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 LaCoeclacoe@uci.edu

Department of Psychology and Social Department of Psychology and Social BehaviorBehavior

School of Social EcologySchool of Social EcologyUniversity of California, IrvineUniversity of California, Irvine