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Moderators in the Relationship between the Socioeconomic Status and Health Behaviors of Individuals in Early Adulthood. Cynthia LaCoe Advisor: Dr. JoAnn Prause UROP Symposium May 31, 2007 Department of Psychology and Social Behavior School of Social Ecology University of California, Irvine. - PowerPoint PPT Presentation
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Moderators in the Relationship Moderators in the Relationship between the Socioeconomic between the Socioeconomic
Status and Health Behaviors of Status and Health Behaviors of Individuals in Early AdulthoodIndividuals in Early Adulthood
Cynthia LaCoeCynthia LaCoeAdvisor: Dr. JoAnn PrauseAdvisor: Dr. JoAnn PrauseUROP Symposium May 31, 2007UROP Symposium May 31, 2007Department of Psychology and Social BehaviorDepartment of Psychology and Social BehaviorSchool of Social EcologySchool of Social EcologyUniversity of California, IrvineUniversity of California, Irvine
OverviewOverview
What is SES?What is SES? What are health behaviors?What are health behaviors? What do we know?What do we know? HypothesesHypotheses Study DesignStudy Design FindingsFindings ImplicationsImplications
Common measures of SES:Common measures of SES: *Income*Income *Educational attainment*Educational attainment Occupational statusOccupational status
SSocioeconomicocioeconomic SStatustatus
(SES)(SES)
SES: An individual’s economic ranking in SES: An individual’s economic ranking in relation to others in his/her society relation to others in his/her society (North Central Regional (North Central Regional
Educational Laboratory, 2004)Educational Laboratory, 2004)
Health BehaviorsHealth Behaviors
*Food Consumption*Food Consumption
*Physical Activity*Physical Activity
*Sedentary Activity*Sedentary Activity
RelaxationRelaxation
Sexual ActivitySexual Activity
Substance UseSubstance Use
Health Behaviors:Health Behaviors: Food ConsumptionFood Consumption
http://www.nal.usda.gov/fnic/Fpyr/pmap.htm
Health Behaviors:Health Behaviors:Physical & Sedentary ActivityPhysical & Sedentary Activity
Physical ActivityPhysical Activity Definition: Bodily activity done to develop and maintain Definition: Bodily activity done to develop and maintain
physical fitness and overall healthphysical fitness and overall health Recommendations Recommendations
Vigorous:Vigorous: 20 min 3 days a week 20 min 3 days a week Moderate:Moderate: 30 min 5 days a wk 30 min 5 days a wk Strength Training:Strength Training: 8-12 reps for each of 8-10 muscle groups 8-12 reps for each of 8-10 muscle groups
on 2 non-consecutive dayson 2 non-consecutive days(Circulation, 2007; Cygan, 2008)(Circulation, 2007; Cygan, 2008)
Sedentary ActivitySedentary Activity Definition: Activity that requires little or no physical activity
(e.g., watching T.V., playing video games, using a computer)
Recommendations: Limit engagement
HHealthealth BBehaviorsehaviors && HHealthealth
SStatustatusOverweight and ObesityOverweight and Obesity
Root Cause: Root Cause: Energy ImbalanceEnergy Imbalance Over ConsumptionOver Consumption Inadequate ExpenditureInadequate Expenditure
PrevalencePrevalence 33% and 34% of U.S. Residents 33% and 34% of U.S. Residents (CDC, 2007)(CDC, 2007) Higher among individuals of lower SES Higher among individuals of lower SES (McLaeren, 2007)(McLaeren, 2007)
ComorbiditiesComorbidities CancerCancer DiabetesDiabetes Heart diseaseHeart disease StrokeStroke
SES and Health BehaviorsSES and Health Behaviors
SES is associated withSES is associated with Education and health knowledgeEducation and health knowledge Access to supermarkets and high quality Access to supermarkets and high quality
grains and producegrains and produce Purchase of high calorie foods Purchase of high calorie foods (Turrell & Kavanagh, (Turrell & Kavanagh,
2006; Jetter & Cassady, 2006)2006; Jetter & Cassady, 2006)
Levels of physical activity Levels of physical activity (Wen, Browning, & Cagney, (Wen, Browning, & Cagney, 2007)2007)
HypothesesHypotheses
How does SES influence health How does SES influence health behaviors?behaviors? HH11: SES will directly effect health behaviors.: SES will directly effect health behaviors.
Does the relationship between SES and Does the relationship between SES and health behaviors depend on ethnicity or health behaviors depend on ethnicity or gender?gender? HH22: Ethnicity and gender moderate the effect : Ethnicity and gender moderate the effect
of SES on health behaviors.of SES on health behaviors.
