San Francisco State University
Emma Sanchez-Vaznaugh, Sc.D., completed a doctorate in social epidemiology at Harvard University’s School of Public Health. Dr. Sanchez is a former W.K. Kellogg Health Scholar at the Center on Social Disparities in Health, University California, San Francisco-Berkeley site, and assistant professor at San Francisco State University, Department of Health Education. Dr. Sanchez is interested in how social, policies and environmental factors shape health, risk factors and behaviors over the life course. This work devotes particular attention to the influence of places and policies (i.e., birthplace, place of residence, schools and physical education laws), socioeconomic position and immigrant status on social disparities in health. Dr. Sanchez’s research examines: 1) the impact of school nutrition and physical education policies on body weight and health behaviors among children and adolescents; 2) how neighborhood conditions (social and physical) and their interaction with individual factors may influence health, disease and behaviors among adults; and 3) the socioeconomic gradients in health and disease among diverse social groups defined by gender, race/ethnicity and immigrant status.
Recent and growing competitive food and beverage (CF&B) policies seek to influence population diet and weight patterns among children throughout the nation. California offers an exceptional opportunity to evaluate the effectiveness of CF&B policies at shifting population patterns in the BMI distribution. Capitalizing on a natural experiment and existing data, this project proposes to investigate the impact of competitive food and beverage policies – -as adopted in the Los Angeles Unified School District (LAUSD) as well as in the state of California overall – on population patterns of BMI among California children in fifth, seventh and ninth grades. Project Aims: To evaluate the impact of the LAUSD CF&B policies on (a) population patterns of BMI, and (b) racial/ethnic disparities in BMI. Study Design: Our study design is based on analyses of trend. The study population is comprised of children and adolescents in fifth, seventh and ninth grades who attended public schools in the LAUSD and other California public schools between 2001 and 2007. Data: California Physical Fitness Test (FITNESSGRAM) database; the California Basic Educational Data System (CBEDS) School Information Form database; and data from the California School Free or Reduced Meal Program. Outcome measure: Body mass index (BMI), calculated based on weight in kilograms divided by height in meters squared. Independent variable: time in years (to calculate trend over time), and its interaction with a post-2004 indicator variable to allow the trend to change after 2004 (time of policy intervention).
Statistical analysis: Descriptive statistics will be calculated for all study variables, followed by computation of average BMI values for participants in the study population overall, by year, and by participants’ characteristics, e.g., gender, race/ethnicity, etc. (bi-variate analyses). A series of linear mixed regression models will be used to address study hypotheses, while controlling for individual-level variables (age, sex, race/ethnicity, physical activity and grade level) and school’s characteristics (school’s size, school’s race/ethnic composition, and school’s socio-economic indicator). Models will include a school-level random intercept and slopes as well as district level random effects as needed. Finally, interaction terms will be added in the models.
My New Connections Experience
I applied for New Connections, because it was one of the few funding vehicles for which I felt I could successfully compete and get funded, given the stage I was in my research career. In addition, my area of research and interests fit well with one of the Robert Wood Johnson Foundation’s major investments –childhood obesity.
The funding I received from the RWJ Healthy Eating Research New Connections Program has impacted my professional life in several critical ways: it has added prestige and credibility to my research, increased my visibility, strengthened my professional network, and expanded my community of learning in the field of childhood obesity. Finally, as a junior, minority investigator, the RWJ-HER support has paved the way for me to build a solid platform from which to have a voice and to make meaningful contributions to prevent childhood obesity in our country.
I am interested in analyzing, documenting and monitoring the social, environmental and policy determinants of health, with an emphasis on obesity and health disparities across the lifespan. The overarching goals of this research are to generate sound evidence, as well as inform policies and programs, so that population health can be improved and health disparities can be mitigated.
One strand of my research portfolio examines the role of macro-level (i.e., state-level) policies as determinants of obesity risk among children. With colleagues from the University of Michigan and the University of California, Berkeley, I am studying whether new policies to regulate food and beverages in schools in the Los Angeles Unified School District and the rest of California influence childhood overweight trends from 2001-2008. Another study investigates whether population level trends in racial/ethnic disparities in childhood obesity are influenced by new school food and beverage policies (i.e., specifically the extent to which racial/ethnic disparities are mitigated by these policies). Finally, a third study examines the association of compliance with California physical education policies with physical fitness and childhood obesity among Latino children.
A second thread of my research adds ‘immigrant status’ to the list of social determinants of health. This body of work involves analyzing and documenting obesity patterns among immigrants as compared to natives. A just finished study investigates disparities in obesity within and between Asian subgroups by gender, birthplace and length of residence. This work builds from my recent research which examined the influence of birthplace and migration (U.S. length of residence) on obesity among adults; whether there was a differential effect of these factors by gender, education and race/ethnicity (Social Science and Medicine, 67(18):1300-10, 2008.); and documented the shape, direction and magnitude of the socioeconomic patterning in obesity among immigrants compared to natives (American Journal of Epidiiology, 169(9):1102-12, 2009).
A third component of my research entails analyzing the joint influences of environmental determinants of obesity, including physical and social features of neighborhoods as well as nearby school environments.
- New Connections Status: Junior Investigator
- Award Year: 2008, Healthy Eating Research
RWJF Team/Portfolio: Childhood Obesity
- Project Name: Impact of Competitive Food and Beverage Policies on Population Patterns of Body Weight Among Children in Los Angeles Unified School District: Trend Analyses of Secondary Data.