Multiple Levels of Social Disadvantage and Links to Obesity in Adolescence and Young Adulthood

BACKGROUND The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family‐, peer‐, school‐, and neighborhood‐level, to determine which contexts are related to obesity in adolescence and young adulthood. METHODS We analyzed longitudinal data from Waves I (1994‐1995), II (1996), and III (2001‐2002) of the National Longitudinal Study of Adolescent Health, a nationally representative population‐based sample of adolescents in grades 7‐12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family‐, peer‐, school‐, and neighborhood‐level using multilevel logistic regression. RESULTS When all levels of disadvantage were modeled simultaneously, school‐level disadvantage was significantly associated with obesity in adolescence for males and females and family‐level disadvantage was significantly associated with obesity in young adulthood for females. CONCLUSIONS Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96235/1/josh12009.pd

Child obesity associated with social disadvantage of children's neighborhoods

Evidence suggests variability in adult obesity risk at a small-scale geographic area is associated with differences in neighborhood socioeconomic status (SES). However, the extent to which geographic variability in child obesity is associated with neighborhood SES is unknown. The objective of this paper was to estimate risk of child obesity associated with multiple census tract SES measures and race within a large urban U.S. county. Height, weight, age, sex, medical insurance type and census tract residence were obtained for 6-18 year old children (n = 8616) who received medical care at a health plan in King County, Washington, in 2006. Spatial analyses examined the individual risk of obesity (BMI >= 95th percentile) with 2000 US census tract measures of median household income, home ownership, adult female education level, single parent households, and race as predictors. Conditional autoregressive regression models that incorporated adjacent census tracts (spatial autocorrelation) were applied to each census tract variable, adjusting for individual variables. We found that in adjusted spatial models, child obesity risk was significantly associated with each census tract variable in the expected direction: lower household income, lower home ownership, and for each 10% increase in less educated women, and single parent households, as well as non-white residents. In a spatial model including all variables, the SES/race variables explained approximately 24% of geographic variability in child obesity. Results indicated that living in census tracts with social disadvantage defined by multiple different measures was associated with child obesity among insured children in a large U.S. urban county. These results contribute new information on relationships between broader social and economic context and child obesity risk using robust spatial analyses.USA Child obesity Neighborhood Socioeconomic status Spatial epidemiology Social inequality Children

Community socioeconomic deprivation and obesity trajectories in children using electronic health records.

Longitudinal studies of the role of community context in childhood obesity are lacking. The objective of this study was to examine associations of community socio economic deprivation (CSD) with trajectories of change in body mass index (BMI) in childhoo