The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States.

Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.

Racial/ethnic and nativity disparities in U.S. Covid-19 vaccination hesitancy during vaccine rollout and factors that explain them.

While research has begun to investigate disparities in Covid-19 vaccine hesitancy between White, Black and Hispanic adults, no nationally representative studies to date have accounted for Hispanic immigrants as a unique group or fully investigated the reasons behind racial/ethnic and nativity disparities. We make these contributions by substantively drawing from what is known about the ways that immigrant fear and structural racism create conditions that produce countervailing forces that are likely to contribute to racial/ethnic and nativity disparities in vaccine hesitancy. We use OLS regression and decomposition techniques to analyze data from 1936 18-65 year-old United States (U.S.) adults who participated in the COVID-19 and its Implications for American Communities (CIAC) study during February and March 2021, a period of time that coincides with early stages of the U.S. vaccine roll-out effort that pre-dated universal adult eligibility for Covid-19 vaccination. Results indicate that U.S.-born Black adults are more vaccine hesitant than U.S.-born White adults. This disparity is largely due to differences in anti-vaccine beliefs. U.S.-born Hispanic adults are less vaccine hesitant than U.S.-born White adults in adjusted OLS regression models and personal experiences with Covid-19 drive this difference. There were not significant differences between foreign-born Hispanic and U.S.-born White adults in vaccine hesitancy. These findings suggest that foreign-born Hispanic adults did not drive early disparities in vaccine hesitancy and that alleviating concerns about anti-vaccine beliefs and utilizing personal stories have important roles in preventing future racial/ethnic disparities in Covid-19 vaccine hesitancy as new Covid-19 vaccines and booster shots are rolled out. Study findings may also have implications for reducing racial/ethnic disparities in the uptake of other new vaccines.

Extradyadic Sex and Psychological Distress among Married and Cohabiting Young Adults: An Examination of Internalized and Externalized Responses.

Extradyadic sex (EDS) is a major relationship violation, yet it occurs in nearly a quarter of U.S. cohabiting and marital unions. While many relationships dissolve in the wake of EDS, a majority remain intact. Theories of social stress suggest that substantial psychological distress should result unless EDS is a symptom of stress caused by involvement in a relationship marked by other negative characteristics. This study investigates how one's own EDS, a partner's EDS, and mutual EDS are related to internalizing and externalizing behaviors: depressive symptoms and heavy alcohol use, respectively. Analyses of data from the National Longitudinal Study of Adolescent to Adult Health suggest that one's own EDS is associated with heavy alcohol use among cohabiters and spouses and with depressive symptoms among spouses, while partner EDS has no association with either outcome net of confounders. We discuss the implications of these findings in the study's conclusions.

Would the elimination of obesity and smoking reduce U.S. racial/ethnic/nativity disparities in total and healthy life expectancy?

Obesity and smoking are the two leading causes of preventable death and disability in the United States. Both of these health risks are socially patterned in ways that likely produce racial/ethnic/nativity disparities in total and healthy life expectancy. The current study simulates the extent to which the hypothetical elimination of smoking and obesity would change disparities in longevity and disability by analyzing data from 19,574 U.S.-born white, black, Hispanic and foreign-born Hispanic men and women in the 1999-2000 through 2009-2010 National Health and Nutrition Examination Survey and linked mortality files. Results suggest that the elimination of both obesity and smoking would significantly narrow disparities in total and healthy life expectancy between black and white adults and remaining differences are statistically non-significant. The longstanding life expectancy advantage of Hispanic immigrants over whites is reduced, but remains large. The life expectancy advantage of U.S.-born Hispanics is reduced as well, though to a smaller extent than what is observed for Hispanic immigrants. There were no significant observed healthy life expectancy differences between white and U.S.-born Hispanic adults. Overall study results suggest that the elimination of obesity and smoking would change the shape of racial/ethnic/nativity disparities in ways that would result in greater health equity.

