lunes, 8 de junio de 2015

A Longitudinal Study of Structural Risk Factors for Obesity and Diabetes Among American Indian Young Adults, 1994-2008


A Longitudinal Study of Structural Risk Factors for Obesity and Diabetes Among American Indian Young Adults, 1994-2008

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A Longitudinal Study of Structural Risk Factors for Obesity and Diabetes Among American Indian Young Adults, 1994-2008

Tennille L. Marley, PhD, MPH; Molly W. Metzger, PhD

Suggested citation for this article: Marley TL, Metzger MW. A Longitudinal Study of Structural Risk Factors for Obesity and Diabetes Among American Indian Young Adults, 1994–2008. Prev Chronic Dis 2015;12:140469. DOI:


American Indian young adults have higher rates of obesity and type 2 diabetes than the general US population. They are also more likely than the general population to have higher rates of structural risk factors for obesity and diabetes, such as poverty, frequent changes of residence, and stress. The objective of this study was to investigate possible links between these 2 sets of problems.
Data from the American Indian subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine potential links between obesity and type 2 diabetes and structural risk factors such as neighborhood poverty, housing mobility, and stress. We used logistic regression to explore explanatory factors.
American Indians in the subsample had higher rates of poor health, such as elevated hemoglobin A1c levels, self-reported high blood glucose, self-reported diabetes, and overweight or obesity. They also had higher rates of structural risk factors than non-Hispanic whites, such as residing in poorer and more transient neighborhoods and having greater levels of stress. Self-reported stress partially mediated the increased likelihood of high blood glucose or diabetes among American Indians, whereas neighborhood poverty partially mediated their increased likelihood of obesity.
Neighborhood poverty and stress may partially explain the higher rates of overweight, obesity, and type 2 diabetes among American Indian young adults than among non-Hispanic white young adults. Future research should explore additional neighborhood factors such as access to grocery stores selling healthy foods, proximity and safety of playgrounds or other recreational space, and adequate housing.


This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant no. P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. We especially acknowledge Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant no. P01-HD31921 for this analysis. This publication was made possible by grant no. 1P30DK092950 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDDK.

Author Information

Corresponding Author: Molly W. Metzger, PhD, Washington University in St Louis, George Warren Brown School of Social Work, One Brookings Dr, Campus Box 1196, St Louis, MO 63130. Telephone: 314-935-6989. Email:
Author Affiliation: Tennille L. Marley, Arizona State University, Tempe, Arizona.


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