Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the USA

Abstract

Background Low-income and some racial and ethnic subpopulations are more likely to suffer from obesity. Inequities in the physical and social environment may contribute to disparities in paediatric obesity, but there is little empirical evidence to date. This study explored whether neighbourhood-level socioeconomic factors attenuate racial and ethnic disparities in obesity among youth in the USA and whether individual-level socioeconomic status (SES) interacts with neighbourhood deprivation. Methods This analysis used data from 17 100 youth ages 2–18 years participating in the 2001–2010 National Health and Nutrition Examination Survey linked to census tract-level socioeconomic characteristics. Multilevel logistic regression models were used to examine neighbourhood deprivation in association with odds of obesity (age-specific and sex-specific body mass index percentile ≥95). Results The unadjusted prevalence of obesity was 15% among non-Hispanic white children and 21% among non-Hispanic black and Mexican-American children. Adjustment for individual-level SES neighbourhood deprivation and the interaction between these two factors resulted in a 74% attenuation of the disparity in obesity between non-Hispanic black and non-Hispanic white children and a 49% attenuation of the disparity between Mexican-American and non-Hispanic white children. There was a significant interaction between individual-level SES and neighbourhood deprivation where higher individual-level income was protective for children living in low-deprivation neighbourhoods, but not for children who lived in high-deprivation areas. Conversely, area deprivation was associated with higher odds of obesity, but only among children who were above the poverty threshold. Conclusions Future research on disparities in obesity and other health outcomes should examine broader contextual factors and social determinants of inequities.

Living in “Cold Spot” Communities Is Associated with Poor Health and Health Quality

“…[35][36][37][38][39][40][41] This reinforces the notion that deprived neighborhoods have distinct effects on health and care delivery and underscores the importance of using geography as a lens through which to view population health. Although imperfect, we provide a reproducible, practical, and feasible method for integrating community data into EHRs.…”

An Examination of Factors Associated With Self-Efficacy for Food Choice and Healthy Eating among Low-Income Adolescents in Three U.S. States

“…This discrepancy may be associated with the unhealthy food environment where the samples were drawn -low-income communities. Previous studies have shown that low-income communities face unhealthier food environments, with reduced access to supermarkets, a plethora of convenience stores, fast food outlets, and environmental factors such as crime and lack of access to physical activity resources, all of which contribute to ethnic disparities in weight among children (Rossen, 2014). The discrepancy may also be due to low nutrition literacy or knowledge about a healthy food environment among adolescents, which was not measured in the current study.…”

Latino parents’ perceptions of the eating and physical activity experiences of their pre-school children at home and at family child-care homes: a qualitative study

“…Racial/ethnic disparities in being overweight and obese among minority and immigrant children in the USA, including Latinos, are associated with socio-economic disparities (e.g. lower maternal education and family income) (3)(4)(5) . A recent study by Guerrero et al (5) using a nationally representative cohort of children of pre-school age found that significant racial and ethnic differences exist in early childhood BMI trajectories, with African-American and Latino children displaying higher BMI growth trajectories than white children.…”