Abstract:
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Research has shown consistent racial and ethnic disparities in obesity between non-Hispanic whites (NHW), Hispanic whites (HW) and blacks (BL) in US population. Accounting for the disparities is a challenge given the variety of factors, the nature of the association (i.e., linear versus non-linear) as well as the multi-categorical exposure variable (i.e., NHW, HW and BL). A multivariate mediation analysis methodology is developed to address the challenge. Restricted geographic data from the 2003-2004 and 2005-2006 cycles of the NHANES allowed by individual and tract level variables to be used in characterizing the disparities in both continuous (i.e., BMI) and dichotomous (i.e., obesity risk) models. The novel multivariate mediation analysis method is used to account for races and ethnicities as the exposure variables, and for potential nonlinear associations and complex interactions among variables. With the multivariate multiple mediation analysis, the nonlinear models explained about 40% (95% confidence interval: 18.6%, 58.3%) of racial disparity in obesity risk. However, we did not find significant ethnic disparity (NHW vs. HW) in obese.
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