Dietary Assimilation among Mexican Children in Immigrant Households: Code-switching and Healthy Eating across Social Institutions.

Immigrant health assimilation is often framed as a linear, individualistic process. Yet new assimilation theory and structural theories of health behavior imply variation in health assimilation as immigrants and their families interact with different US social institutions throughout the day. We test this idea by analyzing how two indicators of dietary assimilation-food acculturation and healthy eating-vary throughout the day as Mexican children in immigrant households consume food in different institutional settings. Using individual fixed-effects models and data from the National Health and Nutrition Examination Survey, we find that Mexican children in immigrant households (N = 2,337) engage in "dietary code-switching," eating more acculturated but not necessarily less healthy food in schools and more acculturated but less healthy food in restaurants compared to homes. Findings advance theory and knowledge about how social institutions condition dietary assimilation in particular and health assimilation more broadly.

Extradyadic sex and union dissolution among young adults in opposite-sex married and cohabiting unions.

This study investigates extradyadic sex (EDS) among contemporary opposite-sex married and cohabiting young adults and examines how EDS is associated with union dissolution. By analyzing data from 8301 opposite-sex spouses and cohabiters in the National Longitudinal Study of Adolescent to Adult Health, we estimate the prevalence of self-reported EDS, reports of partners' EDS, and reports of mutual EDS (i.e., both partners' engagement in EDS). Roughly 1 in 4 respondents reported that either they, their partner or both engaged in EDS. Young men were more likely than women to self-report EDS, while young women were more likely to report partners' EDS. Relative to no EDS, partners' EDS was associated with union dissolution, but self-reported EDS and mutual EDS were not. A partner's EDS was also associated with union dissolution relative to self-reported EDS. Associations between a partner's EDS and dissolution were consistent among spouses and cohabiters and among men and women.

One Size May Not Fit All: How Obesity Among Mexican-Origin Youth Varies by Generation, Gender, and Age.

Immigrants' health (dis)advantages are increasingly recognized as not being uniform, leading to calls for studies investigating whether immigrant health outcomes are dependent on factors that exacerbate health risks. We answer this call, considering an outcome with competing evidence about immigrants' vulnerability versus risk: childhood obesity. More specifically, we investigate obesity among three generations of Mexican-origin youth relative to one another and to U.S.-born whites. We posit that risk is dependent on the intersection of generational status, gender, and age, which all influence exposure to U.S. society and weight concerns. Analyses of National Health and Nutrition Examination Studies (NHANES) data suggest that accounting for ethnicity and generation alone misses considerable gender and age heterogeneity in childhood obesity among Mexican-origin and white youth. For example, second-generation boys are vulnerable to obesity, but the odds of obesity for first-generation girls are low and on par with those of white girls. Findings also indicate that age moderates ethnic/generational differences in obesity among boys but not among girls. Overall, ethnic/generational patterns of childhood obesity do not conform to a "one size fits all" theory of immigrant health (dis)advantage, leading us to join calls for more research considering how immigrants' characteristics and contexts differentially shape vulnerability to disease and death.

It is Hard to Swim Upstream: Dietary Acculturation Among Mexican-Origin Children.

Health and immigration researchers often implicate dietary acculturation in explanations of Mexican children of immigrants' weight gain after moving to the U.S., but rarely explore how diet is shaped by immigrants' structural incorporation. We used data from the 1999/00-2009/10 National Health and Nutrition Examination Survey to assess how indicators of Mexican-origin children's acculturation and structural incorporation influence two outcomes: how healthy and how "Americanized" children's diets are. Indicators of acculturation were strongly associated with more Americanized and less healthy diets. However, structural incorporation indicators were mostly unrelated to diet outcomes net of acculturation. An exception was that parental education was positively associated with consuming a healthy diet. Finally, children of natives consumed more Americanized, unhealthy diets than children of immigrants and these differences were largely explained by differences in the acculturation. Children of natives would have consumed an even less healthy diet were it not for their higher levels of parental education. Overall, the results suggest that the process of adapting to the U.S. life style is associated with the loss of cultural culinary preferences and less healthy eating behaviors despite improvements in socioeconomic status.

