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When It Comes to Obesity, It's Location, Location, Location

Five socioeconomic factors account for much of the variability in childhood obesity rates

June 14, 2010

Researchers studied kids living in King County, Washington and found obesity most common in those living in neighborhoods with the least-educated females, most single-parent households, lowest median household income, highest proportion of non-white residents, and fewest homes owned.

Together, these five socioeconomic factors accounted for 24 percent of the variability in childhood obesity rates across neighborhoods.

"Children are raised not only at home but also in their community," said lead author H. Mollie Greves Grow, MD MPH, an assistant professor of pediatrics at the UW, Seattle Children's, and Harborview Medical Center.

Everybody's problem

Disadvantaged neighborhoods may present many obstacles for children's weight, such as less access to healthy foods and more unhealthy fast-food outlets, the authors said. They also often lack safe places for children to play outdoors.

"Childhood obesity is not just a family problem, but a larger community and societal problem," Grow said. "A disadvantaged environment can set families up for ill health, and it's unfair to blame them for not taking enough 'personal responsibility' to manage their weight. We don't yet know all of the factors that may create disadvantage, but we know it is present and associated with higher obesity."

The research team collected anonymous, "de-identified" electronic medical record information on 8,616 children age 6-18 receiving care at Group Health Cooperative-and then correlated these data to the social and economic characteristics of Seattle-area census tracts.

Cumulative effect

"We were a little surprised that each of the census tract factors we included appeared to contribute, in a slightly different way, to the likelihood of childhood obesity," Grow said.

The likelihood of childhood obesity rose by 17 percent to 24 percent for each of three measures of neighborhood social disadvantage: each 10 percent decrease in female education and two-parent households, and each $10,000 decline in household income. Effects related to race and homeownership were smaller but still statistically significant. Overall, King County's demographics resemble those of other urban U.S. areas.

"But King County has one of the strongest public health efforts, a relatively walkable environment, and efforts to expand affordable access to healthy, fresh foods," said Grow.

So she and her colleagues expect the links between childhood obesity and neighborhood disadvantage may be even more pronounced elsewhere.

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