Understanding Childhood Obesity in America: Linkages Between Household Income, Community Resources, and Children’s Behaviors

Study Questions:

Is there an association between childhood obesity and household income, and do household income and childhood behaviors promote childhood obesity?

Methods:

The body mass index in 109,634 Massachusetts children was used to identify the percentage of children who were overweight/obese (defined as body mass index above the 85th percentile) versus the percentage of children in each community residing in low-income homes. The authors then compared activity patterns and diet in 999 sixth graders residing in four Michigan communities with varying annual household income.

Results:

In Massachusetts, the percentage of overweight/obese by community varied from 9.6% to 42.8%. As household income dropped, the percentage of overweight/obese children rose. In Michigan 6th graders, 33.2% in Ann Arbor and 47.7% in Detroit were overweight/obese. As mean household income decreased (maximum Ann Arbor $64.7K and minimum Detroit $25.8K), frequency of fried food consumption helpings per day doubled from 0.23 to 0.54 (p < .002), and daily TV/video time tripled from 0.55 to 2.00 hours (p < .001), whereas vegetable consumption and moderate/vigorous exercise decreased.

Conclusions:

The prevalence of overweight/obese children rises in communities with lower household income. Children residing in lower income communities exhibit poorer dietary and physical activity behaviors, which affect obesity.

Perspective:

I agree with T.F. Eagle et al., that a child’s health status involves a complex interplay between individual factors, social factors, environmental factors, and a child’s ultimate selection (within their range of choices) of nutrient consumption, energy expenditure, and genetic predisposition. Community-wide action can have a dramatic impact on childhood health. The degree to which public legislation supports healthier and affordable choices for nutrition and formal and leisure time activity, will determinate the health and well-being of our country’s children and young adults as they enter middle age.

Clinical Topics: Prevention, Diet

Keywords: Prevalence, Michigan, Body Mass Index, Obesity, Diet, Massachusetts, Poverty


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