Racial and Ethnic Differences in Obesity in People With Spinal Cord Injury: The Effects of Disadvantaged Neighborhood

Huacong Wen; Amanda L. Botticello; Sejong Bae; Allen W. Heinemann; Mike Boninger; Bethlyn Vergo Houlihan; Yuying Chen

doi:10.1016/j.apmr.2019.02.008

Racial and Ethnic Differences in Obesity in People With Spinal Cord Injury: The Effects of Disadvantaged Neighborhood

Huacong Wen, Amanda L. Botticello, Sejong Bae, Allen W. Heinemann, Mike Boninger, Bethlyn Vergo Houlihan, Yuying Chen^*

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objective: To examine the role of neighborhood in the relation between race and obesity in people with spinal cord injury (SCI). Design: A cross-sectional analysis of survey data from National SCI Database linked with neighborhood data from American Community Survey by census tract. Setting: A total of 17 SCI Model Systems centers. Participants: Individuals (N=3385; 2251 non-Hispanic whites, 760 non-Hispanic blacks, 374 Hispanics) who completed a follow-up assessment during 2006-2017 (mean duration of injury, 8.3±9.9y) and resided in 2934 census tracts. Intervention: Not applicable. Main Outcome Measures: Body mass index (BMI) (kg/m²). Results: The overall prevalence of obesity was 52.9% (BMI≥25.0) and 23.3% (BMI≥30.0). Hispanics were 67.0% more likely to be obese (BMI≥30.0 kg/m²) relative to non-Hispanic whites (odds ratio, 1.67; 95% confidence interval, 1.27-2.18), after controlling for demographic and injury-related characteristics. Most of the non-Hispanic blacks (66.8%) were living in neighborhoods with high concentrated disadvantaged index (CDI), compared to 35.0% of Hispanics and 9.2% of non-Hispanic whites living in this similar neighborhood status (P<.0001). After accounting for CDI, the odds of being obese in Hispanics decreased (odds ratio, 1.51; 95% confidence interval, 1.15-1.99). Regardless of race and ethnicity, people with SCI from disadvantaged neighborhoods were 42.0%-70.0% more likely to be obese than those from minimal CDI neighborhoods. Conclusions: Neighborhood characteristics partially diminish racial differences in obesity. Weight management for the SCI population should target those who are Hispanic and living in the disadvantaged neighborhoods.

Original language	English (US)
Pages (from-to)	1599-1606
Number of pages	8
Journal	Archives of physical medicine and rehabilitation
Volume	100
Issue number	9
DOIs	https://doi.org/10.1016/j.apmr.2019.02.008
State	Published - Sep 2019

Funding

Supported by the National Institute of Minority Health and Health Disparities (grant no. U54MD008176), the Eunice Kennedy Shriver National Institute of Child Health & Human Development (grant no. 4R00HD065957-03), and the National Institutes on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. 90DP0083). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government. Supported by the National Institute of Minority Health and Health Disparities (grant no. U54MD008176), the Eunice Kennedy Shriver National Institute of Child Health & Human Development (grant no. 4R00HD065957-03), and the National Institutes on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. 90DP0083). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government. Supported by the National Institute of Minority Health and Health Disparities (grant no. U54MD008176), the Eunice Kennedy Shriver National Institute of Child Health & Human Development (grant no. 4R00HD065957-03), and the National Institutes on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. 90DP0083). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.

Keywords

Health status disparities
Minority health
Obesity
Rehabilitation
Residence characteristics
Spinal cord injuries

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.apmr.2019.02.008

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title = "Racial and Ethnic Differences in Obesity in People With Spinal Cord Injury: The Effects of Disadvantaged Neighborhood",

abstract = "Objective: To examine the role of neighborhood in the relation between race and obesity in people with spinal cord injury (SCI). Design: A cross-sectional analysis of survey data from National SCI Database linked with neighborhood data from American Community Survey by census tract. Setting: A total of 17 SCI Model Systems centers. Participants: Individuals (N=3385; 2251 non-Hispanic whites, 760 non-Hispanic blacks, 374 Hispanics) who completed a follow-up assessment during 2006-2017 (mean duration of injury, 8.3±9.9y) and resided in 2934 census tracts. Intervention: Not applicable. Main Outcome Measures: Body mass index (BMI) (kg/m2). Results: The overall prevalence of obesity was 52.9% (BMI≥25.0) and 23.3% (BMI≥30.0). Hispanics were 67.0% more likely to be obese (BMI≥30.0 kg/m2) relative to non-Hispanic whites (odds ratio, 1.67; 95% confidence interval, 1.27-2.18), after controlling for demographic and injury-related characteristics. Most of the non-Hispanic blacks (66.8%) were living in neighborhoods with high concentrated disadvantaged index (CDI), compared to 35.0% of Hispanics and 9.2% of non-Hispanic whites living in this similar neighborhood status (P<.0001). After accounting for CDI, the odds of being obese in Hispanics decreased (odds ratio, 1.51; 95% confidence interval, 1.15-1.99). Regardless of race and ethnicity, people with SCI from disadvantaged neighborhoods were 42.0%-70.0% more likely to be obese than those from minimal CDI neighborhoods. Conclusions: Neighborhood characteristics partially diminish racial differences in obesity. Weight management for the SCI population should target those who are Hispanic and living in the disadvantaged neighborhoods.",

