Acquired Health: The Role of Cultural Health Capital in Adolescent Obesity-Prevention Behaviors

Background

Poor engagement in obesity prevention behaviors in adolescents is linked to higher chronic disease burden in adulthood. Further, compared to high-income and White adolescents, low-income and racial and ethnic minority adolescents have higher obesity rates and engage in fewer obesity-related preventive health behaviors. Cultural health capital (CHC) theories suggest that poor socioeconomic conditions limit opportunities for developing the health skills, values, and beliefs required for a healthy lifestyle; perhaps accounting for the low obesity prevention behaviors of adolescents who are low-income. The current study used exploratory methods to better understand the role of CHC in the obesity prevention-related behavioral determinants of adolescents who are low-income and racial and ethnic minorities.

Method

Four focus groups with adolescents ages 12-18-years-old (N=13; 53.8% girls, 61.5% Black/African-American, 92.3% free/reduced price lunch) were conducted at a community organization in New England. The purpose of the focus groups was to determine the extent of adolescent engagement in obesogenic preventive health behaviors, media use, and adolescent motivation for health behavioral change. Focus groups were audio-recorded, transcribed verbatim, and coded using Smith and Firth’s (2001) framework approach.

Results

The determinants of adolescents’ obesity prevention behaviors were indicative of the three types of CHC and were patterned across the levels of adolescents’ ecology. At the individual level adolescents referred to cultural capital or values and beliefs as their motivation for engaging in diet and physical activity behaviors. Specifically, the cultural value of future orientation was expressed as wanting to be an athlete or having a culturally-celebrated body image. At the relational level social capital referred to peers and parents as agents who provided adolescents with information about normative health behaviors and social support for engaging in normative health behaviors. At the community and household levels, economic capital, or resources were deemed vital for adolescents to practice these health behaviors; however, these resources were not always available.

Conclusions

This study highlights the importance of CHC as a determinant of adolescent obesity prevention-related behaviors. Despite the limited resources adolescents had to engage in health promoting behaviors, adolescents acquired adaptive health-related skills and values (e.g., future orientation) through relational processes. Thus, CHC for obesity prevention-related behaviors may be cultivated in under-resourced contexts. Understanding the ways in which adolescents who are low-income develop adaptive preventive health skills in under-resourced contexts may serve to inform targeted obesity prevention programs.