevertheless, can experience reduced risks (Whitt-Glover et al., 2009, p.s323). Studies agreed, however, that environmental factors have a significant correlation with obesity rates and obesity-related illnesses (Sallis & Glanz, 2009, p. 133; Tandon et al., 2012, p.7; Wang & Beydoun, 2007, p. 24; Whitt-Glover et al., 2009, p.s323). Walkable spaces must be safe and engaging to promote physical activity and to reduce obesity and overweight rates, and people may be encouraged by aesthetic built environment designs to walk or bike when conducting their various daily activities (Sallis & Glanz, 2009, p. 131). These researchers highlighted the role of the environment in shaping obesity rates. Conclusion Definitely, this paper agrees that individuals must be responsible for their health and in avoiding becoming overweight and fat. Parents are held accountable too for the health of their children. Nonetheless, it agrees with these studies that the environment has an important function in promoting health and well-being. This study proved its hypothesis that people with lower socio-economic status and who are from minority ethnic groups are at higher risks of obesity because they tend to live in obesogenic environments and to perform sedentary activities. Race, ethnicity, and SES are risk factors because they tend to be exposed to obesogenic environments and cultures and communities that resist physical activity because of convenience and safety reasons and because fast foods are more accessible and cheaper nutritional sources. Thus, economic and racial disadvantages have turned into health disadvantages too, thereby suggesting the need for further studies on the prevalence of health oppression in the U.S. References Freeman, A. (2007). Fast food: Oppression through poor nutrition. California Law Review, 95(6), 2221-2260. Retrieved from http://scholarship.law.berkeley.edu/cgi/viewcontent.cgi?article=1198&context=californialawreview Lovasi, G.S. Hutson, M.A., Guerra, M., & Neckerman, K.M. (2009). Built environments and obesity in disadvantaged populations. Epidemiologic Reviews, 1-14. Retrieved from http://epirev.oxfordjournals.org/content/early/2009/07/09/epirev.mxp005.full.pdf+html Sallis, J.F., & Glanz, K. (2009). Physical activity and food environments: Solutions to the obesity epidemic. The Milbank Quarterly, 87(1), 123-154. Retrieved from http://www.homeworkmarket.com/sites/default/files/physical_avtivity.pdf Tandon, P.S., Zhou, C., Sallis, J.F., Cain, K.L., Frank, L.D., & Saelens, B.E. (2012). Home environment relationships with children’s physical activity, sedentary time, and screen time by socioeconomic status. International Journal of Behavioral Nutrition and Physical Activity, 9(88), 1-9. Retrieved from http://www.biomedcentral.com/content/pdf/1479-5868-9-88.pdf Wang, Y. (2001). Cross-national comparison of childhood obesity: The epidemic and the relationship between obesity and socioeconomic status. International Journal of Epidemiology, 30(5), 1129-1136. Retrieved from http://ije.oxfordjournals.org/content/30/5/1129.long Wang, Y., & Beydoun, M.A. (2007). The obesity epidemic in the United States—Gender, age, socioeconomic, racial/ethnic, and geographic characteristics: A systematic review and meta-regression analysis. Epidemiologic Reviews, 29, 6-28. Retrieved from http://www.americanobesity.org/downloads/Obesity_epidemic_USA_By_DR_Wang_JohnHopikens.pdf Whitt-Glover, M.C., Taylor, W.C, Floyd, M.F., Yore, M.M., Yancey, A.K., and Matthews, C.E. (2009). Disparities in physical activity and sedentary behaviors among US Children and adolescents: Prevalence, correlates, and intervention implications. Journal of Public Health Policy, 30(1), S309–S334. Retrieved from http://gogreen.ccs.k12.nc.us/files/2012/07/disparities-in-physical-activity-and-sedentary-behaviors.pdf Read More