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Accepted (AM)Open Access (License Unspecified), Open
Journal article
The role of neighborhood characteristics and the built environment in understanding racial/ethnic disparities in childhood obesity
Preventive medicine, v 91, pp 103-109
01 Oct 2016
PMID: 27404577
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Childhood obesity prevalence remains high and racial/ethnic disparities may be widening. Studies have examined the role of health behavioral differences. Less is known regarding neighborhood and built environment mediators of disparities. The objective of this study was to examine the extent to which racial/ethnic disparities in elevated child body mass index (BMI) are explained by neighborhood socioeconomic status (SES) and built environment.
We collected and analyzed race/ethnicity, BMI, and geocoded address from electronic health records of 44,810 children 4 to 18years-old seen at 14 Massachusetts pediatric practices in 2011–2012. Main outcomes were BMI z-score and BMI z-score change over time. We used multivariable linear regression to examine associations between race/ethnicity and BMI z-score outcomes, sequentially adjusting for neighborhood SES and the food and physical activity environment.
Among 44,810 children, 13.3% were black, 5.7% Hispanic, and 65.2% white. Compared to white children, BMI z-scores were higher among black (0.43units [95% CI: 0.40–0.45]) and Hispanic (0.38 [0.34–0.42]) children; black (0.06 [0.04–0.08]), but not Hispanic, children also had greater increases in BMI z-score over time. Adjusting for neighborhood SES substantially attenuated BMI z-score differences among black (0.30 [0.27–0.34]) and Hispanic children (0.28 [0.23–0.32]), while adjustment for food and physical activity environments attenuated the differences but to a lesser extent than neighborhood SES.
Neighborhood SES and the built environment may be important drivers of childhood obesity disparities. To accelerate progress in reducing obesity disparities, interventions must be tailored to the neighborhood contexts in which families live.
•This study examines the role of neighborhood features in child obesity disparities.•We collected race/ethnicity, growth data and geocoded address for 44,810 children.•Adjusting for neighborhood SES attenuated observed racial/ethnic BMI disparities.•Built environment measures also attenuated BMI differences but to a lesser extent.•Interventions to reduce child obesity must address neighborhood context.
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Details
- Title
- The role of neighborhood characteristics and the built environment in understanding racial/ethnic disparities in childhood obesity
- Creators
- Mona Sharifi - Massachusetts General HospitalThomas D. Sequist - Brigham and Women's HospitalSheryl L. Rifas-Shiman - Harvard Pilgrim Health CareSteven J. Melly - Department of Environmental Health, Harvard School of Public Health, Boston, MA, United StatesDustin T. Duncan - New York UniversityChristine M. Horan - Massachusetts General HospitalRenata L. Smith - Harvard Pilgrim Health CareRichard Marshall - Harvard Vanguard Medical AssociatesElsie M. Taveras - Massachusetts General Hospital
- Publication Details
- Preventive medicine, v 91, pp 103-109
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000388322800016
- Scopus ID
- 2-s2.0-84981306400
- Other Identifier
- 991021875475904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health