Date of Award

Spring 5-16-2014

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Daniel James Whitaker, Ph.D.

Second Advisor

Jenelle Shanely, Ph.D.

Abstract

Introduction: Approximately 3 million child maltreatment (CM) referrals are made each year to state and social service agencies (U.S. Department of Health and Human Services- Children’s Bureau, 2012). This number appears to be an underestimate of the size of the problem however. Survey data collected by the Children’s Bureau of the U.S. Department of Health and Human Services estimates that about six million children are maltreated in the U.S. per year. CM negatively impacts the mental and physical health and social outcomes of victims in childhood and adulthood. For example, CM has been linked to obesity and overweight in children and adults. Similar to CM, overweight and obesity are also associated with various long-term and short-term health conditions for children and adults. Beyond the specific provision of food and modeling of eating and exercise behaviors, other family factors have been shown to relate to obesity including disorganized family environments, low parental supervision, maternal antipathy, child maltreatment, and family dysfunction.

Objective: To examine the relationship between CM and obesity using a large sample of twin and sibling pairs, I will first examined the simple relationship between various form of abuse and obesity, and then, following the methodology of Vámosi et al. (2011), examine twin and sibling pairs to look at differences in experiences of CM and obesity.

Methods: The current study used the Midlife Development in the United States (MIDUS), a public use longitudinal data set with information in the areas of physical, emotional/mental, and lifestyle characteristics of individuals in their 20’s, 40’s, and 60’s. The data set also includes nationally representative data about sibling and twin pairs. The MIDUS I had a sample of 7,108 participants. The MIDUS II was a follow-up of the MIDUS I and included 4,963 participants. The main variables I used were Body Mass Index (BMI) and CM, which was measured through the Conflict Tactics Scale. I controlled for various variables that contribute to overweight or obesity, such as socioeconomic status, educational attainment, physical activity, and depression. The comparison of twin and non-twin sibling data was of particular interest because of the strong genetic component of obesity.

Results: Analyses were conducted using SPSS. I first examined simple correlations between abuse variables and obesity. Next, I conducted regression analyses examining the relationship between abuse and obesity, while controlling for gender, educational attainment, age, and several other variables associated with CM and obesity. The third analyses focused on examining differences in the abuse – obesity relationship between twin and sibling pairs. There was a small, negative relationship between BMI continuous and emotional abuse and physical abuse. There was a small, positive relationship between each form of abuse and BMI categories.

Discussion: Although statistically significant results were found, they were small. The relationship between obesity and overweight and experience of CM is valid after controlling for various predictors, like health insurance, depression, and self-rated physical and emotional health. Public health practitioners should be sensitive to the physical health of victims of CM, especially concerning obesity and overweight. Many public health practitioners focus on the mental and emotional health of victims of CM, but they should also be made aware of the impact that CM has on physical health. There are several limitations. Regarding the CM variables, participants may have had difficulties recalling events from their childhood, so recall bias is a major limitation. Another limitation is that much of the data is self-reported which could have led to some data, like BMI, being inaccurate. Finally, we do not know the quality of the phone interviews or how well phone interviewers were trained.

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