Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 17
Socio - c ultural i ssues and b ody i mage
Helen Mavoa, 1 Shiriki Kumanyika 2 and Andre Renzaho 3
1 WHO Collaborating Centre for Obesity Prevention, Melbourne, Australia
2 Department of Biostatistics and Epidemiology, and Department of Pediatrics, University of
Pennsylvania School of Medicine, Philadelphia, PA, USA
3 WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Medicine, Nursing
and Behavioural Sciences, Deakin University, Burwood, Australia
Summary
The increasing prevalence of childhood obesity and
overweight is disproportionate in some ethnic groups.
Drawing on data from three separate countries, we
focus on three populations that have high or similar
levels of obesity relative to other ethnic groups in the
same countries to discuss relationships between socio -
cultural factors, other environmental components and
childhood obesity. We refer to: (1) indigenous Fijians
(Fijians), who constitute the majority of the population
in Fiji; (2) African Americans, who have resided
in the United States of America for generations and
remain a minority ethnic group; and (3) Africans, who
have recently migrated to Australia and constitute a
fast - growing minority ethnic group. We focus on:
• how socio - cultural factors underpin body - size preferences
and eating and physical activity (activity)
patterns
• examining socio - cultural factors in a wider context,
including the physical environment and historical,
social, economic and political factors
• the conceptualisation and integration of socio -
cultural factors into research and contextually -
relevant programs that reduce childhood obesity by
encouraging a healthy lifestyle.
Introduction
Contextual b ackground
The independent Pacific nation of Fiji comprises 57%
indigenous Fijians (Fijians) and 38% Indo - Fijians. 1
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
Fiji has experienced a series of influences and socio -
political changes, including: the arrival of indentured
labourers from India (1897 – 1916; the gaining of independence
(1971); and four coups. Since the 1960s, Fiji
has been exposed to increasing international movement
of people, ideas and goods, a rural – urban shift,
greater access to cash, increasing consumption of
high-energy imported foods
2 – 4 and changes in actual
and ideal body size. 5,6 There is a high prevalence of
obesity among Fijian adults; 42% of males 7 and > 47%
of females 7 – 9 have a BMI > 25 kg/m 2 . The higher prevalence
of obesity in young Fijian adults than Indo -
Fijians 7 suggests that the physical environment is not
the only influence on body size, and that socio -
cultural, historical and economic factors also come
into play.
African Americans (also referred to as non - Hispanic
black Americans) are descendants of people
brought to the USA during the slave trade. Even
counting the increasing numbers of immigrants from
Africa or the Caribbean who may identify themselves
in this census bureau category, >90% of African
Americans are US-born. 10 African Americans constitute
13% of the US population 11,12 and, until recently,
were the largest US “ethnic minority ” group. * In
the US black population overall, people of any race
who identify as “ Hispanic ” , now outnumber African
*The term “ethnic minority ” refers to a sub-population that is
disadvantaged in terms of language, economic status or
religion and whose people have limited space to express
themselves culturally and socially. “ Ethnic minority ” does not
necessarily imply numerical disadvantage. In Australia the
term “ culturally and liguistically diverse communities ” is used
when describing ethnic minority groups. 13,14
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