Language
English (en)
Date of Award
7-4-2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Chair and Committee
Alexis Duncan
Abstract
Traditional epidemiologic research has often neglected the degree to which interlocking systems of oppression may (1) describe the distribution of population health inequities and (2) moderate health exposure-outcome associations. Grounded in an intersectional framework, this three-aim dissertation used an intersectional multilevel modeling approach (i.e., intersectional MAIHDA) and US nationally representative data to answer a series of intersectionality-informed research questions relevant to disordered eating, depression, and cardiometabolic health. With data from the National Health and Nutrition Examination Survey, Aim 1 quantified the population distribution of weight loss-oriented disordered eating behaviors (DEBs) among US adults across intersectional groups defined by race/ethnicity, sex/gender, sexual orientation, and weight status. Using the same data source and intersectional group definitions as the prior analysis, Aim 2 examined comorbidity patterns between DEBs and depression and estimated whether the association between DEBs and depression varied across intersectional groups. With data from the National Longitudinal Study of Adolescent to Adult Health, Aim 3 estimated whether disordered eating, depression, and their comorbidity (assessed in adolescence/young adulthood) were prospectively associated with incident risk of diabetes, hypertension, and/or hyperlipidemia (assessed in middle adulthood). Using intersectional groups defined by race/ethnicity, gender identity, and weight status, effect modification of these longitudinal associations was assessed. Overall, this dissertation highlights the importance of considering the role of interlocking systems of oppression when conducting both descriptive and analytical epidemiologic research. In particular, these studies offer insights into how an intersectional lens can advance the equitable design and distribution of policy and public health intervention efforts.
Recommended Citation
McGuire, Franklin Hunter, "Comorbidity of disordered eating and depression: Examining intersectional inequities and cardiometabolic health consequences across the life course" (2024). Brown School Theses and Dissertations. 37.
https://openscholarship.wustl.edu/brown_etds/37