Racial Differences in Mechanisms Linking Childhood Socioeconomic Status With Growth in Adult Body Mass Index: The Role of Adolescent Risk and Educational Attainment

Purpose: The present study examined whether risk factors during adolescence, including substance use, depression, overweight status, and young adult educational attainment, mediated the association between low childhood socioeconomic status (SES) and higher body mass index (BMI) in adulthood. We also evaluated whether the hypothesized pathways differed based on racial group status. Methods: Participants from the Seattle Social Development Project were followed from ages 10 to 39 years. The present study included white (n = 381), African American (n = 207), and Asian American (n = 171) participants. Structural equation models tested pathways linking low childhood SES to BMI from ages 24 to 39 years. Multiple-group modeling was used to test potential racial differences. Results: Analyses indicated racial differences in the pathways linking low childhood SES with adult BMI. For whites, overweight status and educational attainment were significant mediators. For Asian Americans, there was an unmediated and significant pathway between low childhood SES and low adult BMI. For African Americans, there were no significant mediated or unmediated pathways. Conclusions: Results stress that the pathways that link childhood SES with adult BMI may operate differently based on race. Research is particularly needed to identify mechanisms for African Americans in order to better inform obesity prevention efforts. (C) 2018 Society for Adolescent Health and Medicine. All rights reserved.