Effects of neighborhood SES and racial/ethnic composition on adolescent obesity: A multilevel, multi-cohort analysis

Little research has examined the effects of neighborhood characteristics on childhood obesity, independent of individual and household characteristics. To our knowledge, no research to date has investigated the degree to which neighborhood environments are responsible for the growing epidemic of childhood obesity.

Hierarchical linear models were run on the risk of adolescent obesity for those born in Salt Lake County, Utah, between 1983 and 1990 (n=60,955). Data were taken from the Utah Population Database (UPDB), a genaelogical database that includes birth, death, drivers' license and other administrative data. Residential information and self-report of height and weight were taken from drivers' license records in 1998-2007. Individual and household demographic characteristics were taken from birth certificates. Neighborhoods were defined as block groups (n=564).

Results indicated that each standard deviation increase in median neighborhood income was associated with a 44% decrease in the risk of adolescent obesity (95% CI, 34%-52%), after adjusting for all first-level controls, including individual minority and socioeconomic status. Similarly, each percentage increase in neighborhood minority concentration was associated with a 1% increase in the risk of adolescent obesity (95% CI, 0.8%-1.5%) in the full model. Results on risk for severe obesity were nearly identical. Moreover, the risk of obesity associated with area characteristics increased significantly with successive cohorts, suggesting that obesogenic environments are partly responsible for the epidemic. Policies aimed at the neighborhood material and socio-cultural environments are critical to reversing the childhood obesity epidemic.