Increased body weight is associated with decreased cognitive function in school-aged children. The role of self-efficacy in shaping the connection between children's educational achievement and obesity-related comorbidities has not been examined to date. Evidence of the predictive ability of self-efficacy in children is demonstrated in cognitive tasks, including math achievement scores. This study examined the relationship between self-efficacy and math achievement in normal weight, overweight, and obese children. I hypothesized that overweight and obese children with higher self-efficacy will be less affected in math achievement than otherwise comparable children with lower self-efficacy. I tested this prediction with multilevel growth modeling techniques using the ECLS-K 1998-1999 survey data, a nationally representative sample of children. Increased self-efficacy moderates the link between body weight and children's math achievement by buffering the risks that increased weight status poses to children's cognitive function. My findings indicate that self-efficacy moderates math outcomes in overweight, but not obese, children.
Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to examine differences in asthma diagnoses across children in these different neighborhoods. Results Both compositional (the characteristics of the children and the ambient air quality in the neighborhood) and associational (the relationship between child and air quality characteristics and asthma) differences within the distinctive neighborhood contexts influence asthma outcomes. For example, unequal exposure to PM and O among children in Disadvantaged and Middle-class neighborhoods contribute to asthma diagnosis disparities within these contexts. For children in Disadvantaged and Advantaged neighborhoods, associational differences between racial/ethnic and socioeconomic characteristics and asthma diagnoses explain a significant proportion of the gap. Conclusions for Practice Our results provide evidence that differential exposure to pollution and protective factors associated with non-Hispanic White children and children from affluent families contribute to asthma disparities between neighborhoods. Future researchers should consider social and racial inequalities as more proximate drivers, not merely as associated, with asthma disparities in children.
The relationship between obesity and depression is well described. However, the evidence linking depression and body mass index (BMI) across the broad range of body size is less consistent. We examined the association between depressive symptoms and BMI in a sample of adult women in the Buffalo-Niagara region between 1997 and 2001. Using logistic regression, we investigated whether increased weight status beyond normal-weight was associated with a higher prevalence of depressive symptoms, and if educational attainment modified the association between obesity and depression. There was a trend for increased weight status to be associated with higher depressive symptoms (obese II/III, OR 1.57, 95% CI 1.03–2.41), whereas higher education was associated with lower odds of depressive symptoms, in an adjusted model including BMI (more than 12 but less than 16 years, OR 0.70, 95% CI 0.49–0.98; 16 or more years of education, OR 0.61, 95% CI 0.40–0.93). The association of being obese I with depressive symptoms was different for more educated (OR 2.15, 95% CI 1.27–3.62) compared to less educated women (OR 0.90, 95% CI 0.50–1.62); the sample was larger for the more educated women and reached statistical significance. There were no differences in the association for obese II/III women in strata of education. There was evidence of risk-difference heterogeneity (0.88, 95% CI 0.84–0.93). In this population-based sample of women in western New York State, increased weight was negligibly associated with depressive symptoms. The association of being obese I with depressive symptoms was different for more compared to less educated women.
The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but living in the same neighborhoods, have different odds of obesity. Specifically, we find lower-SES children benefit, but to a lesser degree, from neighborhood advantages and higher-SES children are negatively influenced, to a larger degree, by neighborhood disadvantages. The resulting narrowing of the gap in obesity by neighborhood disadvantage helps clarify how place matters for children's odds of obesity and suggests that efforts to improve access to community advantages as well as efforts to address community disadvantages are important to curbing obesity and improving the health of all children.
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