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?


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.


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.


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.


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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