A new approach is necessary to combat the disproportional effect of obesity and its related illnesses among some racial and ethnic groups in the United States, say Brigham Young University researchers.
Steven R. Hawks, a BYU professor of health sciences, says that, based on available obesity data, unfavorable disparities in the United States are most evident for Native American, African-American and Hispanic populations as compared with Caucasians.
"Scientific literature suggests that there are many social, economic and cultural reasons for this disparity," says Hawks. "The bottom line is that current methods of obesity prevention fall short of a realistic, effective solution for these racial and ethnic populations."
Hawks and BYU student co-author Hala N. Madanat conducted a meta-analysis of the problem as discussed in medical literature dating back to 1990 and propose a three-pronged approach to narrowing the gap in the current issue of the American Journal of Health Education.
"Public health interventions basically fall into three categories -- programs that emphasize the individual, the community or broad populations," says Hawks. "Programs that focus on individual behavior change alone -- even if they are racially sensitive -- don't seem to produce long-term reductions in obesity."
Community efforts, such as work site wellness programs, seldom focus on the specific needs of racial or ethnic groups. Additionally, the duo found no reports of population-level interventions or programs intended to reduce obesity-related disparities among racial and ethnic groups.
"What is needed is a balance among the three approaches that have well-defined objectives, clear theoretical foundations and culturally appropriate methodologies," says Hawks.
To guide obesity-prevention efforts among racial and ethnic groups, the researchers offer the following five suggestions:
Intervention goals should relate to diet composition and activity levels rather than focusing on weight loss or other measures of body size.
Because the prevention of obesity is more cost-effective than attempts at reversal, the primary focus of immediate efforts should be on community- and population-level strategies that prevent obesity among minority children.
Successful interventions must take into account the culture-specific context of food and activity, approaching dietary and activity changes in ways that complement cultural values and build on traditions.
Racial and ethnic differences in the genetic, environmental and cultural causes of obesity should be evaluated and understood before national dietary recommendations or body-size standards are established.
Obesity prevention and management programs must be offered in ways that are sensitive to different cultural ideals for body size, while avoiding complicity with the fashion industry. "It would be unfortunate if obesity control efforts merely reinforced the media message that personal worth and thinness are synonymous," says Hawks regarding his final recommendation. "That would just undermine the self-confidence of overweight minority women while doing little to improve their health."
For Madanat, participating in the research was the most exciting part of her graduate education. Like Hawks, she says she hopes the study's recommendations will provide health educators and government officials with information they need to competently address the struggle against obesity.
"It's our hope they will make needed changes before the obesity problem in the United States escalates even further," Madanat says.
