Defense Date

2006

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Public Policy & Administration

First Advisor

Dr. Judith B. Bradford

Abstract

Using data from the Black Women's Health Study (BWHS) and building on what is currently known about perceptions of racism and discrimination and its mechanisms, this study attempts to demonstrate the value of identifying additional variables that may serve as potential risk factors for obesity among African American women. Using secondary data analysis, the purpose of this study was to expand the scope of existing obesity research by examining a 1997 cross-sectional dataset of self-reported questionnaire responses among a random sample of African American women enrolled in the Black Women's Health Study (BWHS) to examine the association between perceptions of racism and discrimination within 3 domains (e.g., perceived racism, institutional racism, race consciousness) and body mass index (BMI) after controlling for selected sociodemographic, psychological, behavioral, and reproductive factors. The general hypothesis of the study was that self-reported responses to perceptions and experiences of racism and discrimination would be significantly associated with differences in weight (as measured by BMI) among the sample utilized for the current study. A convenience sample of 5,044 African American women enrolled in the BWHS was included for analysis in this non-probability cross-sectional study. A biopsychosocial theoretical framework was used to understand the unique role of perceived racism, institutional racism and race consciousness had on body mass index (BMI) among the BWHS cohort. These factors were examined because of their relevance to African American females' experiences. The data were analyzed through hierarchical multiple and logistic regression through SPSS 14.0.The major findings of this research indicate that a large random sample of African American women enrolled in the Black Women's Health Study found a clear relationship between perceived racism and body mass index (BMI). Results revealed consistent with the study's main hypothesis that self-reported responses to perceptions and experiences of racial discrimination would be significantly associated with differences in weight (as measured by BMI), the summary variable for perceived racism was significantly correlated with body mass index (BMI) among the BWHS cohort. Elevated odds ratios were observed for the variable that summarized perceived racism. Elevated odds ratios were also observed for most of the individual perceived racism questions. Results also revealed the variable for race consciousness was a significant individual predictor of body mass index (BMI) among the sample. Notably, perceptions and experiences of racial discrimination did not predict differences in the level of obesity among the sample. Overall, the finding that the summary variable for perceived racism was predictive of the odds of being obese (BMI > 30kg/m') vs. non-obese (BMI ≥ 30kg/m 2 ) in the regression analyses, even in the presence of other theoretically related variables, provides strong support for the unique role of perceived racism as a risk factor for obesity in African American women. The major implications of this research include (a) gaining a better understanding of the factors associated with perceived racial discrimination and reported frequency among African American women; (b) use of social health indicators in Healthy People 2010 and 2020 that consider the influence of racial discrimination in health outcomes that can be used to develop strategies to generate public dialogue and create a better defined policy landscape and health agenda informed by social justice and reflects multiple levels of influence (e.g., individual behavior, community or neighborhood attributes, and broad policy change) as it pertains to the ethnic and racial disparity in obesity; lends further support to both HP2010 and HP2020 goals and objectives for future policy actions to guide the development of culturally competent prevention programming aimed at reducing the prevalence of obesity among African American women; (c) recognition of race-related stress as a contributing risk factor for obesity in African American women; (d) recognition of the need to improve the measurement of perceived racial discrimination through questions that adequately measure the stress and coping related to the experiences of racism; (e) better restructuring of selected agencies that fund health research to broaden research topics regarding African American women as a homogeneous group; and (f) expansion of the U.S. healthcare system to incorporate established cultural competence guidelines and practices to address social and structural causes of race-related stressors that negatively impact the health status of African American women and similar minority populations at-risk for obesity.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008

Share

COinS