The food similarity index: a new measure of dietary acculturation based on dietary recall data.

This study introduces a flexible indicator of dietary acculturation that measures immigrants' eating behavior relative to U.S.-born persons. Using 24-hour dietary recall data from the continuous National Health and Nutrition Examination Survey pooled across multiple years from 1999/00 through 2009/10, we developed and tested the validity of the "Food Similarity Index" (FSI), which indicates the similarity of the foods consumed by individuals to the foods most commonly consumed by same-aged U.S-born persons of all racial/ethnic groups. We demonstrate its utility here for children and adults of four racial-ethnic groups. FSI was positively associated with the consumption of common American foods and negatively associated with eating Hispanic and Asian foods. In addition, FSI was associated with generational status among all racial/ethnic groups and duration of U.S. residence among Hispanics. FSI was also negatively associated with the Healthy Eating Index 2010. The FSI enables researchers to compare immigrants' dietary patterns over generations and across groups. It can be used to study how dietary acculturation shapes health risk factors and diseases.

Early Adult Obesity and U.S. Women's Lifetime Childbearing Experiences.

Literature from multiple disciplines suggests that women who are obese during early adulthood may accumulate social and physiological impediments to childbearing across their reproductive lives. This led the authors to investigate whether obese young women have different lifetime childbearing experiences than leaner peers by analyzing data from 1,658 female participants in the 1979 National Longitudinal Survey of Youth. Study sample members were nulliparous women ages 20 - 25 in 1982. The authors examined their childbearing experiences between 1982 and 2006 and found that young women who were obese at baseline had higher odds of remaining childless and increased odds of underachieving fertility intentions than young women who were normal weight at baseline. These results suggest that obesity has long-term ramifications for women's childbearing experiences, with respect to whether and how many children women have in general and relative to the number of children they want.

Weight change and depression among US young women during the transition to adulthood.

By using data from wave 2 (in 1996) and wave 3 (in 2000-2001) of the US-based National Longitudinal Study of Adolescent Health, we investigated the association between young women's body weight and depression during the transition to adulthood. Respondents (n = 5,243) were 13-18 years of age during wave 2 and 19-25 years of age during wave 3. We used Center for Epidemiologic Studies Depression Scale scores to classify young women as never depressed, consistently depressed, experiencing depression onset, or experiencing depression recovery from wave 2 to wave 3. Results from adjusted multinomial logistic regression models indicated that respondents who experienced significant weight gain were at risk of depression onset. Normal weight (adjusted odds ratio = 2.10, 95% confidence interval: 1.14, 3.84) and overweight (adjusted odds ratio = 1.86, 95% confidence interval: 1.15, 2.99) adolescent girls who were obese by young adulthood, as well as young women who were consistently obese during adolescence and young adulthood (adjusted odds ratio = 1.97, 95% confidence interval: 1.19, 3.26), had roughly twice the odds of depression onset as did young women who were never overweight. We concluded that weight gain and obesity are risk factors for depression onset during the transition to adulthood. Policies prioritizing healthy weight maintenance may help improve young women's mental health as they begin their adult lives.

Obesity, school obesity prevalence, and adolescent childbearing among U.S. young women.

