Health disparity essay – obesity in US adolescents population article critique

Health disparity essay – obesity in US adolescents population article critique

Perform an academic search and choose an article from a peer-reviewed journal that describes a disparity of a population. Write a critique of the article that is not more than 6 pages (excluding title page and reference page). Use APA format. Paper should include and abstract, introduction, critique, conclusion, and reference page.

Disparities in Income Related to Obesity as Seen In the Population of California Adolescents: An Article Critique



That disparities exist among populations on various aspects is a fact that is evident in day-to-day life. That health disparities also exist among different populations is also a sad reality that must be accepted. This is the reason why calls for social justice in health and the addressing of the social determinants of health are growing louder. One of these health disparities in the United States has been observed with regard to obesity. Several studies have shown that obesity is paradoxically more rampant among the low socio-economic class Americans than it is among the wealthy. One particular study by Babey et al. stands out in its attempt to bring out this disparity in the adolescent population of the United States. A look at the merits and demerits of the article and a critique of the same is worthwhile, if the impact of this population disparity is to be appreciated. Health disparity essay – obesity in US adolescents population article critique.

Key words: Obesity, adolescent, prevalence, low socio-economic status

Disparities in Income Related to Obesity as Seen In the Population of California Adolescents: An Article Critique

One of the greatest health disparities among populations ever seen in the United States is found in obesity. This is especially so in the population of adolescents in the country. According to Babey et al. (2010), between 1970 and 2003 obesity in US adolescents aged 12-19 years rose from 6% to 17%. Frederick et al. (2014) and Wang et al. (2011) also arrived at the same conclusion that obesity among US adolescents is on the rise and shows disparity in terms of socio-economic status. Obesity and overweight are conditions that are known to lead to serious health complications that include cardiovascular disease (CVD), hypertension, and type II diabetes mellitus. Because of this, obesity reduces longevity and is a threat and burden to the healthcare system and the Affordable Care Act of 2010 (Babey et al., 2010). Despite an indication that the trend is reaching a plateau, research shows that the prevalence rates of obesity among adolescents in the country is still high, one figure placing the value at 18% nationally (Babey et al., 2010). Among the adolescent population in the United States, numerous studies have demonstrated that income is inversely proportional to obesity prevalence. As a matter of fact, the prevalence of adolescent obesity is still on the rise among subjects from low socio-economic backgrounds. On the contrary, those adolescents from more affluent backgrounds are experiencing a decline in the prevalence of obesity (Babey et al., 2010; Frederick et al., 2014; Wang et al., 2011; Dzewaltowski & Ford, 2008; Zhang & Wang, 2004). This paper selects the journal article by Babey et al. (2010) as a point of reference, examines it and offers a critique of the same in light of this health disparity in the US adolescent population. Health disparity essay – obesity in US adolescents population article critique.

Article for Critique

Babey et al. (2010) tested the hypothesis that the prevalence of obesity has risen among lower socio-economic class adolescents compared to higher socio-economic class adolescents in the US adolescent population. Theirs was not original research as they used data already available from the California Health Interview Survey or CHIS. Considering that environmental influences on obesity affect gender differentially, the authors also looked at the possibility that changes in income disparity observed in obesity differs by gender.


The data used was from a sample of 17,535 adolescents who responded to the CHIS telephone survey between 2001 and 2007 on the disparity in obesity prevalence by family income and gender. To be specific, the authors selected data from adolescent respondents aged 12-17 years who responded to the interview in 2001, 2003, 2005, and 2007. For unspecified reasons, they omitted the responses from the years 2002, 2004, and 2006. The sampling was by geographical stratification and randomization. In each household, one randomly chosen adult responded to the question on family income. In those that had adolescents, one was randomly interviewed after obtaining parental consent. The languages arbitrarily chosen for the interviews were Chinese, Vietnamese, English, Korean, and Spanish. The body mass index (BMI) of each adolescent respondent was calculated based on self-reported values for weight and height. The gender, age, and ethnicity of the respondents were also self-reported over the phone. Finally, to obtain results, nonparametric statistical regression analysis was carried out (Babey et al., 2010). Health disparity essay – obesity in US adolescents population article critique

Results of the Study

The authors found that the prevalence of obesity significantly rose among adolescents from low socio-economic status families between 2001 and 2007. As for the adolescents from more well-to-do families, the prevalence of obesity showed a statistically insignificant change. All this was after adjustment accordingly for gender, age, ethnicity, and race (Babey et al., 2010).

Study Conclusion

The authors concluded that there was a more than two-fold increase in the prevalence of obesity among the population of adolescents in the state of California between the years of 2001 and 2007. They also concluded that males were more affected than females (Babey et al., 2010) Health disparity essay – obesity in US adolescents population article critique.

Critique of Babey et al. (2010)

This was a commendable study, given that the disparity in obesity prevalence through the prism of socio-economic status in the US has been an area of research interest for a while. However, it is an accepted fact that stronger and much more reliable evidence usually comes from primary research. This is because the researchers in that case would have the advantage of controlling for confounding variables and minimising the limitations of the study. Babey et al. opted instead to use data that had already been gathered by another survey. Because of this alone, any conclusion they arrive at will have been influenced by whatever errors and limitations the original survey had. In addition to that, conducting a telephone interview/ survey as was the case with the original survey that generated the data they used is fraught with dangers of the respondents cheating. A subject that you are not physically observing as a researcher can always give you nonfactual information and you will have no way of knowing Health disparity essay – obesity in US adolescents population article critique. For instance, a minor may have lied on phone that they are the adult in the household and cheated about the family income. This kind of information ends up distorting the true picture of the situation as the researchers would have wanted to ascertain.

