Childhood obesity is associated with neighborhood socio-economic status in New York City schoolchildren

Objective: The objective of this study was to conduct a multi-level analysis of the relationship between childhood obesity and socioeconomic status (SES), using both individual- and neighborhood-level indicators of SES.

Methods: A cross-sectional study consisting of a parent-report questionnaire was conducted in 26 randomly selected New York City public elementary schools. Data on individual/household- and neighborhood/ZIP code-level sociodemographic factors were collected, and age-adjusted body mass index (BMI) percentiles were computed from parent-reported height and weight data.

Results: Over one-third of responders (34.2%) were overweight, defined as having an adjusted BMI at or above the 95th percentile. In univariate analyses, gender, ethnicity, household income, and education were associated with weight status. Latino and African-American children had the highest prevalence of overweight, ranging from 40.0% to 43.4% of their respective populations. At the neighborhood/ZIP code level, median household income was significantly inversely correlated with prevalence of overweight. In multivariate analyses, neighborhood median household income remained associated with weight status, controlling for race/ethnicity, household income, and other individual and household factors. We found that the odds of being overweight increased 9% for every $10,000 decrease in median household income. Puerto Ricans and African-Americans had the greatest adjusted odds of being overweight while Asian-American children had the lowest.

Conclusions: These findings underscore the importance of the neighborhood context in contributing to individual weight outcomes. Neighborhood poverty was the factor most strongly associated with obesity. Furthermore, these findings demonstrate racial/ethnic disparities in the prevalence of childhood overweight, with Puerto Rican and African-American children disproportionately affected.