Intersections of Structural State-Level Racism and Neighborhood Deprivation on Nutrition and Obesity for Black Adolescents

Black adolescents in the United States face disproportionate poor nutrition and obesity risk due to racism. Intersections of larger structural contexts that pose differential access to Black adolescents' health resources, such as state-level racism and neighborhood-level disadvantage, may govern these risks. The purpose of this correlational study was to examine the associations between state-level racism, neighborhood disadvantage, and their intersection with nutrition and obesity for Black adolescents in a longitudinal study. Publicly available administrative data measuring state-level racism was linked to 2 waves (collected 2016–2018) of individual-level demographic, health, and neighborhood data from 1,530 Black adolescents (M age at baseline  = 9.46; 47.70% female) from the Adolescent Brain and Cognitive Development Study. Neighborhood deprivation scores were calculated from American Community Survey data. Caregivers reported adolescents' nutrition and demographics. Adolescent waist circumference and height and weight (converted to body mass index) were measured. Residing in a state higher in racism was associated with greater body mass index for adolescents 1 year later ( B  = 0.29, p  =.001), and residing in a neighborhood higher in area deprivation was associated with worse nutrition 1 year later ( B  = −0.02, p  =.001). Both state-level racism and neighborhood disadvantage exert separate negative influences on health outcomes. Targeting separate state- and neighborhood-level social policies for obesity and nutrition risk may be crucial to bolster the health of Black adolescents.