A catalyst for childhood obesity: How racism has 'huge implications' for health trajectory

Racism contributes to childhood obesity, according to a new study that found children as young as 9 were more likely to meet the definition of obesity if they faced racism a year earlier.

Though the link between racism and obesity has long been assumed, this was a clear confirmation in children, said co-author Adolfo Cuevas, an expert on racism and health at the NYU School of Global Public Health.

Children of color are "able to see that they are being treated unfairly based on their skin tone," Cuevas said. "And this has huge, huge implications for their life course trajectory when it comes to their health."

A large body of research connects racial discrimination to poor health outcomes, said David Williams, a leading figure in that research and chair of the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

"What we have discovered over the years is that discrimination is a type of stressful life experience that has negative effects on health just like other types of stressful life experiences. It leads to worse mental health and physical health."

The study is a reminder that individual behavior can have consequences, Williams noted.

"We can be an agent of disease and death just by how we treat others," he said. "The most important thing we need to do is reduce the occurrence of discrimination."

The study, published Tuesday in JAMA Network Open, found significant racial differences in the obesity rates of more than 6,000 children ages 9 to 11. Less than 7% of children who identified as white met the medical definition for having obesity, compared with 9% of Asian Americans, 18% of Hispanics of any race, 21% of Native Americans or Alaskan natives, and more than 24% of Black Americans.

The more racial discrimination a child reported being exposed to in an initial interview between 2017 and 2019, the more likely they were to have a high body mass index a year later, the study found.

More than 24% of children whose parents were in the lowest income category were more likely to meet the definition of obesity, compared with just 4% of children with parents in the highest income category. And children whose parents had a high school diploma or less were more likely to have obesity than those whose parents had a graduate degree.

Cuevas said he could not determine whether either of these factors was more or less important than racism in influencing a child's risk for obesity.

Black children from wealthier families were more likely to report being treated unfairly because of their race than Black children from less financially advantaged families. Cuevas said he suspects that's because children from wealthier families had more interactions with children and adults of other races, while Black children from lower-income families probably live more segregated lives. "This is the double-edged sword of being Black in America," he said.

The children mainly identified teachers, other children at school and adults outside school as most likely to treat them unfairly because of their race or ethnicity. Schools, Cuevas said, are "an environment we should really focus on to create an inclusive place."

People who are subject to discrimination can make themselves more resilient ‒ and protect against many of the health effects of discrimination ‒ by having strong social and community support, Cuevas and Williams said.

One study in Georgia found that teenagers who reported being exposed to a lot of racial discrimination had higher levels of stress hormones, high blood pressure, higher weight and higher levels of inflammation by the time they were 20 than teens without that exposure. But those with good relationships with parents, teachers and friends did not suffer such severe health consequences, the study also showed.

Another study in Canada dug into why the suicide rate among First Nation young people was the highest in the world but unequally distributed. Researchers found Indigenous communities had no suicide problem if they were heavily involved in lobbying the Canadian government for rights to their historical land and control of their own services and who taught young people about their culture and history.

"Feeling that they can make a difference in life and in their community seems to have a protective effect on their health," Williams said.

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: Racism has 'huge' implications for childhood obesity, study finds