Moderators in the Relationship between the Socioeconomic Status and Health Behaviors of Individuals in Early Adulthood

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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

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Overview

• What is SES?
• What are health behaviors?
• What do we know?
• Hypotheses
• Study Design
• Findings
• Implications

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Socioeconomic Status (SES)

• SES An individuals economic ranking in
  relation to others in his/her society (North
  Central Regional Educational Laboratory, 2004)

• Common measures of SES
• Income
• Educational attainment
• Occupational status

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Health Behaviors

• Food Consumption
• Physical Activity
• Sedentary Activity
• Relaxation
• Sexual Activity
• Substance Use

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Health Behaviors Food Consumption
http//www.nal.usda.gov/fnic/Fpyr/pmap.htm
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Health Behaviors Physical Sedentary Activity

• Physical Activity
• Definition Bodily activity done to develop and
  maintain physical fitness and overall health
• Recommendations
• Vigorous 20 min 3 days a week
• Moderate 30 min 5 days a wk
• Strength Training 8-12 reps for each of 8-10
  muscle groups on 2 non-consecutive days
• (Circulation, 2007 Cygan, 2008)
• Sedentary Activity
• Definition Activity that requires little or no
  physical activity (e.g., watching T.V., playing
  video games, using a computer)
• Recommendations Limit engagement

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Health Behaviors Health Status

• Overweight and Obesity
• Root Cause Energy Imbalance
• Over Consumption
• Inadequate Expenditure
• Prevalence
• 33 and 34 of U.S. Residents (CDC, 2007)
• Higher among individuals of lower SES (McLaeren,
  2007)
• Comorbidities
• Cancer
• Diabetes
• Heart disease
• Stroke

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SES and Health Behaviors

• SES is associated with
• Education and health knowledge
• Access to supermarkets and high quality grains
  and produce
• Purchase of high calorie foods (Turrell
  Kavanagh, 2006 Jetter Cassady, 2006)
• Levels of physical activity (Wen, Browning,
  Cagney, 2007)

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Hypotheses

• How does SES influence health behaviors?
• H1 SES will directly effect health behaviors.
• Does the relationship between SES and health
  behaviors depend on ethnicity or gender?
• H2 Ethnicity and gender moderate the effect of
  SES on health behaviors.

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Study Design

• Secondary Analysis of NHANES Data
• NHANES 2003-2004
• Sample Methods
• Stratified, Multistage
• 10,122 Non-institutionalized U.S. residents
• Survey (Phone, Face-to-face), Examination (MEC),
  Laboratory (MEC)
• Participant Eligibility
• 22 - 32 years of age

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Sample

• 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 800
• 45.4 Males
• Ethnicity
• 44.9 Non Hispanic White
• 23.4 Non Hispanic Black
• 22.6 Mexican American
• 9.1 Other, Multiracial
• Mean Age 27.1
• Health Insurance 67.9
• Employed 72.3
• Mean BMI 27.9

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Sample Contd
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Measures
Construct(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
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Findings
How does SES influence health behaviors?

• Income
• Positively associated with time spent in moderate
  activities
• Negatively associated with hours spent in
  sedentary activities

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Findings Contd
How does SES influence health behaviors?

• 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

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Findings Contd
Does the relationship between SES and health
behaviors depend on ethnicity or gender?

• Ethnicity
• Income
• Strengthening Activities Positively associated
  among Mexican Americans, but not among Non
  Mexican Americans
• Education
• Fruit Consumption Mexican Americans with less
  than a high school education consumed more fruit
  than those with a high school education, no
  association among Non Mexican Americans

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Findings Contd
Does the relationship between SES and health
behaviors depend on ethnicity or gender?

• Gender
• Income
• Vigorous Activities Females with higher incomes
  engaged in more activities negative relationship
  among males
• Strengthening Activities Females with higher
  incomes engaged in more activities virtually no
  association among males
• Soft Drink Consumption Higher income females
  drank more diet soft drinks than regular soft
  drinks virtually no association among males
• Education
• White bread Females with less than a high school
  education consumed more white bread than did
  those with a high school education no
  significant association among males

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Limitations

• Educational attainment recoded broadly (i.e.,
  less than high school, high school degree or
  equivalent, more than high school vs. K-doctoral
  degree)
• Serving size(s) of food variables
• Barriers to physical activity (e.g., neighborhood
  characteristics such as safety)
• Sample size

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Implications

• Research
• Role of acculturation in the effects of ethnicity
  on the relationship between SES and health
  behaviors
• Ways in which education and income influence
  sedentary activities

• Policy
• Incorporate more health education into high
  school curriculums
• Fund basic research and intervention programs
  with specific target audiences

• Outreach Programs
• Identify a target population
• Develop population appropriate educational
  materials and interventions

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Acknowledgements

• Thank you
• Dr. JoAnn Prause
• Dr. Valerie Jenness
• SE Honors 2007-2008 Cohort
• UROP
• National Center for Health Statistics

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Contact Information

• Cynthia LaCoe
• clacoe_at_uci.edu
• Department of Psychology and Social Behavior
• School of Social Ecology
• University of California, Irvine