Prevalence of overweight and elevated blood pressure among low-income Milwaukee schoolchildren and its association with neighborhood disadvantage

The Center for Urban Population Health with Milwaukee Public Schools (MPS) and the University of Wisconsin-Milwaukee School of Nursing conducted the Health Information Improvement Project in spring of 2006. The purpose of the study was to assess health status of children attending elementary schools in the MPS system. First and fourth grade students in eight schools were assessed. Among other health status indicators, student height and weight were measured and a screening blood pressure was taken. BMI percentile for age and gender and systolic and diastolic blood pressure percentiles for age, gender and height were computed for each child. Home address for each student was geocoded. Census block group level data for median household income and percent of adults without a high school education were linked to each student to indicate neighborhood disadvantage. Distance to the nearest large grocery store was also computed for each student, as an indicator of the nutrition environment. Logistic regression analyses found BMI (>= 85th percentile) was positively associated with percent under-educated adults and increased distance to nearest large store, and negatively associated with income in this predominantly poor sample. However, elevated blood pressure was only associated with BMI >= 85th percentile. We conclude that neighborhood disadvantage and aspects of the nutrition environment are associated with childhood overweight and that overweight is an important predictor of elevated blood pressure in this population. Policy change to improve the nutrition environment, particularly in low-income areas is essential.