Measuring Progress in Obesity Prevention Workshop Report (2012) / Chapter Skim
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7 Disparities and Measurement
7 Disparities and Measurement
Pages 91-112
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From page 91... ...
• It is important to look across both populations groups and types of data to understand physical activity patterns and ways to increase activity levels. • Food marketers have extremely sophisticated means of under standing the interests and needs of various populations and are particularly adept at targeting ethnic and racial minority groups.
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From page 92... ...
Figure 7-1 shows changes in the population percentage at or above a body mass index (BMI) of 30 for African American, Mexican American, and white males and females between 1960 and 2004.
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Persons of Hispanic origin were excluded from the data for whites and blacks from 1976 onward. Data for Mexican Americans shown for 1976-1980 are from the Hispanic Health and Nutrition Examination Survey (1980-1982)
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NOTE: Obesity is defined for children and adolescents as a body mass index (BMI) at or above the 95th percentile on the age- and sex-specific 2000 Centers for Disease 7-3.eps Control and Prevention (CDC)
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From page 95... ...
DISPARITIES RELATED TO DIET Presenter: Sarah Samuels The availability of healthy and unhealthy foods is a key factor in disparities in weight and health, explained Samuels. Despite efforts to curtail the availability of unhealthy foods, one need not travel far in the United
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From page 96... ...
96 • Aesthetic, moral, religious, and social values • Collective psychology Cultural and • Literary expressions Psychosocial Processes Balance • Historical legacy of • Social processes • Media and Calorie in families and marketing Intake communities • Built environment and • Food costs Output Historical Physical and and Economic Social Environments Contexts FIGURE 7-5 Community perspective on obesity influences. 7-5.eps SOURCE: Adapted from Kumanyika et al., 2007.
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From page 97... ...
Individuals make many decisions about diet within the contexts of school, neighborhood, and the workplace, and unhealthy foods are dominant among the available choices in many communities. Community-wide programs, Samuels explained, can create a seamless environment for children, promoting healthier choices wherever they go, and can have a much broader reach than programs focused on changing behavior at the individual level.
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From page 98... ...
A second initiative evaluated -- the Central California Regional Obesity Prevention Program (CCROPP) -- worked in a similar way in eight counties in the Central Valley of California, an area in which there are significant health disparities related to access to both healthy foods and physical activity opportunities, exacerbated by issues of racism and immigration (Samuels & Associates, 2010b; Schwarte et al., 2010)
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From page 99... ...
Looking at effects in the wider community, Samuels noted that innovation resulting from the programs created new venues for the sale of fresh and locally grown produce. Community residents reported making use of farmers' markets and produce stands, and the proportion of advertisements for healthy foods inside stores increased three-fold (although the percentage of such advertisements outside of stores decreased)
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From page 100... ...
Wall Center Varieties Notes Bread - Whole wheat/whole grain Bread - Refined flour/white bread Cereal - <7g sugar per serving and whole grain Cereal - ≥7g sugar per serving and not whole grain Cheese - Regular Cheese - Light/Reduced Fat Fruit- Dried (no sugar added) Fruit - Fresh whole fruit Fruit - Fresh ready-to-eat cut up fruit
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From page 101... ...
Rice - Brown Rice - White Tortilla - Whole wheat/whole grain Tortilla - Refined flour Vegetables - Fresh whole vegetables Vegetables - Fresh ready-to-eat cut-up vegetables Vegetables - Canned (packed in water, no added fat) Vegetables - Frozen (no added fat)
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From page 102... ...
102 FIGURE 7-6 Food choices available in a store analyzed using the Store Assessment Tool. SOURCE: Samuels & Associates, 2010a.
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From page 103... ...
Crespo Obesity "shows up at the doctor's office," Crespo noted, "but the solution is a community solution." There is little a doctor can do for an individual, but the community can do much more, he added, echoing a major theme of the workshop. Changing behaviors and environments at the community level is as complex as is applying the standard scientific approach of using randomized controlled trials to identify the most effective interventions.
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From page 104... ...
. Non-Hispanic black children are the most likely to watch 4 or more hours of television per day -- nearly 40 percent do so as compared with 25-30 percent of Mexican American children, approximately 12 percent of non-Hispanic white girls, and approximately 17 percent of non-Hispanic white boys (there is little gender difference for the other two groups)
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From page 105... ...
Subjective measures have more practical applicability, Crespo suggested, but they do not reflect total energy expenditure and can easily be misinterpreted. Thus to understand physical activity patterns, it is important to look across groups (for example, gender, age, and race/ethnicity)
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From page 106... ...
Moreover, "we need to be able to better capture physical activity and energy expenditure in the workplace," he observed, and "we need to do a much better job of calculating different types of physical activity in different populations." THE ROLE OF MARKETING IN DISPARITIES Presenter: Sonya Grier Marketing is a system designed to influence consumers' choices and consumption, Grier explained. Marketing shapes awareness of and access to food and beverage products, as well as the prices consumers pay.
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From page 107... ...
as well as nationally, through television and the Internet. Research suggests that targeted marketing may predispose minority consumers to poor-quality diets and also limit the effectiveness of general prevention initiatives, Grier noted (Grier and Kumanyika, 2008)
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From page 108... ...
Second, one would want to know whether a particular group is the target of excessive marketing and whether that exposure is influencing the group's behavior. With these questions in mind, Grier and Kumanyika conducted a systematic review of the marketing environments of African American consumers, looking particularly at whether they are more likely than white consumers to be targeted by marketing of unhealthy foods (Grier and Kumanyika, 2008)
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From page 109... ...
makes people more likely to identify with distinctive traits or personalities they associate with their group, and thus respond more favorably to targeted advertising. It may also be, Grier added, that ethnic minority consumers respond to nontargeted advertising differently as well.
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From page 110... ...
While nutrition researchers think poorly of fast-food restaurants, for example, they can provide play spaces, places to congregate, and employment within their neighborhoods, and community members may value them and their products in ways that research does not capture. One participant asked whether there is clear evidence that targeted marketing results directly in obesity, and another asked whether targeted marketing of healthful behaviors could work as well as the marketing of unhealthy foods appears to work.
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From page 111... ...
2000. Race/ ethnicity, social class and their relation to physical inactivity during leisure time: Results from the Third National Health and Nutrition Examination Survey, 1988-1994.
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From page 112... ...
2010. The central California regional obesity prevention program: Changing nutrition and physi cal activity environments in California's heartland.
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