Skip to main content
Top
Published in:

03-01-2024 | Obesity | REVIEW

The Role of Racism in Childhood Obesity

Authors: Ralph I. Lawton, Fatima Cody Stanford

Published in: Current Obesity Reports | Issue 1/2024

Login to get access

Abstract

Purpose of Review

Obesity rates continue to rise among children and have shown persistent racial disparities. Racism plays a potentially essential and actionable role in these disparities. This report reviews some mechanisms through which racism may shape childhood obesity.

Recent Findings

From the youngest ages, disparities in childhood obesity prevalence are already present. Racism may shape intergenerational and prenatal factors that affect obesity and various stressors and environments where children grow up. The relationships between clinicians and patients may also be shaped by everyday racism and legacies of past racism, which may affect obesity prevalence and treatment efficacy.

Summary

Comprehensive data on the extent to which racism shapes childhood obesity is limited. However, compelling evidence suggests many ways through which racism ultimately does affect childhood obesity. Interventions to address racism at multiple points where it shapes childhood obesity, including intergenerational and prenatal mechanisms, may help to close disparities.
Literature
3.
go back to reference Ogden CL, Flegal KM. Obesity and socioeconomic status in adults: United States. 2010;2005–2008:50. Ogden CL, Flegal KM. Obesity and socioeconomic status in adults: United States. 2010;2005–2008:50.
19.
go back to reference Crimmins EM, Seeman TE. Integrating biology into the study of health disparities. Popul Dev Rev. 2004;30:89–107. Crimmins EM, Seeman TE. Integrating biology into the study of health disparities. Popul Dev Rev. 2004;30:89–107.
25.
go back to reference Thomas MD, Michaels EK, Reeves AN, et al. Differential associations between everyday versus institution-specific racial discrimination, self-reported health, and allostatic load among black women: implications for clinical assessment and epidemiologic studies. Ann Epidemiol. 2019;35:20–28.e3. https://doi.org/10.1016/j.annepidem.2019.05.002. Thomas MD, Michaels EK, Reeves AN, et al. Differential associations between everyday versus institution-specific racial discrimination, self-reported health, and allostatic load among black women: implications for clinical assessment and epidemiologic studies. Ann Epidemiol. 2019;35:20–28.e3. https://​doi.​org/​10.​1016/​j.​annepidem.​2019.​05.​002.
34.
go back to reference Cullin JM. Biological normalcy and body fat: obesity prevalence, fat stigma, and allostatic load among late adolescents and young adults. Am J Biol Anthropol. 2023 Aug;181(4):575–587. https://doi.org/10.1002/ajpa.24752. Epub 2023 Apr 25. PMID: 37096804. Cullin JM. Biological normalcy and body fat: obesity prevalence, fat stigma, and allostatic load among late adolescents and young adults. Am J Biol Anthropol. 2023 Aug;181(4):575–587. https://​doi.​org/​10.​1002/​ajpa.​24752. Epub 2023 Apr 25. PMID: 37096804.
36.
go back to reference Premji SS, Pana GS, Cuncannon A, Ronksley PE, Dosani A, Hayden KA, Lalani S, Musana JW, Shaikh K, Yim IS; Maternal-infant Global Health Team (MiGHT) Collaborators in Research. Prenatal allostatic load and preterm birth: a systematic review. Front Psychol. 2022 Oct 4;13:1004073. https://doi.org/10.3389/fpsyg.2022.1004073. PMID: 36267082; PMCID: PMC9577361. Premji SS, Pana GS, Cuncannon A, Ronksley PE, Dosani A, Hayden KA, Lalani S, Musana JW, Shaikh K, Yim IS; Maternal-infant Global Health Team (MiGHT) Collaborators in Research. Prenatal allostatic load and preterm birth: a systematic review. Front Psychol. 2022 Oct 4;13:1004073. https://​doi.​org/​10.​3389/​fpsyg.​2022.​1004073. PMID: 36267082; PMCID: PMC9577361.
44.
go back to reference • Epstein LH, Wilfley DE, Kilanowski C, et al. Family-based behavioral treatment for childhood obesity implemented in pediatric primary care: a randomized clinical trial. JAMA. 2023;329(22):1947–56. https://doi.org/10.1001/jama.2023.8061. This recent randomized trial sets a standard for practical interventions for childhood obesity - family centered and in primary care settings. It also finds lower efficacy among Black children enrolled. • Epstein LH, Wilfley DE, Kilanowski C, et al. Family-based behavioral treatment for childhood obesity implemented in pediatric primary care: a randomized clinical trial. JAMA. 2023;329(22):1947–56. https://​doi.​org/​10.​1001/​jama.​2023.​8061. This recent randomized trial sets a standard for practical interventions for childhood obesity - family centered and in primary care settings. It also finds lower efficacy among Black children enrolled.
48.
go back to reference Nardone A, Rudolph KE, Morello-Frosch R, Casey JA. Redlines and greenspace: the relationship between historical redlining and, 2010 greenspace across the United States. Environ Health Perspect. 129(1):017006. https://doi.org/10.1289/EHP7495. Nardone A, Rudolph KE, Morello-Frosch R, Casey JA. Redlines and greenspace: the relationship between historical redlining and, 2010 greenspace across the United States. Environ Health Perspect. 129(1):017006. https://​doi.​org/​10.​1289/​EHP7495.
49.
