More than 60% of black women in the U.S. are obese. Evidence suggests black women are exposed to more obesogenic microenvironments. To address this issue, research calls for exploration of bold, new obesity intervention approaches to discover unconventional tactics to address weight loss disparities.
PURPOSE: To compare microenvironments and assessment outcomes across obese black and white women for whom weight loss information and services were made available.
METHODS: A research assistant (RA) entered the participant’s home to complete informed consent, baseline assessment, and onboarding. The RA also took note of the home environment without the participants’ awareness. Follow-up assessments occurred in the participant’s home 28 days after baseline.
RESULTS: Of the 186 black and white women, 62.9% self-reported being African American or Black and the mean age of the group was 52.3 ± 8.4. The mean BMI of all participants at baseline was 44.8 ± 10.1 and 45.4 ± 10.5 at the 30-day follow-up. There were significant group differences in social and physical micro-environments. When compared to white women, more black women had lower incomes < $20,000 (58.5% vs 295%, p<0.03) and lower health literacy (50.4% vs 18.8%, p<.0001). In regard to context, more black women had a television visible from their kitchen (17% vs 3%, p<0.01), when compared to white women, a fry pan visible (61% vs 37%; p<0.01), spent significantly fewer average days with a spouse (4.1 vs 10.0; p<0.01), and more consecutive hours alone (20.9 vs. 15.4; p<0.03). Both groups reported seeing similar numbers of people on a weekly basis (4.2 + 2.1 and 4.4 + 2.2), home as their most common location, and the same amount of time at home (39.2 + 50.1 and 35.5 + 30.1 hours; p=.422).
CONCLUSIONS: Variables such as lower health literacy and annual income have commonly been associated with the higher incidence of obesity among black women. Intervening on the higher prevalence of micro-level obesogenic cues in the homes of black women is another potential target for weight loss interventions.