Cumulative exposure to state-level structural sexism and risk of disordered eating: Results from a 20-year prospective cohort study.
Soc Sci Med
; 301: 114956, 2022 05.
Article
en En
| MEDLINE
| ID: mdl-35436662
ABSTRACT
BACKGROUND:
Gendered inequities in disordered eating are well-documented, yet few studies have examined their structural drivers. To help fill this gap, we investigated whether cumulative exposure to state-level structural sexism from childhood through young adulthood potentiates differences in disordered eating risk between cisgender girls/women and boys/men.METHODS:
Participants came from the Growing Up Today Study (N = 16,875), a cohort of children aged 9-14 years in 1996 who we followed through 2016. Using a composite index of relevant state policies and social inequalities from the Institute for Women's Policy Research, we categorized states as having high or low levels of structural sexism and summed the number of years participants had lived in a high structural sexism state during the study period to quantify their cumulative exposure. We fit sequential conditional mean models to estimate the effect of cumulative exposure on risk of four outcomes (chronic dieting, purging, binge eating, and overeating), controlling for individual- and state-level confounders via propensity scores. We then tested whether effects differed between girls/women and boys/men by including cumulative-exposure-by-gender-identity interaction terms and calculating the relative excess risk due to interaction (RERI).RESULTS:
In the full sample, each additional year of living in a high structural sexism state was associated with a 5% increased risk of purging (95% confidence interval (CI) 3%, 7%), an 8% increased risk of binge eating (95% CI 6%, 10%), and a 9% increased risk of overeating (95% CI 8%, 11%). Risk increases were larger on average for girls/women than for boys/men, and girls/women who had lived in a high structural sexism state for four or more years had excess risk of chronic dieting (RERI 0.64, 95% CI 0.18, 1.10), purging (RERI 2.64, 95% CI 1.24, 4.30), and binge eating (RERI 2.21, 95% CI 0.93, 3.50).CONCLUSIONS:
Structural sexism may contribute to inequities in disordered eating between cisgender girls/women and boys/men. Future research should include transgender and gender diverse participants, explore intersectional effects, and identify underlying mechanisms to inform policy-oriented interventions.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Bulimia
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Trastornos de Alimentación y de la Ingestión de Alimentos
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Soc Sci Med
Año:
2022
Tipo del documento:
Article