go back to reference Timmons BW, Naylor PJ, Pfeiffer KA. Physical activity for preschool children — how much and how? This article is part of a supplement entitled Advancing physical activity measurement and guidelines in Canada: a scientific review and evidence-based foundation for the future of Canadian physical activity guidelines co-published by Applied Physiology, Nutrition, and Metabolism and the Canadian Journal of Public Health. It may be cited as Appl. Physiol. Nutr. Metab. 32(Suppl. 2E) or as Can. J. Public Health 98(Suppl. 2). Appl Physiol Nutr Metab. 2007;32(S2E):S122–S134. https://doi.org/10.1139/H07-112. Timmons BW, Naylor PJ, Pfeiffer KA. Physical activity for preschool children — how much and how? This article is part of a supplement entitled Advancing physical activity measurement and guidelines in Canada: a scientific review and evidence-based foundation for the future of Canadian physical activity guidelines co-published by Applied Physiology, Nutrition, and Metabolism and the Canadian Journal of Public Health. It may be cited as Appl. Physiol. Nutr. Metab. 32(Suppl. 2E) or as Can. J. Public Health 98(Suppl. 2). Appl Physiol Nutr Metab. 2007;32(S2E):S122–S134. https://​doi.​org/​10.​1139/​H07-112.
50.
go back to reference • Frakes MD, Gruber J. Racial concordance and the quality of medical care: evidence from the military. 2022. https://doi.org/10.3386/w30767. This study leverages an innovative migration-based study design to causally identify returns to physician-patient racial concordance in chronic disease management.CrossRef • Frakes MD, Gruber J. Racial concordance and the quality of medical care: evidence from the military. 2022. https://​doi.​org/​10.​3386/​w30767. This study leverages an innovative migration-based study design to causally identify returns to physician-patient racial concordance in chronic disease management.CrossRef
66.
70.
go back to reference Mclanahan S, Percheski C. Family structure and the reproduction of inequalities. Ann Rev Sociol. 2008;34:257–76.CrossRef Mclanahan S, Percheski C. Family structure and the reproduction of inequalities. Ann Rev Sociol. 2008;34:257–76.CrossRef
72.
go back to reference •• Merewood A, Bugg K, Burnham L, Krane K, Nickel N, Broom S, Edwards R, Feldman-Winter L. Addressing racial inequities in breastfeeding in the southern United States. Pediatrics. 2019;143(2):e20181897. doi.org/10.1542/peds.2018-1897. This innovative study documents the rollout of comprehensive initiatives to increase the initiation of breastfeeding in a series of hospitals in the Southern US. While the results may have implications for obesity, it also provides large-scale evidence that typifies the type of comprehensive, community and hospital-based interventions that may address the manifestations of racism at multiple points. •• Merewood A, Bugg K, Burnham L, Krane K, Nickel N, Broom S, Edwards R, Feldman-Winter L. Addressing racial inequities in breastfeeding in the southern United States. Pediatrics. 2019;143(2):e20181897. doi.org/10.1542/peds.2018-1897. This innovative study documents the rollout of comprehensive initiatives to increase the initiation of breastfeeding in a series of hospitals in the Southern US. While the results may have implications for obesity, it also provides large-scale evidence that typifies the type of comprehensive, community and hospital-based interventions that may address the manifestations of racism at multiple points.
73.
go back to reference Hemingway S, Forson-Dare Z, Ebeling M, Taylor SN. Racial Disparities in sustaining breastfeeding in a baby-friendly designated Southeastern United States hospital: an opportunity to investigate systemic racism. Breastfeed Med. 2021 Feb;16(2):150–155. https://doi.org/10.1089/bfm.2020.0306. Epub 2021 Feb 4. PMID: 33539272. Hemingway S, Forson-Dare Z, Ebeling M, Taylor SN. Racial Disparities in sustaining breastfeeding in a baby-friendly designated Southeastern United States hospital: an opportunity to investigate systemic racism. Breastfeed Med. 2021 Feb;16(2):150–155. https://​doi.​org/​10.​1089/​bfm.​2020.​0306. Epub 2021 Feb 4. PMID: 33539272.
82.
go back to reference • Gertler P, Gracner T. The sweet life: the long-term effects of a sugar-rich early childhood. 2022. https://doi.org/10.3386/w30799. This study creatively uses changes in early life sugar availability due to rationing to examine the long-term effects on health, and the persistence of dietary preferences formed in childhood.CrossRef • Gertler P, Gracner T. The sweet life: the long-term effects of a sugar-rich early childhood. 2022. https://​doi.​org/​10.​3386/​w30799. This study creatively uses changes in early life sugar availability due to rationing to examine the long-term effects on health, and the persistence of dietary preferences formed in childhood.CrossRef
Metadata
Title
The Role of Racism in Childhood Obesity
Authors
Ralph I. Lawton
Fatima Cody Stanford
Publication date
03-01-2024
Publisher
Springer US
Keywords
Obesity
Obesity
Published in
Current Obesity Reports / Issue 1/2024
Electronic ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-023-00538-9

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.   

Prof. Martha Hickey
Dr. Claudia Barth
Dr. Samar El Khoudary
Developed by: Springer Medicine
Watch now

Keynote webinar | Spotlight on adolescent vaping

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Watch now

Keynote webinar | Spotlight on modern management of frailty

Frailty has a significant impact on health and wellbeing, especially in older adults. Our experts explain the factors that contribute to the development of frailty and how you can manage the condition and reduce the risk of disability, dependency, and mortality in your patients.

Prof. Alfonso Cruz-Jentoft
Prof. Barbara C. van Munster
Prof. Mirko Petrovic
Developed by: Springer Medicine
Watch now

A quick guide to ECGs

Improve your ECG interpretation skills with this comprehensive, rapid, interactive course. Expert advice provides detailed feedback as you work through 50 ECGs covering the most common cardiac presentations to ensure your practice stays up to date. 

PD Dr. Carsten W. Israel
Developed by: Springer Medizin
Start the cases

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Read more