Tali Elfassy, M Maria Glymour, Kiarri N Kershaw, Mercedes Carnethon, Maria M Llabre, Cora E Lewis, Neil Schneiderman, Adina Zeki Al Hazzouri

We sought to determine whether sustained poverty is associated with change in body mass index (BMI) among 4,762 black and white adults of the Coronary Artery Risk Development In Young Adults study. Household income in the past year and current BMI were measured at seven visits between 1990 and 2015. Sustained poverty was the proportion of visits during which household income was below 200% of the federal poverty level (range, 0%-100%). Sustained poverty and BMI were time-updated. Mean age in 1990 was 30 years. In adjusted linear mixed effects models, every 10% increase in sustained poverty was significantly associated with faster BMI growth in white men (+0.004 kg/m2/year, 95% CI: 0.001, 0.008) and white women (+0.003 kg/m2/year, 95% CI: 0.000, 0.006), and slower BMI growth in black men (-0.008 kg/m2/year, 95% CI: -0.010, -0.005) and black women (-0.003 kg/m2/year, 95% CI: -0.006, 0.000). In other words, being always vs. never in poverty from 1990 to 2015 was predicted to result in greater BMI gain by 1.00 kg/m2 and 0.75 kg/m2 among white men and women and less BMI gain by 2.0 kg/m2 and 0.75 kg/m2 among black men and women, respectively. Sustained poverty was a predictor of changes in BMI with differential associations by race.