Influence of elementary school environment on childhood obesity

Purpose: To investigate the impact of the elementary school environment on the prevalence of overweight children and academic achievement in one school district. Methods: Height, weight, body mass index and academic achievement markers were collected on kindergarteners and third graders. Ethnicity, students purchasing school lunches and on free lunch (socioeconomic status), status of playgrounds' surface/ equipment and time spent in teaching healthy habits was collected. Geographical Information Systems (GIS) mapping and correlation/regression analysis were used to define the associations between academic achievement, school lunch program, ethnicity, and socioeconomic status on being overweight for kindergarteners and third graders. Results: 7, 446 kindergartners and third graders from thirty two elementary schools were analyzed. Analysis of GIS maps emphasized a definite relationship- two schools exhibited the highest prevalence of kindergarteners and third graders, the highest percentage of children on free lunch and purchasing school lunches, the lowest passing rate on standardized reading/math tests and a high failure rate on the kindergarten test. Six other schools followed the same trend. Six of these eight schools had playgrounds which were in immediate need of improvement. Correlation analysis demonstrated the prevalence of overweight children in kindergarten/ third grade was associated with: the purchase of school lunches ( r=0.543, p=.001 and r=0.682,p=.000); an inverse relationship between the schools with a greater number of white student and overweight status (r=-.57, p<.001 and r=-.72, p<.001); a higher percentage of overweight students in third grade with lower academic achievement rates for the reading/math standardized tests (r=-0.577, p=.000 & r=-0.511,p=.001). Regression determined the SES explained 59% of the variance in the percentage of overweight third graders. The amount of time spent teaching healthy habits was less than 1 hour a year. Conclusions: The school environment has a significant impact on the prevalence of overweight kindergartners and third graders; especially, for children from minority groups and lower SES. The prevalence of overweight third-graders was associated with the school's academic achievement. Public health nurses must work with school policymakers on guidelines establishing a comprehensive nutrition and activity curriculum and a healthy eating and physically active environment targeted to reach the disadvantaged student.