American Indian Alaska Native (American Indian and Alaska Native (AIAN)) adolescents and obesity: the influence of social determinants of health, mental health, and substance use
Authors' conclusion
Our findings inform future obesity prevention and treatment programs among AIAN youth; in particular, the need to consider mental health, substance use, and SDOH.
Study context
- Population
- AIAN adolescents aged 12–19 years, Indian Health Service (IHS) Improving Health Care Delivery Data Project, Fiscal Year 2013, with county-level U.S. Census and USDA data
- Participants
- 26,226 adolescents
- Outcome
- Prevalence of obesity in association with social determinants of health (SDOH), mental health and substance use disorders
Methodological detailsmultivariable logit generalized linear mixed model
- Multivariable logit generalized linear mixed model
Main finding
As reported in the abstract
Prevalence
Obesity prevalence
32.5%
Mental health disorder prevalence
13.8%
Substance use disorder prevalence
5.5%
Observational data: associations, not effects.
Further findings
Odds of obesity by individual and county characteristics (multivariable model)
| OR | P value | |
|---|---|---|
| Medicaid coverage | 1.09 | P < 0.01 |
| County with lower education attainment | 1.17 | P < 0.05 |
| County with higher rates of poverty | 1.51 | P < 0.001 |
| County with high access to a grocery store | 0.73 | P < 0.001 |
| County with higher proportion of AIANs | 0.83 | P < 0.01 |
| Mental health disorders | 1.26 | P < 0.001 |
| Substance use disordersDecreased odds of obesity | 0.73 | P < 0.001 |
| Outcome | OR | P value |
|---|---|---|
| Odds of obesity by individual and county characteristics (multivariable model)Females vs Males · lower odds in females; decreased with age | 0.76 | P < 0.001 |
- Odds of obesity by individual and county characteristics (multivariable model): adjusted for other individual and county level characteristics
Original publication
American Indian Alaska Native (AIAN) adolescents and obesity: the influence of social determinants of health, mental health, and substance use. Int J Obes (Lond). Published 7 February 2023. doi:10.
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