Preventing Chronic Disease | Relationship Between Social Support and Body Mass Index Among Overweight and Obese African American Women in the Rural Deep South, 2011–2013 - CDC
Relationship Between Social Support and Body Mass Index Among Overweight and Obese African American Women in the Rural Deep South, 2011–2013
Erica R. Johnson, MSPH; Tiffany L. Carson, PhD; Olivia Affuso, PhD; Claudia M. Hardy, MPA; Monica L. Baskin, PhD
Suggested citation for this article: Johnson ER, Carson TL, Affuso O, Hardy CM, Baskin ML. Relationship Between Social Support and Body Mass Index Among Overweight and Obese African American Women in the Rural Deep South, 2011–2013. Prev Chronic Dis 2014;11:140340. DOI: http://dx.doi.org/10.5888/pcd11.140340
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Abstract
Introduction
African American women in the Deep South of the United States are disproportionately obese, a condition strongly influenced by their social environment. The objective of this study was to characterize the prevalence of social support from family and friends for healthy eating and exercise in rural communities.
African American women in the Deep South of the United States are disproportionately obese, a condition strongly influenced by their social environment. The objective of this study was to characterize the prevalence of social support from family and friends for healthy eating and exercise in rural communities.
Methods
This study is an analysis of a subgroup (N = 195) of overweight and obese African American women from a larger ongoing weight loss trial (N = 409) in rural communities of the Alabama Black Belt and Mississippi Delta. The Social Support and Eating Habits Survey and Social Support and Exercise Survey were used to measure support from family and friends for healthy eating and exercise, respectively. Linear regression was conducted to determine the association between social support factors and body mass index (BMI).
This study is an analysis of a subgroup (N = 195) of overweight and obese African American women from a larger ongoing weight loss trial (N = 409) in rural communities of the Alabama Black Belt and Mississippi Delta. The Social Support and Eating Habits Survey and Social Support and Exercise Survey were used to measure support from family and friends for healthy eating and exercise, respectively. Linear regression was conducted to determine the association between social support factors and body mass index (BMI).
Results
Concurrently prevalent in our sample were encouraging support for healthy eating (family, median,14.0; range, 5.0–25.0; friends, median, 13.0; range 5.0–25.0) and discouraging support for healthy eating (family, median, 12.0; range, 5.0–25.0; friends, median, 11.0; range, 5.0–25.0). Median scores for support for exercise received in the form of participation from family and friends were 24.0 (range 10.0–48.0) and 24.0 (range 10.0–50.0), respectively. The median score for support for exercise in the form of rewards and punishment from family was 3.0 (range, 3.0–11.0). Social support factors were not associated with BMI.
Concurrently prevalent in our sample were encouraging support for healthy eating (family, median,14.0; range, 5.0–25.0; friends, median, 13.0; range 5.0–25.0) and discouraging support for healthy eating (family, median, 12.0; range, 5.0–25.0; friends, median, 11.0; range, 5.0–25.0). Median scores for support for exercise received in the form of participation from family and friends were 24.0 (range 10.0–48.0) and 24.0 (range 10.0–50.0), respectively. The median score for support for exercise in the form of rewards and punishment from family was 3.0 (range, 3.0–11.0). Social support factors were not associated with BMI.
Conclusion
Overweight and obese African American women in the rural Deep South experience minimal social support from family and friends for healthy eating and exercise. Given the evidence that social support promotes healthy behaviors, additional research on ways to increase support from family and friends is warranted.
Overweight and obese African American women in the rural Deep South experience minimal social support from family and friends for healthy eating and exercise. Given the evidence that social support promotes healthy behaviors, additional research on ways to increase support from family and friends is warranted.
Introduction
Obesity prevalence in the United States is higher in rural than in urban areas, particularly among people from racial/ethnic minorities. An estimated 40% of rural residents, compared with 33% of urban residents, are obese (body mass index [BMI] ≥30 kg/m2). Likewise, 56% of African American rural residents are obese compared with 43% of African American urban residents and 38% of white rural residents (1). Additional geographic disparities include greater obesity prevalence among residents of the South relative to other regions of the United States (1,2).
African American women residing in the Deep South states of Alabama, Georgia, Louisiana, Mississippi, and South Carolina are disproportionately burdened by obesity, physical inactivity, and poor-quality diets (2–5); therefore, there is an urgent need to more fully understand what influences the behaviors of this group at the individual, interpersonal, communal, and societal levels (6). Most weight loss interventions that target the modification of individual factors have been conducted mostly in white and urban populations; these studies demonstrated short-term weight reductions among African American women, although the reductions were less than those for women of other races as an effect of the intervention among African American women when compared with other racial groups (7).
Prior studies of various populations found no cross-sectional association between social support and BMI; however, this relationship has not been examined among African American women in the rural Deep South where the negative effects of certain social circumstances (eg, high rates of unemployment and poverty, low educational levels, limited access to health care, high risk for chronic disease) (8–11) may be lessened with appropriate social support. Social support for healthy eating and exercise, both elements of the social environment, are suggested as essential components of weight loss and weight management for residents in rural communities (12,13). Studies also suggest that people attempting weight loss rely on support from family and friends as a primary source of encouragement (8,14,15). Despite the potential benefits of social support for weight loss or weight management, few studies examined the prevalence of social support for healthy eating and exercise in a subgroup at great risk of obesity and other chronic conditions: African American women. The objective of this study was to characterize the social support environment for overweight and obese African American women residing in Deep South rural communities and to examine its association with BMI.
Acknowledgments
This study was made possible by grants (U54CA153719 and R25CA076023) from the National Cancer Institute. We acknowledge and appreciate the support provided by all of the Deep South Network for Cancer Control staff. We especially thank the community health advisors trained as research partners and the study participants who helped make this research possible. In addition, we thank Dr. Gerald McGwin for his statistical consultation with the lead author.
Author Information
Corresponding Author: Monica L. Baskin, PhD, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Ave S, MT 618, Birmingham, AL 35294-4410. Telephone: 205-975-5703. E?mail: mbaskin@uab.edu.
Author Affiliations: Erica R. Johnson, Tiffany L. Carson, Olivia Affuso, Claudia M. Hardy, University of Alabama at Birmingham, Birmingham, Alabama.
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