Perceptions of Health, Weight, and Body Image among Afro-Caribbean Women in the US Virgin Islands
Creators: name: Greenhow, Laura
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2012

description: The United States Virgin Islands (USVI) are located between the Atlantic Ocean and the Caribbean Sea, southeast of the southern tip of Florida, and directly east of Puerto Rico. The USVI is comprised of four main islands: St. Thomas, St. Croix, St. John, and Water Island. The demographics of the 105,000 people in the USVI are 78% black, 10% white, and 12% other. The majority (81%) of Virgin Islanders are of West Indian descent, with 49% born in the Virgin Islands and the remaining 32% with birthplaces on other Caribbean Islands. In the United States, nearly two-thirds of adults are overweight or obese with similar trends in the USVI (66.2%). African American (AA) women have the highest rates of overweight and obesity compared to other groups in the United States, with four out of five AA women being overweight or obese. In 2010, AA women were 70% more likely to be obese than non-Hispanic White women. AA women are 1.8 times as likely to be diagnosed with diabetes, 1.4 times as likely to die of heart disease, and 1.4 times as likely to suffer a stroke as non-Hispanic white women. Data from Puerto Rico, Guam, and Latin America is often combined with data gathered in the USVI, making it difficult to pinpoint the rates of chronic disease specific to this area. BRFSS data is available for some years and some chronic diseases; however, less than 70% of Virgin Islanders have a main phone line to participate in this survey. Additionally, this data is not divided into prevalence rates specific to gender or racial/ethnic groups. The relationship between body image and body mass index (BMI) is not well understood, especially among ethnic minorities. Perceived body image varies by ethnicity and may be indicative of awareness of weight and health risks. There is evidence that AA women have heavier body image ideals than white women and that AA women are more likely to perceive themselves as normal weight when they are actually overweight. Several studies suggest that AA women may perceive an obese body size as desirable for health and beauty. Other research shows that AA women have a definition of health that incorporates the mind-body-spirit connection and encompasses body type and the need to maintain equilibrium. In gauging attractiveness, AA women describe shapeliness and the fit of clothing and appear more concerned with their public image of “looking good” involving their general presentation when dressed. In a study by Ristovki-Slijepcevic et al. (2010), AA women were far more likely than white women, and all men, to express resistance towards obesity discourse and the equation between thinness and healthiness, emphasizing the value of having “meat on one’s bones”. In another study, AA participants espoused self-acceptance and nurturance, rejecting mainstream cultural pressures. Previous research has neglected to incorporate health behaviors, such as healthy eating and physical activity, which may influence body image perceptions and contribute to obesity. Fresh fruits and vegetables and low-fat foods have been included in definitions of a healthful diet among AAs. A study by Lynch et al. (2012) found that fruits and vegetables were considered most healthful and starchy foods were considered least healthful among low-income AA women. Starchy foods were considered unhealthful mostly due to the belief that starch was high in fat and contributed to weight gain. Rowe’s study (2010) of AA women found fruits, vegetables, and low-fat foods as well as whole grains, brown rice, cereal, oatmeal, and popcorn to be considered healthy. Perceived unhealthy foods contained high fat, salt and/or sugar like ribs, hamburger, fried foods, processed foods, lunchmeat, cakes, and cookies. Despite having mainstream knowledge of healthy foods, AA women are less likely to consume healthy diets. Additionally, in 2009, AAs had the highest median percentage of physical inactivity with AA women leading in physical inactivity statistics in almost all communities in the US. There is conflicting research about a link between obesity and chronic disease among AA women. Some research has linked obesity among AA women to higher mortality and incidence rates of coronary heart disease, hypertension, diabetes, and certain cancers. Other research has failed to find a direct relationship between the prevalence of obesity and obesity-related diseases in AA women. Psychologic factors such as weight-related quality of life (QOL) may play a role in the discrepancy between obesity and obesity-related diseases among AA women as AA women report less impairment than white women in their weight-related QOL. Normally, as BMI increases, QOL decreases. However, AA women report higher QOL compared to white women of similar BMIs. While previous research has examined health beliefs and behaviors among AA women, few studies have focused on Afro-Caribbean (AC) women, and we were unable to identify research specific to the USVI. Therefore, the primary objective of this pilot study was to qualitatively examine the relationships among health, weight, and body image among Afro-Caribbean women in the USVI.