Sustained Obesity And Depressive Symptoms Over 10 Years: Race By Gender Differences In - PowerPoint Presentation

1. Sustained Obesity And Depressive Symptoms Over 10 Years: Race By Gender Differences In The Health And Retirement StudyJulia CarterSite Preceptor: Shervin Assari, MD, MPHFaculty Advisor: Brenda Diergaarde, PhD

2. My Internship Experience MICHR – Michigan Institute for Clinical and Health ResearchSummer Immersion Program 10-week internship experience designed to engage students in clinical, translational, and health disparities research and inspire them to choose a career focused on researchThe program included:Orientation and required training in the protection of human subjects and the responsible conduct of researchWork with a faculty mentor on an ongoing, funded research projectClassroom workTeam projectsVarious experiential learning requirementsA stipend to support full-time commitment (health care expenses are not provided)

3. IntroductionIncreasing prevalence of obesity has become a major public health concern in the United States 1.Although research has consistently shown that obesity impacts psychological well-being 2-4, a growing body of evidence suggests that psychosocial correlates of obesity may depend on race 5-7, gender 7-8, and their intersection 9. It is still, however, unknown whether or not race by gender differences exist in the link between sustained high levels of body mass index (BMI) and psychosocial distress. This study aimed to explore race by gender differences in additive effects of sustained high BMI and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH).

4. MethodsData were used from the time period 2004-2010 of the Health and Retirement Study (HRS), a longitudinal cohort study of a representative sample of American adults over the age of 50 that began in 1992. Measures included: Sustained health problems (BMI, SRH, CES-D, and physical activity)Latent variables were created to demonstrate sustained conditions using three measured cross-sectional time periods (2004, 2006, 2010). The variables were treated as indicators of stable or sustained levels over the 6-year time period. Stability of health problems = long-term vulnerability Univariate and bivariate analysis were done in SPSS 20.0. AMOS 18.0 was used for the multivariable data analysis, where group was defined race by gender.

5. Results Figures 1-a to 1-d illustrate the Structural Equation Model (SEM) for race by gender group. In each of the four figures, the primary paths of interest are exhibited using arrows from sustained BMI to CES-D and sustained BMI to SRH. The secondary paths of interest present arrows from sustained physical activity to CES-D and sustained physical activity to SRH. Group differences were apparent in the association between sustained high BMI and depressive symptoms. No group differences were demonstrated in the associations between sustained physical activity and CES-D, physical activity and SRH, or BMI and SRH.

6. Descriptive Statistics  nMeanSDnMeanSDnMeanSDnMeanSDnMeanSD  All  White Men  White Women  Black Men  Black Women Age (2004)1928067.5110.78670567.5810.25886068.4411.14146864.8710.13224765.3510.72Education (1992)1925712.283.34669412.803.30885012.393.00146710.884.16224611.243.65Income (2004)1928058932.35101032.56670572960.71124145.63886056116.1094500.53146848172.8262464.07224735205.9750845.06Activity 1192611.921.3066992.151.3788521.821.2614651.951.3022451.571.10Activity 2170531.911.3259222.161.4079391.771.2512182.051.3519741.631.15Activity 3140081.961.3147992.161.3565261.841.2610082.141.3616751.731.21BMI 11892627.425.64667627.564.69863026.725.87145327.685.11216729.636.94BMI 21681827.835.83590527.904.85777227.246.10120527.945.18193629.907.18BMI 31385828.015.95479028.135.01642227.436.21100128.125.61164529.817.15CES-D 1174911.501.9859041.151.7382971.572.0312221.682.0120682.072.25CES-D 2159521.522.0054601.171.7575551.612.0510741.671.9218632.072.28CES-D 3129541.381.9343751.091.7161281.451.998961.401.8615551.902.16SRH 1192632.901.1467012.821.1488482.831.1414683.161.1222463.241.08SRH 2170502.901.1359272.801.1179322.841.1312153.111.1219763.281.08SRH 3140382.901.0948112.841.0865402.831.0910103.061.0416773.221.05Table 1. Descriptive statistics in the pooled sample and based on race and gender Body Mass Index (BMI); Self-rated Health (SRH); Depressive Symptoms (CES-D)

7. White MenThe association between BMI and CES-D was marginally significant for White men (B = -.03, p = .062).Figure 1a. SEM for White Men

8. White WomenThe association between BMI and CES-D was significant for White women (B = .03, p = .007).Figure 1a. SEM for White Women

9. Black MenThe association between BMI and CES-D was non-significant among Black men (B = -.02, p = .564).For Black men, age was protective for SRH (B=-.10, p = .007). Figure 1a. SEM for Black Men

10. Black WomenThe association between BMI and CES-D was non-significant among Black women (B = .03, p = .110). Figure 1a. SEM for Black Women

11. DiscussionResilience Jolly Fat Hypothesis Body Image and Behaviors James Jackson’s Law of Small EffectsCorey Keyes ”Black Advantage”

12. Public Health Significance Because culture has shown to have an influence on the association between BMI and health outcomes for Blacks, there are external factors that may need to be addressed when aiming to reduce body mass. Therefore, when developing and implementing clinical interventions and programs, it is crucial to not universalize interventions for Whites to Blacks. To maximize benefits, it is vital that interventions and programs are modified for race and gender to match that of the target population.

13. Conclusion In conclusion, sustained high level of BMI is differentially associated with sustained depressive symptoms across race by gender groups. Depressive symptoms reflect high BMI for White women but not White men, Black men, or Black men. These results indicate that the association between sustained BMI and emotion is not uniform across race and gender, and our group membership greatly alters these associations. Thus, there requires an understanding of culture in order to address this issue, and clinical and public health interventions and programs should be tailored to the target population in order to be effective.

14. Lessons Learned from My Internship Importance of collaboration with and exposure to outside institutionsFaculty mentors and preceptors are great resources in helping students explore their interests Not everyone will agree with your researchKnow the literature Writing is key!

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