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Emerging Infectious Diseases Journal
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Volume 6: No. 3, July 2009

SPECIAL TOPIC
A Health Disparities Perspective on Obesity Research

Family Income, % of Federal Poverty Level % of Children (95% Confidence Interval)
<100 17.8 (16.0-19.7)
100–199 15.8 (13.6-18.2)
200–299 15.9 (13.1-19.1)
300–399 15.2 (12.2-18.7)
≥400 11.7 (9.5-14.3)

Figure 1. Prevalence (95% confidence interval) of obesity among children (2-19 years, age adjusted), according to family income as a percentage of the federal poverty level; the federal poverty level during 2004 was $18,850 for a family of 4 (7). Data source: National Health and Nutrition Examination Survey, 1999-2004.

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The policy context is the outermost shell of the model. The next layer is the social context. At the top, as a part of the society stratum, an intervention can be made here by influencing social stratification. Social stratification influences social position by race and class in the individual stratum. This results in differential exposure to health hazards, and an intervention can be made here by decreasing harmful exposures (or increasing health-promoting exposures). Social position by race and class not only leads to differential exposure but also to differential vulnerability to the adverse health effects of exposure. Interventions can be made here to decrease vulnerability (or increase resilience). Exposure of a vulnerable person leads to disease or injury. Social position by race and class also results in differential consequences of disease or injury. Interventions can be made here by preventing unequal consequences. The differential social consequences of ill health result in further social stratification (linked back to the top of the model).

Figure 2. How health disparities are produced and reproduced across a lifetime and generations, and possible points to intervene. Adapted from Finn Diderichsen, Karolinska Institute, Stockholm; reprinted with permission.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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