In the United States, adolescent obesity reduces young women's odds of forming romantic and sexual partnerships but increases the likelihood of risky sexual behavior when partnerships occur. This led us to conduct a study examining the relationship between adolescent obesity and adolescent childbearing. Our study has two aims. We draw from prior research to develop and test competing hypotheses about the association between adolescent obesity and young women's risk of an adolescent birth. Drawing from risk regulation theory, we also examine whether the association between obesity and young women's risk of an adolescent birth may vary across high schools with different proportions of obese adolescents. Multilevel logistic regression models are used to analyze data from 4242 female students in 102 U.S. high schools who participated in Wave I (1994-1995) of the National Longitudinal Study of Adolescent Health. Results are the first to show that obesity reduces female adolescents' odds of childbearing, but that this association is not uniform across schools with different proportions of obese students. As the obesity prevalence in a school increases, so do obese young women's odds of childbearing. We conclude that understanding whether and how obesity is associated with young women's odds of having an adolescent birth requires attention to the weight context of high schools.

Social stratification and adolescent overweight in the United States: how income and educational resources matter across families and schools.

The current study examines how poverty and education in both the family and school contexts influence adolescent weight. Prior research has produced an incomplete and often counterintuitive picture. We develop a framework to better understand how income and education operate alone and in conjunction with each other across families and schools. We test it by analyzing data from Wave 1 of the U.S.-based National Longitudinal Study of Adolescent Health (N = 16,133 in 132 schools) collected in 1994-1995. Using hierarchical logistic regression models and parallel indicators of family- and school-level poverty and educational resources, we find that at the family-level, parent's education, but not poverty status, is associated with adolescent overweight. At the school-level, the concentration of poverty within a school, but not the average level of parent's education, is associated with adolescent overweight. Further, increases in school poverty diminish the effectiveness of adolescents' own parents' education for protecting against the risks of overweight. The findings make a significant contribution by moving beyond the investigation of a single socioeconomic resource or social context. The findings push us to more fully consider when, where, and why money and education matter independently and jointly across health-related contexts.

The multidimensional relationship between early adult body weight and women's childbearing experiences.

This study has three primary goals that make an important contribution to the literature on body weight and childbearing experiences among United States' women. It sheds light on the physiological and social nature of this relationship by examining whether the consequences of early adult weight for lifetime childbearing are shaped by historical social context, women's social characteristics, and their ability to marry. We analyze data from two female cohorts who participated in the National Longitudinal Study of Youth (NLSY79). Cohort 1 entered early adulthood before the U.S. obesity prevalence increased. Cohort 2 entered early adulthood after the obesity prevalence increased. We find that early adult weight is negatively related to the childbearing trajectories and marital status of Cohort 1 but not Cohort 2. Failing to account for race/ethnicity and women's educational background as confounders masks some of these associations, which are evident for both White and Black women. Our results suggest that the health consequences of body weight do not fully drive its impact on childbearing. Rather, the lifetime fertility consequences of early adult weight are malleable, involve social processes, and are dependent on social context.

Canaries in a coalmine: Immigration and overweight among Mexican-origin children in the US and Mexico.

The prevalence of overweight is higher for Hispanic children of immigrants than children of natives. This does not fit the pattern of the epidemiological paradox, the widely supported finding that immigrants tend to be healthier than their U.S.-born peers, and it suggests that exposure to the U.S. increases immigrant children's risk of overweight. This study's primary contribution is to better assess how exposure to the U.S. environment affects childhood overweight among a homogamous ethnic group, Mexican-Americans. We do so by using an innovative binational study design to compare the weight of Mexican-American children of immigrants, Mexican-American children of natives, and Mexican children in Mexico with different propensities of having immigrant parents. Cross-sectional data are derived from a pooled sample of 9982 6-19 year old children living in either Mexico or the United States in the early 2000s. Mexican-resident children with a very high propensity to have immigrant parents have significantly lower percentile BMIs and lower odds of overweight than Mexican children with lower propensities of emigration and U.S.-resident Mexican-American children. This suggests that selection into immigration streams does not account for the high prevalence of overweight among children of Mexican immigrants. Rather, U.S. exposure significantly raises children of Mexican immigrants' risk of being overweight. Moreover, second generation children have the highest percentile BMIs and greatest odds of overweight of all comparison groups, including children of natives. This suggests that they experience risks above and beyond the effects of exposure to American society.

