Is higher education protective against obesity in the face of discrimination?

INTRODUCTION:   Obesity is highly prevalent among U.S. blacks, especially females, across the socioeconomic spectrum, and may be in part attributable to stressful experiences of discrimination.  Current research suggests that higher socioeconomic position (SEP) may be associated with more experiences of discrimination and inversely associated with obesity prevalence, yet discrimination is positively associated with obesity prevalence.  It is unclear whether SEP and discrimination during middle and later adulthood are differentially associated with obesity prevalence. 

METHODS:   Using data from 2001 follow-up of the Pitt County (NC) Study cohort, which included 1163 middle-aged African American adults (66% female), we examined whether cross-sectional associations between SEP, measured by education, and BMI are moderated by perceived experiences of discrimination.  Discrimination was measured using a 6-item subset from the Everyday Discrimination Scale (EDS).  Education was categorized as < high school, completed high school, some college, and completed college. 

RESULTS:   Confounder adjusted linear regression models suggested having a high school degree (b=-1.11, SE=0.53, p=0.04) or some college (b=-2.67, SE=0.82, p<0.01) was associated with lower BMI compared to having less than a high school degree.  Discrimination was not associated with BMI.  Interaction models showed slightly higher BMIs for respondents with vocational training/some college and low discrimination compared to those with less than a high school degree (p=0.07). 

CONCLUSIONS:  These findings suggest that discrimination minimally influences associations between education and BMI.  Future research on African American health should carefully evaluate the role of having some college education on health, and assess the consistency of these associations using additional measures of obesity.