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Journal of Community Health

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01.04.2008 | Original Paper

A Multilevel Analysis of State and Regional Disparities in Childhood and Adolescent Obesity in the United States

verfasst von: Gopal K. Singh, Michael D. Kogan, Peter C. van Dyck

Erschienen in: Journal of Community Health | Ausgabe 2/2008

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Abstract

This study examines state- and regional disparities in obesity prevalence among 46,707 US children and adolescents aged 10–17 years before and after adjusting for individual socioeconomic and behavioral characteristics and area deprivation measures. The 2003 National Survey of Children’s Health was used to calculate obesity prevalence in nine geographic regions and in the 50 states and the District of Columbia (DC). Logistic regression was used to estimate odds of obesity and adjusted prevalence. OLS regression was used to determine the amount of variance explained by income inequality, poverty, and violent crime rates. The prevalence of childhood obesity varied substantially across geographic areas, with the Southcentral regions of the US having the highest prevalence (≥18%) and the Mountain region the lowest prevalence (11.4%). Children in West Virginia, Kentucky, Texas, Tennessee, and North Carolina (adjusted prevalence >18.3%) had over twice the odds of being obese than their Utah counterparts (adjusted prevalence = 10.4%). Geographic disparities in obesity were similar for male and female children. Individual characteristics such as race/ethnicity, household socioeconomic status, neighborhood social capital, television viewing, recreational computer use, and physical activity accounted for 55% of the state and 25% of the regional disparities in obesity. Area poverty rates accounted for an additional 18% of the state variance in adjusted obesity prevalence. Although individual and area level socioeconomic factors are important predictors, substantial geographic disparities in childhood and adolescent obesity remain. Prevention efforts targeting individual risk factors as well as contextual social and environmental factors may reduce geographic disparities in childhood and adolescent obesity.

Koplan J. P., Liverman C. T., & Kraak V. A. (Eds) (2005). Preventing childhood obesity: Health in the balance. Institute of medicine. Washington, DC: The National Academies Press.

National Center for Health Statistics. (2005). Health, United States, 2005 with Chartbook on Trends in the Health of Americans. Hyattsville, MD: US Department of Health and Human Services.

Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Felgal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 295, 1549–2850.PubMedCrossRef

Miech, R. A., Kumanyika, S. K., Setler, N., Link, B. G., Phelan, J. C., & Chang, V. W. (2006). Trends in the association of poverty with overweight among US adolescents, 1971–2004. JAMA, 295, 2385–2393.PubMedCrossRef

Jiles, R., Hughes, E., & Murphy, W., et al. (2005). Surveillance for certain health behaviors among states and selected local areas––behavioral risk factor surveillance system, United States, 2003. MMWR. Morbidity and Mortality Weekly Report, 54 (SS-8), 1–116.

US Department of Health and Human Services.(2000). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: US Government Printing Office.

Ford, E. S., Mokadad, A. H., Giles, W. H., & Galuska, D. A. (2005) Geographic variation in the prevalence of obesity, diabetes, and obesity-related behaviors. Obesity Research, 13, 118–122.PubMed

National Center for Health Statistics. (2005). The national survey of children’s health (NSCH), 2003: The public use data file. Hyattsville, MD: US Department of Health and Human Services.

van Dyck, P., Kogan, M. D., Heppel, D., Blumberg, S. J., Cynamon, M. J., & Newacheck, P. W. (2004). The national survey of children’s health: a new data resource. Maternal and Child Health Journal, 8, 183–188.PubMedCrossRef

10.

Blumberg, S. J., Olson, L., & Frankel, M. R., et al. (2005). Design and operation of the National Survey of Children’s Health, 2003. Vital and Health Statistics, 1, 1–124.

11.

Jotangia, D., Moody, A., Stamatakis, E., & Wardle, H. (2005). Obesity among children under 11. London, UK: National Centre for Social Research.

12.

Stamatakis, E., Primatesta, P., Chinn, S., Rona, R., & Falascheti, E. (2005). Overweight and obesity trends from 1974 to 2003 in English children: what is the role of socioeconomic factors. Archives of Disease in Childhood, 90, 999–1004.PubMedCrossRef

13.

Booth, M. L., Chey, T., & Wake, M., et al. (2003). Change in the prevalence of overweight and obesity among young Australians, 1969–1997. The American Journal of Clinical Nutrition, 77, 29–36.PubMed

14.

US Census Bureau. Statistical Abstract of the United States (2006) (125th ed). Washington, DC: US Government Printing Office.

15.

Janssen, I., Katzmarzyk, P. T., & Boyce, W. F., et al. (2005). Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obesity Reviews, 6, 123–132.PubMedCrossRef

16.

McMurray, R. G., Harrell, J. S., Deng, S., Bradley, C. B., Cox, L. M., & Bangdiwala, S. I. (2000) The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents. Obesity Research, 8, 130–139.PubMed

17.

Gordon-Larsen, P., Adair, L. S., & Pokin, B. M. (2003). The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obesity Reviews, 13, 121–129.

18.

Gortmaker, S. L., Must, A., Sobol, A. M., Peterson, K., Colditz, G. A., & Dietz, W. H. (1996) Television viewing as a cause of increasing obesity among children in the United States,1986–1990. Archives of Pediatrics & Adolescent Medicine, 150, 356–362.

19.

Kawachi, I., Kim, D., Coutts, A., & Subramanian, S. V. (2004). Commentary: reconciling the three accounts of social capital. International Journal of Epidemiology, 33, 682–690.PubMedCrossRef

20.

