Why Do Black Women Have a Higher Obesity Prevalence Than White Women in the United States?

Although there are large Black‒White obesity inequities among women in the United States, the factors that explain this racialized health inequity are not well understood, most likely because previous research has generally focused on a limited number of adult obesity determinants. We posit that more fully explaining Black‒White female obesity inequities requires greater attention to multiple life course stages and obesity determinants, including upstream and proximate determinants. Results from this study support this notion. Our analysis of data from a national sample of Black and White women finds that socioeconomic and social disadvantages, such as living in disadvantaged neighborhoods and single-parent households as adolescents and having lower adult household income, explain the majority of group differences in obesity prevalence. Population health initiatives aimed at tackling racialized inequities in obesity will be most effective if they focus on systemic and structural determinants rather than individual-level behavioral factors alone. Moreover, interventions that target individuals earlier in the life course would help to alleviate Black‒White obesity inequities among women in the United States.