keywords = "Health status disparities, Minority health, Obesity, Rehabilitation, Residence characteristics, Spinal cord injuries",

author = "Huacong Wen and Botticello, {Amanda L.} and Sejong Bae and Heinemann, {Allen W.} and Mike Boninger and Houlihan, {Bethlyn Vergo} and Yuying Chen",

note = "Publisher Copyright: {\textcopyright} 2019 American Congress of Rehabilitation Medicine",

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T1 - Racial and Ethnic Differences in Obesity in People With Spinal Cord Injury

T2 - The Effects of Disadvantaged Neighborhood

AU - Wen, Huacong

AU - Botticello, Amanda L.

AU - Bae, Sejong

AU - Heinemann, Allen W.

AU - Boninger, Mike

AU - Houlihan, Bethlyn Vergo

AU - Chen, Yuying

PY - 2019/9

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N2 - Objective: To examine the role of neighborhood in the relation between race and obesity in people with spinal cord injury (SCI). Design: A cross-sectional analysis of survey data from National SCI Database linked with neighborhood data from American Community Survey by census tract. Setting: A total of 17 SCI Model Systems centers. Participants: Individuals (N=3385; 2251 non-Hispanic whites, 760 non-Hispanic blacks, 374 Hispanics) who completed a follow-up assessment during 2006-2017 (mean duration of injury, 8.3±9.9y) and resided in 2934 census tracts. Intervention: Not applicable. Main Outcome Measures: Body mass index (BMI) (kg/m2). Results: The overall prevalence of obesity was 52.9% (BMI≥25.0) and 23.3% (BMI≥30.0). Hispanics were 67.0% more likely to be obese (BMI≥30.0 kg/m2) relative to non-Hispanic whites (odds ratio, 1.67; 95% confidence interval, 1.27-2.18), after controlling for demographic and injury-related characteristics. Most of the non-Hispanic blacks (66.8%) were living in neighborhoods with high concentrated disadvantaged index (CDI), compared to 35.0% of Hispanics and 9.2% of non-Hispanic whites living in this similar neighborhood status (P<.0001). After accounting for CDI, the odds of being obese in Hispanics decreased (odds ratio, 1.51; 95% confidence interval, 1.15-1.99). Regardless of race and ethnicity, people with SCI from disadvantaged neighborhoods were 42.0%-70.0% more likely to be obese than those from minimal CDI neighborhoods. Conclusions: Neighborhood characteristics partially diminish racial differences in obesity. Weight management for the SCI population should target those who are Hispanic and living in the disadvantaged neighborhoods.

AB - Objective: To examine the role of neighborhood in the relation between race and obesity in people with spinal cord injury (SCI). Design: A cross-sectional analysis of survey data from National SCI Database linked with neighborhood data from American Community Survey by census tract. Setting: A total of 17 SCI Model Systems centers. Participants: Individuals (N=3385; 2251 non-Hispanic whites, 760 non-Hispanic blacks, 374 Hispanics) who completed a follow-up assessment during 2006-2017 (mean duration of injury, 8.3±9.9y) and resided in 2934 census tracts. Intervention: Not applicable. Main Outcome Measures: Body mass index (BMI) (kg/m2). Results: The overall prevalence of obesity was 52.9% (BMI≥25.0) and 23.3% (BMI≥30.0). Hispanics were 67.0% more likely to be obese (BMI≥30.0 kg/m2) relative to non-Hispanic whites (odds ratio, 1.67; 95% confidence interval, 1.27-2.18), after controlling for demographic and injury-related characteristics. Most of the non-Hispanic blacks (66.8%) were living in neighborhoods with high concentrated disadvantaged index (CDI), compared to 35.0% of Hispanics and 9.2% of non-Hispanic whites living in this similar neighborhood status (P<.0001). After accounting for CDI, the odds of being obese in Hispanics decreased (odds ratio, 1.51; 95% confidence interval, 1.15-1.99). Regardless of race and ethnicity, people with SCI from disadvantaged neighborhoods were 42.0%-70.0% more likely to be obese than those from minimal CDI neighborhoods. Conclusions: Neighborhood characteristics partially diminish racial differences in obesity. Weight management for the SCI population should target those who are Hispanic and living in the disadvantaged neighborhoods.

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KW - Minority health

KW - Obesity

KW - Rehabilitation

KW - Residence characteristics

KW - Spinal cord injuries

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Racial and Ethnic Differences in Obesity in People With Spinal Cord Injury: The Effects of Disadvantaged Neighborhood

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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