Kim, D., Subramanian, S. V., Gortmaker, S. L., & Kawachi, I. (2006). US state- and county-level social capital in relation to obesity and physical inactivity: a multilevel, multivariable analysis. Social Science and Medicine, 63, 1045–1059.PubMedCrossRef

21.

US Census Bureau. (2003). United states summary: 2000 summary social, economic, and housing characteristics. PHC-2–1. Washington, DC: US Government Printing Office.

22.

Singh, G. K. (2004). Area deprivation and widening inequalities in US mortality, 1969–1998. American Journal of Public Health, 93, 1137–1143.

23.

Singh, G. K., & Siahpush, M. (2006). Widening socioeconomic inequalities in US life expectancy, 1980–2000. International Journal of Epidemiology, 35, 969–979.PubMedCrossRef

24.

Singh, G. K., & Siahpush, M. (2002). Increasing inequalities in all-cause and cardiovascular mortality among US adults aged 25–64 years by area socioeconomic status, 1969–1998. International Journal of Epidemiology, 31, 600–613.PubMedCrossRef

25.

Oliver, L. N., & Hayes, M. V. (2000). Neighborhood socio-economic status and the prevalence of overweight Canadian children and youth. Canadian Journal of Public Health, 54, 456–460.

26.

Pickett, K. E., Kelly, S., Brunner, E., Lostein, T., & Wilkinson, R. G. (2005). Wider income gaps, wider waistbands? An ecological study of obesity and income inequality. Journal of Epidemiology and Community Health, 59, 670–674.PubMedCrossRef

27.

Wardle, J., Jarvis, M. J., & Steggles, N., et al. (2003) Socioeconomic disparities in cancer-risk behaviors in adolescence: baseline results from the health and behavior in teenagers study (HABITS). Preventive Medicine, 36, 721–730.PubMedCrossRef

28.

Jones, A. F., Weinberg, D. H. (2000). The changing shape of the nation’s income distribution, 1947–1998. Current population reports, P60–P204. Washington, DC: US Census Bureau.

29.

Gomez, J. E., Johnson, B. A., Selva, M., & Sallis, J. F. (2004). Violent crime and outdoor physical activity among inner-city youth. Preventive Medicine, 39, 876–881.PubMedCrossRef

30.

Gordon-Larsen, P., McMurray, R. G., & Popkin, B. M. (2000). Determinants of adolescent physical activity and inactivity patterns. Pediatrics, 105(6), E83.PubMedCrossRef

31.

Nelson, M. C., Gordon-Larsen, P., Song, Y., & Popkin, B. M. (2006). Built and social environments: Associations with adolescent overweight and activity. American Journal of Preventive Medicine, 31, 109–117.PubMedCrossRef

32.

SAS Institute Inc. (2003). SAS/STAT User’s Guide, Version 9.1: The REG Procedure. Cary, NC: SAS Institute, Inc.

33.

SUDAAN. (2005). Software for the statistical analysis of correlated data, Release 9.0.1. Research Triangle Park, NC: Research Triangle Institute.

34.

Percey, J. N., & Keppel, K. G. (2002). A summary measure of health disparity. Public Health Reports, 117, 273–280.CrossRef

35.

Harper, S., & Lynch, J. (2005). Methods for measuring cancer disparities: using data relevant to healthy people 2010 cancer-related objectives. NCI cancer surveillance monograph series, No. 6. Bethesda, MD: National Cancer Institute, NIH Publ. No. 05–5777.

36.

Willms, J. D., Tremblay, M. S., & Katzmarzyk, P. T. (2003). Geographic and demographic variation in the prevalence of overweight Canadian children. Obesity Research, 11, 668–673.PubMed

37.

Kinra, S., Nelder, R. P., & Lewendon, G. J. (2000). Deprivation and childhood obesity: a cross sectional study of 20,973 children in Plymouth, United Kingdom. Journal of Epidemiology and Community Health, 54, 456–460.PubMedCrossRef

38.

Lethbridge-Cejku, M., Rose, D., & Vickerie, J. (2006). Summary health statistics for the U.S. adults: National Health Interview Survey, 2004. Vital and health statistics, 10, 1–154.

39.

Booth, K. M., Pinkston, M. M., & Poston, W. S. C. (2005). Obesity and the built environment. Journal of the American Dietetic Association, 105, S110–S117.PubMedCrossRef

40.

Goodman, E. , Hinden, B. R., & Khandelwal, S. (2000). Accuracy of teen and parental reports of obesity and body mass index. Pediatrics, 106, 52–58.PubMedCrossRef

41.

Brener, N. D., McManus, T., Galuska, D. A., Lowry, R., & Wechsler, H. (2003). Reliability and validity of self-reported height and weight among high school students. The Journal of Adolescent Health, 32, 281–287.PubMedCrossRef

42.

Ogden, C. L., Fryar, C. D., Carroll, M. D., & Flegal, K. M. (2004). Mean body weight, height, and body mass index, United States 1960–2002. Advance Data, 347, 1–20.PubMed

Titel: A Multilevel Analysis of State and Regional Disparities in Childhood and Adolescent Obesity in the United States
verfasst von: Gopal K. Singh
Michael D. Kogan
Peter C. van Dyck
Publikationsdatum: 01.04.2008
Verlag: Springer US
Erschienen in: Journal of Community Health / Ausgabe 2/2008
Print ISSN: 0094-5145
Elektronische ISSN: 1573-3610
DOI: https://doi.org/10.1007/s10900-007-9071-7

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