Moderators in the Relationship between the Socioeconomic Status and Health Behaviors of Individuals in Early Adulthood Cynthia LaCoe Advisor: Dr. JoAnn Prause UROP Symposium May 31, 2007 Department of Psychology and Social Behavior School of Social Ecology University of California, Irvine

Overview  What is SES?  What are health behaviors?  What do we know?  Hypotheses  Study Design  Findings  Implications

 Common measures of SES:  *Income  *Educational attainment  Occupational status S ocioeconomic S tatus (SES)  SES: An individual’s economic ranking in relation to others in his/her society (North Central Regional Educational Laboratory, 2004)

Health Behaviors  *Food Consumption  *Physical Activity  *Sedentary Activity  Relaxation  Sexual Activity  Substance Use

Health Behaviors: Food Consumption

Health Behaviors: Physical & Sedentary Activity  Physical Activity  Definition: Bodily activity done to develop and maintain physical fitness and overall health  Recommendations  Vigorous: 20 min 3 days a week  Moderate: 30 min 5 days a wk  Strength Training: 8-12 reps for each of 8-10 muscle groups on 2 non-consecutive days (Circulation, 2007; Cygan, 2008)  Sedentary Activity   Definition: Activity that requires little or no physical activity (e.g., watching T.V., playing video games, using a computer)   Recommendations: Limit engagement

H ealth B ehaviors & H ealth S tatus Overweight and Obesity  Root Cause: Energy Imbalance  Over Consumption  Inadequate Expenditure  Prevalence  33% and 34% of U.S. Residents (CDC, 2007)  Higher among individuals of lower SES (McLaeren, 2007)  Comorbidities  Cancer  Diabetes  Heart disease  Stroke

SES and Health Behaviors SES is associated with  Education and health knowledge  Access to supermarkets and high quality grains and produce  Purchase of high calorie foods (Turrell & Kavanagh, 2006; Jetter & Cassady, 2006)  Levels of physical activity (Wen, Browning, & Cagney, 2007)

Hypotheses  How does SES influence health behaviors?  H 1 : SES will directly effect health behaviors.  Does the relationship between SES and health behaviors depend on ethnicity or gender?  H 2 : Ethnicity and gender moderate the effect of SES on health behaviors.

Study Design Secondary Analysis of NHANES Data  NHANES  Sample Methods  Stratified, Multistage  10,122 Non-institutionalized U.S. residents  Survey (Phone, Face-to-face), Examination (MEC), Laboratory (MEC)  Participant Eligibility  years of age

Sample   Marital Status:   39.4% Married  .3% Widowed   3.2% Divorced   2.5% Separated   39.1% Never married   15.5% Living with a partner  Sample Size = 800  45.4% Males  Ethnicity  44.9% Non Hispanic White  23.4% Non Hispanic Black  22.6% Mexican American  9.1% Other, Multiracial  Mean Age = 27.1   Health Insurance: 67.9%   Employed: 72.3%  Mean BMI = 27.9

Sample Cont’d

Measures Construct(s)Variable(s) Dependent Diet Physical Activities Sedentary Activities (Un)healthy Food Frequencies Moderate, Vigorous, & Strengthening Activities T.V. and Computer/Game usage Independent SESIncome, Education Moderating Ethnicity Gender Covariates Age BMI Health Insurance Employment Status Marital Status

Findings   Income   Positively associated with time spent in moderate activities   Negatively associated with hours spent in sedentary activities How does SES influence health behaviors?

Findings Cont’d   Compared with a high school education   Less than a high school education was associated with   Less time spent in moderate activities   Higher consumption of fruits   Higher consumption of vegetables   More than a high school education was associated with   Less time spent in moderate activities   More time spent in sedentary activities   Higher consumption of vegetables   Higher consumption of whole grains   Lower consumption of white bread How does SES influence health behaviors?

Findings Cont’d  Ethnicity:  Income  Strengthening Activities: Positively associated among Mexican Americans, but not among Non Mexican Americans  Education  Fruit Consumption: Mexican Americans with less than a high school education consumed more fruit than those with a high school education, no association among Non Mexican Americans Does the relationship between SES and health behaviors depend on ethnicity or gender?

Findings Cont’d  Gender  Income  Vigorous Activities: Females with higher incomes engaged in more activities; negative relationship among males  Strengthening Activities: Females with higher incomes engaged in more activities; virtually no association among males  Soft Drink Consumption: Higher income females drank more diet soft drinks than regular soft drinks; virtually no association among males  Education  White bread: Females with less than a high school education consumed more white bread than did those with a high school education; no significant association among males Does the relationship between SES and health behaviors depend on ethnicity or gender?

Limitations  Educational attainment recoded broadly (i.e., less than high school, high school degree or equivalent, more than high school vs. K-doctoral degree)  Serving size(s) of food variables  Barriers to physical activity (e.g., neighborhood characteristics such as safety)  Sample size

Implications  Research  Role of acculturation in the effects of ethnicity on the relationship between SES and health behaviors  Ways in which education and income influence sedentary activities  Policy  Incorporate more health education into high school curriculums  Fund basic research and intervention programs with specific target audiences  Outreach Programs  Identify a target population  Develop population appropriate educational materials and interventions

Acknowledgements Thank you:  Dr. JoAnn Prause  Dr. Valerie Jenness  SE Honors Cohort  UROP  National Center for Health Statistics

Contact Information Cynthia LaCoe Department of Psychology and Social Behavior School of Social Ecology University of California, Irvine