To compound the questionable validity and reliability of their conclusions further, Babey et al. decided to omit responses from the years 2002, 2004, and 2006 without good reason. In any case, if there was any good reason for the action, they didn’t expressly state it in their article. Despite these glaring shortcomings, however, Frederick et al. (2014) also reached a similar conclusion in a study of the same calibre. They also examined changes in US adolescent obesity prevalence by socio-economic status among ages 12-17 years. Like Babey et al. (2010), these researchers also used secondary data from the 1988-2010 National Health and Nutrition Examination Surveys and the 2003-2011 National Survey of Children’s Health. Their finding showed that overall adolescent obesity prevalence appeared to have stagnated. However, they agreed with Babey et al. (2010) that this prevalence has dropped among adolescents from well-off families and increased among adolescents from poor families. Health disparity essay – obesity in US adolescents population article critique.

By only choosing to arbitrarily use five languages in conducting the telephone interviews, the CHIS limited itself in the amount of factual data that it could have collected. This limitation was inevitably absorbed in the study by Babey et al. that relied on this data. The United States is a melting pot of numerous cultures and languages from around the world. A journey across the country would take someone to far-off places right here at home. This is because many immigrants have settled in the US over the years for economic and other reasons. As a matter of fact, the parents to millions of Americans were not born in the United States. To therefore limit the languages of the interview to only five in an important research undertaking is to shoot oneself in the foot in scholarly terms. Without doubt, this decision was most likely informed by cost considerations. But its impact on the validity and reliability of the study by Babey et al. (2010) may be considerable. Babey et al. have however achieved plausibility by stating that despite other studies finding the association between obesity and socio-economic status weakening, among African Americans and Hispanics the correlation is strengthening. The authors quote Goodman et al. as stating unequivocally that the prevalence of obesity among the American adolescent population would not be high if their families were not poor (Babey et al., 2010). This is the result of the American reality where minorities have traditionally been discriminated against in terms of education opportunities, employment, and political representation. Elsewhere, this has been called institutionalised racism. As a result, low socio-economic status is associated with Black and Hispanic communities while prosperity and high social standing is almost a preserve of the white majority. According to Dzewaltowski and Ford (2008), any “built or social environment” (p. 2016) will therefore follow these long established social inequality patterns. High obesity prevalence among the poor US adolescents has simply followed these same patterns. Health disparity essay – obesity in US adolescents population article critique


In the CHIS survey whose data Babey et al. (2010) relied upon, it has been seen that the BMI was calculated from self-reported weight and height by the adolescents surveyed. This is hugely significant. As anyone would tell, the percentage of adults – let alone adolescents – that could correctly tell you their weight and height is quite small in the target population (low socio-economic status Americans). This conclusion is informed by the reality of the low family incomes that would not allow for disposable income to buy even a weighing scale. A weighing scale in the poor communities that suffer most from this obesity scourge in the US is quite higher up in the Maslow’s hierarchy of human needs of the population. It therefore follows that there is a high likelihood that figures that were used by Babey et al. to compute the BMI of the adolescent respondents in the study are erroneous and not entirely representative.

The other self-reporting was on family income. To begin with, it has already been observed above that a minor could have easily assumed the role of an adult and given erroneous financial information about the family. This is a real situation because the researchers were not physically on location to interview subjects. In the case where an adult indeed responded to the income question, there is also a high likelihood that they could have lied out of embarrassment for being poor. If the researchers were physically present, this would not have been possible because they would see physical indicators of poverty or affluence with their own eyes and correlate that with the answer. These are factors like housing, a car in the driveway, or even grooming. Health disparity essay – obesity in US adolescents population article critique

Lastly, self-reported gender, age, and ethnicity as was the case in the CHIS survey would also be problematic for similar reasons as above. By the mere fact that the interviewers were not physically present, respondents could have lied about their age, gender, or ethnicity. For instance, it is a known fact that there are Americans who are not proud of their ethnic extraction as a consequence of generations of abuse and racism. Given a chance, these persons would lie to a stranger on phone that they are a race they are not. Also, if a respondent were transsexual, it would have been difficult for them to answer the gender question.

In all, however, the study by Babey et al. (2010) was a laudable effort at adding knowledge on the issue of health disparities among populations within the United States of America.


Obesity prevalence among adolescents from the poor families in America demonstrates the reality of the health disparities that exist in the US population. Many studies have been conducted to study this phenomenon, and one of them is that by Babey et al. (2010). This study relied on secondary data from the CHIS survey. Despite its shortcomings stemming from the limitations of the original survey, the study reveals important insights into the obesity prevalence disparity in terms of socio-economic status of adolescents in the US. Health disparity essay – obesity in US adolescents population article critique


Babey, S.H., Hastert, T.A., Wolstein, J. & Diamant, A.L. (2010).  Income disparities in obesity trends among California adolescents. American Journal of Public Health, 100(11), 2149-2155.

Dzewaltowski, D.A. & Ford, P.B. (2008). Disparities in obesity prevalence due to variation in the retail food environment: three testable hypotheses.  Nutrition Reviews, 66(4), 216–228,

Frederick, C.B., Snellman, K., & Putnam, R.D. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338–1342.

Wang, C.Y., Gortmaker, S.L., & Taveras, E.M. (2011). Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. International Journal of Pediatric Obesity, 6(1), 12–20.

Zhang, Q., & Wang, Y. (2004). Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter? Social Science & Medicine, 58(6), 1171–1180.  Health disparity essay – obesity in US adolescents population article critique



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