Saturday, 14 January 2006 - 2:00 PM

Obesity, Body Weight, and Self-Reported Mental Health: The Double Jeopardy Problem among California Racial Minoriies

Julia F. Hastings, PhD, University of California, Berkeley, Julian Chow, PhD, University of California, Berkeley, and George J. Unick, MSW, University of California, Berkeley.

Purpose: Obesity is highly prevalent among minority groups, African Americans in particular, and has also been positively associated with poor mental health (Flegal, et. al., 1998). Unfortunately, few studies focus on the relationship between ethnic differences in body weight, self-reported mental health, and the social environment. Studies combining these topics show conflicting results, probably due to differences in sampling and measurement. Methods: This study uses data from the 2001 California Health Interview Survey, a population-based telephone survey of adult residents of California (N = 53,697), to assess how body weight affects self-reported mental health among racial and ethnic minorities in California communities. Mental health was assessed using three different items. First, the mental health was measured continuously using the SF12 scale. Secondly, perceived mental health need was dichotomously measured in response to “During the past 12 months, did you think you needed help for emotional or mental health problems, such as feeling sad, blue, anxious or nervous?” Lastly, respondents responded dichotomously to seeking mental health services “In the past 12 months, did a doctor or family physician, nurse, chiropractor or other health clinic staff, talk to you about emotional or mental health problems?” Body Mass Index was calculated using responses to self-reported height and weight (weight [kg]/height [m2]) and divided into four standard categories: underweight, normal weight, overweight, and obese. The social environment was measured as either urban or rural residential location. One ordinary least squares regression model assessed the estimated effect of obesity on mental health for the entire sample measured by the continuous SF-12 measurement, controlling for known covariates. Logistic regression models assessed the effect of obesity on mental health problems for perceived mental health need (yes or no) and sought out mental health services (yes or no). Full models using the entire CHIS sample and separate models were conducted for each of the self identified race categories of African American, Asian American, Hispanic and White for each of the three dependent variables. All statistical analysis utilized replicate weighting. Results: African Americans (36.2%) and Hispanics (26.7%) in metropolitan areas record the highest obesity rates when reporting a mental health problem. Logistic regression analysis revealed a positive relationship between self-reported mental health problems and obesity (OR=1.23, p = .000). Other analysis shows that covariates increasing mental health self-reports include being poor, a woman, lower education, decreased exercise, rating physical health fair or poor, and living in a metropolitan environment. Racial group membership shows no relationship to mental health reports. Implications: The findings highlight how metropolitan social experiences may result in weight gain for African Americans and Hispanics, but diminish mental health problem recognition. Obesity's higher prevalence among poor African Americans calls for intervention strategies that integrate body weight concerns with mental health symptom awareness. Session participants will be able to: 1) identify social and environmental barriers linking body weight and mental health conditions for racially diverse populations; and 2) discuss environment strategies that can provide needed social services to ethnic minorities with weight issues. Word Count: 495

See more of Cultural and Health Disparities among Multi-Ethnic Populations: Findings from the California Health Interview Survey
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