Affected by Association: Having a family member with legal/police problems and body mass index in a multi-ethnic cohort of women transitioning through menopause Open Access

Lemon, Tiffany La'Shay (2016)

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Background: Millions of Americans encounter the legal system each year. The health implications of having legal or police problems have been well-documented, especially among incarcerated populations. Missing from the literature, however, is an insight into the health of those closest to the individuals facing legal and/or police problems--their family.

Methods: We examined the association between a specific network stressor, family legal/police problems (FLPP) and body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) over 11 years in 3,302 women from Study of Women Across the Nation (SWAN). SWAN is a multi-ethnic longitudinal cohort study of women transitioning through menopause. Data were analyzed with generalized linear mixed modeling techniques.

Results: Of the 3,302 women included in these analyses, 506 women reported FLPP at baseline. Compared with women who did not report FLPP at baseline, women who did report FLPP had higher BMIs by 1.20 (95% CI: 0.49 - 1.90) kg/m2 in models adjusting only for demographic factors. After controlling for behavioral and health factors (smoking, physical activity, daily caloric intake, diabetes, menopause status, and depression), women who reported FLPP still had higher BMIs by 0.96 (95% CI: 0.14 - 1.77) kg/m2. Within stratified categories of age, race, and education, BMI increases yearly by 0.14 (95% CI: 0.13 - 0.15) kg/m2; however, increase in BMI over time was not different by FLPP report at baseline (b = 0.03, 95% CI: -0.01 - 0.06). Sensitivity analyses confirmed the results from our primary analyses.

Discussion: The results of this study demonstrate that the reach of the legal system extends well beyond the alleged offender and into the lives of the women that care about them. Our findings show that mid-life women who report having a family member with legal or police problems at baseline have higher BMI at study start and that their elevated BMI remains stable across the length of follow-up. Future studies should seek to better understand and characterize health disparities in this population and identify ways in which communities and health care professionals can better serve their unique health needs.

Table of Contents

Introduction. 1

Methods. 3

Study Design. 3

Participants. 3

Family Legal/Police Problems (FLPP). 4

Covariates. 5

Body Mass Index. 6

Statistical Analyses. 6

Results. 7

Descriptive Statistics. 7

Generalized Linear Mixed Modeling. 7

Sensitivity Analysis. 8

Discussion. 10

References. 16

Tables. 21

Table 1. 21

Table 2. 22

Table 3. 23

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