EDUCATION, HEALTH BEHAVIORS, AND THE BLACK-WHITE DIFFERENCE IN WAIST-TO-HIP RATIO

Few epidemiologic studies have investigated the impact of body mass in dex, low educational attainment, cigarette smoking, and physical activ ity on the considerable black-white difference in waist-to-hip ratio, These relationships were assessed with multivariable linear regression among 3,094 adults (24% black) who were examined in 1987 in South Car olina, The unadjusted mean waist-to-hip ratio was lower for black men than for white men (-0.03 units) and higher for black women than for w hite women (+0.03 units), After adjustment for age, body mass index, e ducation, smoking, and physical activity, the black-white difference i n mean waist-to-hip ratio was -0.02 units (p<0.001) among men and +0.0 1 units (p<0.01) among women, Although differing distributions of age, body mass index, and educational attainment accounted for a 59% reduc tion in the black-white difference among women, these factors did not explain the difference among men, Thus, these results suggest that oth er environmental or biologic factors may also play an important role i n the marked variation in body Eat distribution between the two ethnic groups, The results also support the importance of the prevention of cigarette smoking and overweight in potentially preventing abdominal o besity in both black adults and white adults.