Nicole Carlson, “Racial and Socioeconomic Disparities in Self-Reported Childhood Body Size”
Mentors: Ellen Velie, Elizabeth Duthie & Darek Lucas, Public Health
The prevalence of obesity has increased in the United States in recent decades and is associated with negative health outcomes, including breast cancer. The association between childhood body size and breast cancer, however, is not well understood. Childhood body size is difficult to assess. The objective of this project is to evaluate the validity of self-reported relative childhood body size at age 12. We also evaluate factors associated with self-reported childhood body size, e.g., race/ethnicity, household percent poverty, pubertal status, adult BMI, and childhood food insecurity and physical activity. Participants in the Young Women’s Health History Study rated their body size at age 12 on the Stunkard scale, which consists of nine body figures ranging from underweight (1) to overweight (9) and is commonly used to assess recalled body size. Participants also provided the study team with childhood photographs. A total of 62 participant photos at age 12 were independently assessed by two study staff evaluators who assigned each image a Stunkard body size. The two evaluators’ assessments were compared to one another to assess reliability. The evaluators’ assessments were then averaged and compared to the participants’ self-report of relative childhood body size. Factors associated with recall, such as race/ethnicity, household percent poverty, pubertal status, adult BMI, and childhood food insecurity and physical activity were also evaluated. Comparisons were analyzed using Cohen’s Kappa statistic. The two independent evaluators’ ratings have fair agreement with one another (Kappa = 0.40), while the averaged evaluators’ assessments have low agreement with the participants’ self-assessments (Kappa = 0.21). Additional analyses are in progress. This study develops a method to evaluate childhood body size that can be used in future studies to examine the impact of childhood body size on adult health and exposes limitations affecting this method.