Date of Degree
Neil G. Bennett
Mary Clare Lennon
Jennifer Beam Dowd
Demography, Population, and Ecology | Family, Life Course, and Society | Medicine and Health | Nutrition | Sociology
Life Course, Obesity, Mortality, Panel Study of Income Dynamics, Nutritional Knowledge, Health
This dissertation seeks to examine obesity in different contexts throughout the life course. Through empirical analyses, separate stages of the life course are considered: namely childhood through adolescence, young adulthood, and adulthood. By using a life course perspective, it is possible to consider longitudinal and intergenerational approaches to these questions, which will update and inform the current debates surrounding obesity.
Beginning with children, the intergenerational transmission of diet disease knowledge, socioeconomic status, and child health behaviors are considered in their associations with the outcomes of child diet in 2002, and in turn their associations with child obesity in 2007. Information used in this analysis includes, but is not limited to, age, race, sex, Body Mass Index, diet, sleep, and exercise. For this portion of the dissertation, 1,691 parent-child pairs make up the samples which will be weighted in order to make the sample nationally representative of the age group in United States population. By linking parent and child variables into one data set, it is possible to look at how demographic, socioeconomic, health status, and health behaviors are associated with child diet and child obesity. By utilizing linear and logistic regression methods, it is possible to look at these factors to see which items are associated with obesity. In order to facilitate this research, three key indexes are created to capture parental diet disease knowledge, child dietary diversity, and child obesity for each parent-child pair. The results show that increased diet-disease knowledge of the parent significantly increases the dietary diversity of the child, and in turn, the more diverse a child’s diet the lower odds they have of becoming obese.
Continuing to adults, a longitudinal measure of obesity over 13 years defined as ‘chronic obesity’ is investigated as the key independent variable of interest. The sample for this analysis consists of a panel of 4,287 adults from 1986 to 2013. Individuals between the ages of 31 and 65 in 1999 were followed through 2013, which is the latest wave of data to be released. Also beginning in 1999 were the health condition questions that ask about the presence of conditions including asthma, diabetes, hypertension, heart attack, heart disease, and stroke. The second set of analyses estimate multivariate competing-risks proportional hazard models of health condition onset using each disease sample separately. Each of these four health condition sub-samples, Asthma, Diabetes, Stroke/Heart Attack, and Hypertension uses death as a competing risk factor and contains four models. Cox proportional hazard models were used to perform multivariate analyses to better understand the association between ‘chronic obesity’ and all-cause mortality as compared to other weight status categories, while controlling for demographic, socioeconomic, and health covariates. Overall, chronic obesity increased the hazard of either being diagnosed with a health condition or dying from all-cause mortality more than the other measures of obesity and weight status during the time period.
Insolera, Noura E., "Obesity over the Life Course: Perspectives in Health and Mortality" (2016). CUNY Academic Works.