Document Type

Capstone Experience

Graduation Date

12-2021

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Dr. Sharon Medcalf

Second Committee Member

Dr. Brandon Grimm

Third Committee Member

Dr. Nicole Kolm-Valdivia

Abstract

Obesity is a primary public health concern and is associated with several chronic health diseases that can have dire consequences. According to the World Health Organization (WHO), there were about 1.9 billion overweight adults aged 18 years and above and at least 650 million adults were obese worldwide in 2016. Adults living in Mississippi are of particular concern, due to the high obesity rate which has continued to increase over the past 25 years. Mississippi’s obesity rate is 37.3%, which is one of the highest rates of adult obesity in the United. While obesity increases the risk of disease outcomes, there is gender disparity with some of the obesity-related disease outcomes. Therefore, this study will investigate the gender disparity of obesity and lifestyle characteristics among adult Mississippians. To answer the research questions, BMI, lifestyle variables and sociodemographic characteristics of 2017 Behavioral Risk Factor Surveillance participants were obtained. Descriptive statistics were performed on all the variables using frequencies and percentages. Obesity was included as a binary outcome variable with a “Yes” and “No” response. Participants in the Yes category were at least overweight while those in the No category were at most normal weight. Exercise and general health were also included in this study as outcomes. Sociodemographic characteristics and, fruit and vegetable consumption were included as explanatory variables while gender was the effect modifier. Pearson chi square analysis was performed to determine associations between the explanatory variables and outcomes between the gender. Further exploratory analysis included a logistic regression model stratified by gender between the outcomes and the explanatory variables. Participants were a total of 3040 participants of which males were 1286 and females were 1754. Adult male obesity prevalence significantly differ from that of females (79% vs 68%, p<0.0001). While being obese has no relationship with employment status among males, females unable to work had higher likelihood of obesity as compared to employed females (AOR: 2.29 95% CI:1.43,3.64). Moreover, among males the odds of obesity increased linearly with income while among females it decreased linearly. Furthermore, among males (OR: 1.53 95% CI: 1.16, 2.01), education was positively associated with obesity however among females the relationship was reversed (OR: 0.72 95% Cl: 0.57,0.90). While Black females were more likely to be obese as compared to white females (OR: 2.85 95% CI: 2.22,3.65), that was not the case for black males in comparison to their white counterparts (OR: 0.93 95% CI: 0.69,1.26). Exercise was positively associated with marital status (males OR=1.43 95% Cl: 1.11,1.84, females OR=1.30 95% Cl:1.05,1.61), education (males OR=1.83 95% Cl: 1.42,2.37, females OR=1.88 95% Cl:1.51,2.35) and health coverage (males OR=1.55 95% Cl: 1.12, 2.15 females OR=1.68 95% Cl:1.17,2.41) for both genders. However, black males were less likely to participate in exercise (AOR=0.8 95% Cl: 0.59,1.18). Participants with health coverage were more likely to have good general health irrespective of gender (males OR=1.50 95% Cl: 1.09, 2.07 females OR=1.34 95% Cl:1.02, 1.79). Furthermore, exercise was positive associated with being healthy among both genders (males AOR=1.74 95% Cl: 1.14, 2.66 females AOR=3.00 95% Cl:2.05,4.40). Intervention for obesity should target males and females who are married, black males and high-income males. Awareness and the importance of exercise should be emphasized among black males.

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