Assistant Professor Baylor College of Medicine The Woodlands, Texas, United States
Background: Childhood obesity and its attendant metabolic complications have emerged as major global health challenges. Racial disparities in obesity prevalence exist with the highest prevalence in Hispanic and African American children. Area-based socioeconomic factors like poverty levels, which affect access to healthy foods and opportunities for physical activity, contribute to the complex relationships between socioeconomic resources and obesity prevalence. There are conflicting views on their link to childhood obesity. Neighborhood socioeconomic status (SES), as measured by the area deprivation index (ADI), is a potential predictor of childhood obesity. Objective: To investigate the racial variations in obesity prevalence based on neighborhood social disadvantage. We hypothesized that the prevalence of obesity would vary by neighborhood deprivation within racial/ethnic groups. Design/Methods: Using an existing dataset from a school- based blood pressure screening project by the Houston Pediatric and Adolescent Hypertension Program, students were clustered into 28 neighborhoods based on their school matriculation. To capture student-level SES, a weighted ADI for each school to reflect the catchment area was generated. with quartile 4 (Q4) representing schools in disadvantaged neighborhoods and Q1 representing schools in good neighborhoods. Data from 21,381 students (mean age of 13 years), who participated in the school screening program was utilized; students who did not report their race/ ethnicity were excluded (n=113). Results: The highest prevalence of obesity was seen in Hispanic students who attended school in the most disadvantaged school neighborhoods- Q4 (28.2%) followed by African American in schools located in Q4 (27.7%). Among Hispanic and African American students, a stepwise increase in obesity prevalence was observed with the lowest prevalence in Q1 and highest prevalence in Q4. Among White and Asian students, those attending schools located in Q1 had the lowest prevalence of obesity, while students attending school in Q3.
Conclusion(s): Hispanic and African American students attending schools in high-poverty areas had the highest rates of obesity. Study findings suggest that in addition to race/ethnicity, neighborhood SES is a significant predictor of obesity rates, emphasizing the relationship between environmental and biological determinants of obesity. Built environment and disadvantaged areas contribute significantly to childhood obesity, which highlights the need for policies that ensure safe places for physical activity and access to healthy food choices in poor and minority neighborhoods.
.png)
