Date of Award

12-2008

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Nursing

Research Advisor

Muriel Curry Rice, Ph.D.

Committee

Patricia Cowan, Ph.D. Patricia Cunningham, Ph.D. Mona Newsome Wicks, Ph.D. Hossein Yarandi, Ph.D.

Keywords

Depressive symptoms, obesity, African American women, welfare, health risk behaviors, personal risk factors

Abstract

Depression and obesity are significant public health problems that adversely affect the health and quality of life of women in the United States, particularly female African American welfare recipients transitioning to work. African American women are twice as likely to experience depressive symptoms as women of other races. Fifty percent of African American women are obese. The prevalence of depression and depressive symptoms and obesity is higher among African American women who receive welfare benefits. These health conditions jeopardize their health status, ability to work, and chances to become self-sufficient. To ensure the successful transition of recipients to work, health care providers and researchers must better understand how depression and obesity affect the overall health status of African American women on welfare. It is imperative that factors that predict these disorders in this population are identified and used to guide risk reduction interventions. Few studies have examined risk factors for depressive symptoms and obesity and the relationships among these variables in African American women welfare recipients moving into the workforce. Thus, the purposes of this study were to describe the prevalence of depressive symptoms, obesity, and health risk behaviors among African American women transitioning from welfare to work. Additionally, the investigator explored the associations among health risk behaviors (physical inactivity, poor nutrition, smoking, and alcohol consumption), personal demographic risk factors (age and education), one biological risk factor (BMI), perceived health, depressive symptoms, and obesity in this population. This descriptive, correlational study utilized a secondary data source to examine the health assessments of 162 African American women aged 18 to 55 years, enrolled in welfare to work program at a large research university in the mid-southern region of the United States. Three instruments were used to assess study variables: the Healthier People Network Health Risk Appraisal (HPN-HRA), the Perceived Health Status Appraisal, and the Center for Epidemiological Studies Depression Scale (CESD). Thirty-five percent of the participants reported moderate levels of depressive symptoms (CES-D score 21-30). Twelve percent of participants reported severe levels of depressive symptoms (CES-D score ≥ 30). Forty-eight percent of the participants had body mass index (BMI) scores ≥30kg/m². The average BMI was 33.6±6.7 kg/m² which is indicative of obesity. Despite the high rates of depressive symptoms and obesity found in this sample, there were no statistically significant relationships indicated between depressive symptoms and obesity. Findings warrant further investigation to improve health outcomes of African American women transitioning from welfare to work. Long term retention in the workforce and economic independence are closely linked to the health status of recipients. More prospective studies are needed to determine the pathways by which depressive symptoms and obesity interact in this population in order to develop tailored effective prevention strategies.

DOI

10.21007/etd.cghs.2008.0269

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