Study DesignStudy Design
Secondary Analysis of NHANES DataSecondary Analysis of NHANES Data NHANES 2003-2004NHANES 2003-2004
Sample MethodsSample Methods Stratified, MultistageStratified, Multistage 10,122 Non-institutionalized U.S. residents10,122 Non-institutionalized U.S. residents Survey (Phone, Face-to-face), Examination (MEC), Survey (Phone, Face-to-face), Examination (MEC),
Laboratory (MEC)Laboratory (MEC)
Participant EligibilityParticipant Eligibility 22 - 32 years of age22 - 32 years of age
SampleSample Marital Status:
39.4% Married .3% Widowed 3.2% Divorced 2.5% Separated 39.1% Never married 15.5% Living with a partner
Sample Size = 800Sample Size = 800 45.4% Males45.4% Males EthnicityEthnicity
44.9% Non Hispanic White44.9% Non Hispanic White 23.4% Non Hispanic Black23.4% Non Hispanic Black 22.6% Mexican American22.6% Mexican American 9.1% Other, Multiracial9.1% Other, Multiracial
Mean Age = 27.1Mean Age = 27.1 Health Insurance: 67.9% Employed: 72.3% Mean BMI = 27.9Mean BMI = 27.9
Sample Cont’d
MeasuresMeasuresConstruct(s)Construct(s) Variable(s)Variable(s)
Dependent Diet
Physical Activities
Sedentary Activities
(Un)healthy Food Frequencies
Moderate, Vigorous, & Strengthening Activities
T.V. and Computer/Game usage
Independent SES Income, Education
Moderating Ethnicity
Gender------
Covariates
------
Age
BMI
Health Insurance
Employment Status
Marital Status
FindingsFindings
Income Positively associated with time spent in
moderate activities Negatively associated with hours spent in
sedentary activities
How does SES influence health behaviors?How does SES influence health behaviors?
Findings Cont’d
Compared with a high school education Less than a high school education was associated with
Less time spent in moderate activities Higher consumption of fruits Higher consumption of vegetables
More than a high school education was associated with Less time spent in moderate activities More time spent in sedentary activities Higher consumption of vegetables Higher consumption of whole grains Lower consumption of white bread
How does SES influence health behaviors?How does SES influence health behaviors?
Findings Cont’dFindings Cont’d
Ethnicity:Ethnicity: IncomeIncome
Strengthening Activities:Strengthening Activities: Positively associated among Positively associated among Mexican Americans, but not among Non Mexican Mexican Americans, but not among Non Mexican AmericansAmericans
Education Education Fruit Consumption:Fruit Consumption: Mexican Americans with less than a Mexican Americans with less than a
high school education consumed more fruit than those high school education consumed more fruit than those with a high school education, no association among with a high school education, no association among Non Mexican AmericansNon Mexican Americans
Does the relationship between SES and health Does the relationship between SES and health behaviors depend on ethnicity or gender?behaviors depend on ethnicity or gender?
Findings Cont’d
Gender Gender IncomeIncome
Vigorous Activities:Vigorous Activities: Females with higher incomes engaged in Females with higher incomes engaged in more activities; negative relationship among malesmore activities; negative relationship among males
Strengthening Activities:Strengthening Activities: Females with higher incomes Females with higher incomes engaged in more activities; virtually no association among engaged in more activities; virtually no association among malesmales
Soft Drink Consumption:Soft Drink Consumption: Higher income females drank more Higher income females drank more diet soft drinks than regular soft drinks; virtually no diet soft drinks than regular soft drinks; virtually no association among malesassociation among males
EducationEducation White bread:White bread: Females with less than a high school education Females with less than a high school education
consumed more white bread than did those with a high school consumed more white bread than did those with a high school education; no significant association among maleseducation; no significant association among males
Does the relationship between SES and health Does the relationship between SES and health behaviors depend on ethnicity or gender?behaviors depend on ethnicity or gender?
LimitationsLimitations
Educational attainment recoded broadlyEducational attainment recoded broadly (i.e., less than high school, high school degree or (i.e., less than high school, high school degree or equivalent, more than high school vs. K-doctoral degree)equivalent, more than high school vs. K-doctoral degree)
Serving size(s) of food variablesServing size(s) of food variables
Barriers to physical activityBarriers to physical activity (e.g., neighborhood (e.g., neighborhood characteristics such as safety)characteristics such as safety)
Sample sizeSample size
ImplicationsImplications
ResearchResearch Role of acculturation in the effects of ethnicity on the Role of acculturation in the effects of ethnicity on the
relationship between SES and health behaviors relationship between SES and health behaviors Ways in which education and income influence sedentary Ways in which education and income influence sedentary
activitiesactivities
PolicyPolicy Incorporate more health education into high school curriculumsIncorporate more health education into high school curriculums Fund basic research and intervention programs with specific Fund basic research and intervention programs with specific
target audiencestarget audiences
Outreach Programs Outreach Programs Identify a target populationIdentify a target population Develop population appropriate educational materials and Develop population appropriate educational materials and
interventionsinterventions
AcknowledgementsAcknowledgements
Thank you:Thank you:
Dr. JoAnn PrauseDr. JoAnn Prause
Dr. Valerie JennessDr. Valerie Jenness
SE Honors 2007-2008 CohortSE Honors 2007-2008 Cohort
UROP UROP
National Center for Health StatisticsNational Center for Health Statistics
Contact InformationContact Information
Cynthia LaCoeCynthia [email protected]
Department of Psychology and Social Department of Psychology and Social BehaviorBehavior
School of Social EcologySchool of Social EcologyUniversity of California, IrvineUniversity of California, Irvine