Abstract
Background
In human beings, dark skin requires more exposure to ultraviolet light to synthesize
the same amount of vitamin D as lighter skin. It is has been repeatedly shown that
at the latitude of the United States there are vitamin D disparities related to skin
color. Although inadequate vitamin D status and health disparities have been associated
with many of the same diseases, neither nutrition policy nor public health policy
in the United States currently recognizes any role at all for vitamin D as a determinant
of health disparities.
Objective
This study investigated the relationship between health, skin color, and vitamin D
nutriture in the US population.
Design
The design is cross-sectional, correlational, and can be generalized to the population
of the United States.
Participants
We used data from 12,505 (unweighted) subjects (3,402 non-Hispanic blacks, 3,143 Mexican
Americans, and 5,960 non-Hispanic whites), aged 13 years or older, from the continuous
National Health and Nutrition Examination Survey 2003-2006.
Main outcome measure
Self-rated health, a repeatedly validated indicator of objective health status, was
used as a continuous measure of health.
Statistical analyses performed
Using software appropriate for the complex survey design of the National Health and
Nutrition Examination Survey, the study consisted of six regression models, one predicting
vitamin D status and five predicting self-rated health.
Results
Controlling for the covariates sex, interview language, country of birth, tobacco
use, age, body mass index, and leisure exercise as well as the socioeconomic variables
education and family income, remaining disparities in self-rated health are greatly
reduced or eliminated by controlling for serum 25-hydroxyvitamin D levels.
Conclusions
We found that socioeconomic factors are the strongest determinant of skin-color based
health disparities in the US population, but that it may not be possible to eliminate
health disparities in the United States without eliminating the skin-color–related
disparities in vitamin D nutriture.
Keywords
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Biography
T. Weishaar is a student in the Health Education masters degree program, Teachers College, Columbia University, New York, NY.
Biography
J. Marcley Vergili is director of the Diabetes Education Program, Columbia Memorial Hospital, Hudson, NY; at the time of the study, she was a visiting professor, Teachers College, Columbia University, New York, NY.
Article info
Publication history
Published online: February 13, 2013
Accepted:
December 3,
2012
Available online 13 February 2013Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
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