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APHA Scientific Session and Event Listing

Qi (Harry) Zhang, PhD, School of Community and Environmental Health, Old Dominion University, 104E William B Spong Hall, Norfolk, VA 23529, 757-683-4259, qzhang@odu.edu and Youfa Wang, MD PhD, Department of International Health, Johns Hopkins University, Room E2546, 615 N. Wolfe Street, Baltimore, MD 21205.

Background: Previous studies suggest socioeconomic inequality of overweight among US children. Little research has been conducted to study the trends in socioeconomic inequality of overweight among US adolescents.

Methods: We used a newly-introduced Concentration Index (CI) to measure the changes in the socioeconomic inequality in overweight among American adolescents (10-18 y old) over the past 3 decades. CI equals zero when there is no socioeconomic inequality in the distribution of overweight, and is negative (positive) when overweight is more concentrated in low- (high) SES groups. Data collected in the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 were used. Overweight was classified based on the 2000 CDC Growth Chart, the 95th age-sex-specific Body Mass Index (BMI) percentile. Poverty income ratio tertiles were used to indicate low-, medium-, and high-SES. Gender and race/ethnicity were controlled in the analysis.

Results: The prevalence of overweight increases from 5.3% in NHANES I to 17.5% in NHANES 1999-2002 in boys, and from 6.0% to 15.5% in girls. The socioeconomic disparities varied by gender and race/ethnicity groups. The socioeconomic disparity among white girls was most severe, while it peaked in NHANES III (CI=-0.32). White boys showed a similar trend. There were no clear patterns in black adolescents.

Conclusions: We found no significant socioeconomic inequality of overweight in US adolescents in the 1970s. The disparity increased during the late 80s; but thereafter it has been decreasing. Intervention targeting at all SES groups are needed to fight the growing obesity epidemic in the US.

Learning Objectives:

• Recognize the socioeconomic disparity across overweight adolescents has been changed over time.
• Examine how the trends in the relationship between socioeconomic status and overweight vary by race.
• Understand how to use the Concentration Index to measure the socioeconomic inequality.

Keywords: Obesity, Adolescent Health

Presenting author's disclosure statement:

Any relevant financial relationships? No