The image in the mirror and the number on the scale: weight, weight perceptions, and adolescent depressive symptoms.

Double jeopardy and health congruency theories suggest that adolescents' joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study ofAdolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.

Equal weights but different weight perceptions among US adolescents.

We investigate sex and race/ethnic differences in adolescents' perceptions of the same objectively measured weight in a nationally representative US sample. At the same BMI z-score, girls perceive themselves as heavier than boys. Regardless of sex and relative to Whites, African-Americans perceive the same BMI z-score as leaner and Native Americans are more likely to perceive objectively heavier weights as 'about the right weight'. Asian boys consider a narrower weight range to be 'about the right weight' relative to White boys, and Asian girls are less likely than White girls to perceive objectively lower weights as 'about the right weight'.

Gender and race/ethnic differences in inaccurate weight perceptions among U.S. adolescents.

PURPOSE: Inaccurate weight perceptions may lead to unhealthy weight control practices among normal weight adolescents and to a greater risk of adult obesity and related morbidities for overweight adolescents. To examine which U.S. adolescents are at risk of these outcomes, we examine gender and racial/ethnic differences in weight perception inaccuracy. This is the first study of weight perception inaccuracy to include Latino/a and Asian American adolescents. METHODS: Among the 12,789 Wave II participants of the National Longitudinal Study of Adolescent Health, we estimate multivariate models that reveal how gender, race/ethnicity, and clinical weight categories predict weight perception inaccuracy. RESULTS: Relative to boys, girls have lower odds of underestimating their weight and greater odds of overestimating their weight. In particular, among overweight and obese adolescents, girls are more accurate than boys, but among normal weight adolescents, boys are more accurate. Compared with Whites, African Americans are more likely to underestimate their weight, particularly among overweight girls and obese boys. Overall and particularly among girls and normal weight adolescents, African Americans are less likely to overestimate their weight than their White counterparts. Finally, Asian American girls are more likely to underestimate their weight than White girls. CONCLUSION: These findings have important implications for identifying and intervening with adolescents at the greatest risk of long-term weight problems, weight-related morbidity, and unhealthy weight control practices.

Adolescent Weight and Depressive Symptoms: For Whom is Weight a Burden?

OBJECTIVE: Adolescent weight and depressive symptoms are serious population health concerns in their own right and as they relate to each other. This study asks whether relationships between weight and depressive symptoms vary by sex and race/ethnicity because both shape experiences of weight and psychological distress. METHODS: Results are based on multivariate analyses of National Longitudinal Study of Adolescent Health (Add Health) data. RESULTS: There are no associations between adolescent girls' weight and depressive symptoms, but these associations vary considerably among boys. Underweight is associated with depressive symptoms among all boys and subpopulations of White and Hispanic boys. Among Hispanic boys, those who are overweight (versus normal weight) have a lower probability of reporting depressive symptoms. Finally, among normal weight boys, Hispanics and Blacks are more likely to report depressive symptoms than Whites. CONCLUSIONS: Findings are a reminder that understanding population health issues sometimes requires a focus on subpopulations, not simply the population as a whole.

ADOLESCENTS' SEXUAL BEHAVIOR AND ACADEMIC ATTAINMENT.

High school students today have high ambitions but do not always make choices that maximize their likelihood of educational success. This is the motivation for investigating relationships between high school sexual behavior and two important academic attainment milestones: earning a high school diploma and enrollment in distinct postsecondary programs. Analysis of data from 7,915 National Education Longitudinal Study of 1988-1994 participants indicates that timing of sexual initiation, contraceptive nonuse, and parenthood all predict female and male students' academic attainment. Furthermore, sexual behavior has more ramifications as attainment milestones become more competitive. These findings point to the importance of considering how students' choices across multiple life domains influence academic attainment, an important predictor of adult socioeconomic opportunity.