Discrimination and excessive weight gain during pregnancy among Black and Latina young women

• Type of Material: Article
• Authors: Allecia E. Reid, Yale University; Lisa Rosenthal, Yale University; Valerie A. Earnshaw, Yale University; Tene Lewis, Emory University; Jessica B. Lewis, Emory University; Emily C. Stasko, Yale University; Jonathan N. Tobin, Clinical Directors’ Network; Jeannette R. Ickovics, Yale University
• Language: English
• Date: 2016-05-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2016.03.012
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 156
• Start Page: 134
• End Page: 141
• Grant/Funding Information: This research and preparation of this article was supported by National Institute of Mental Health grants R01MH074399, R01MH074394, and T32 MH20031.
• Keywords: Weight gain; EVERYDAY DISCRIMINATION; Public, Environmental & Occupational Health; AFRICAN-AMERICAN WOMEN; UNITED-STATES; Biomedical Social Sciences; Latina; SELF-REPORTED EXPERIENCES; MENTAL-HEALTH; Pregnancy; Young women; Adolescents; Life Sciences & Biomedicine; Black; RACIAL RESIDENTIAL SEGREGATION; ASIAN-AMERICAN; Social Sciences; Science & Technology; Discrimination; Social Sciences, Biomedical; INFANT BIRTH-WEIGHT; LONGITUDINAL ANALYSIS; PERCEIVED DISCRIMINATION
• Research Categories: Health Sciences, Public Health; Psychology, General; Sociology, Individual and Family Studies

Abstract

Rationale: Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective: We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method: Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results: Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion: Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women.