Childhood overweight and family socioeconomic status

Childhood overweight rates in the United States increased more than 2-3 fold for children and adolescents in the United States during the past 30 years. Childhood overweight is associated with physical and psychosocial health risks that often extend into adulthood. Fifth, seventh, and ninth grade students in public schools in California are measured annually for physical fitness and weight. We used these data to examine differences in childhood overweight among 84 cities and communities in Los Angeles County. In some instances four-fold and higher differences existed. Median family income had a strong negative association with childhood overweight rates, and the results are supported by a second epidemiological study conducted by the Los Angeles County Public Health Department. Multiple linear regression yielded a strong association among childhood overweight rates, median family income, and ethnicity. We combined these analyses with field visits to four cities, two with high childhood overweight rates and two with lower rates. All four cities were saturated with fast food and other eating places. The cities with the highest overweight rates, however, had few major grocery chains. These cities also had far fewer places for discretionary health spending such as gyms, spas, and dance studios. Because Los Angeles County is a region of substantial income differences, it no longer seems surprising that childhood overweight rates vary among cities and communities. Our challenge as public health professionals is to introduce interventions that are not dependent upon community and family wealth, which we will discuss in the session.