Community-level childhood obesity prevalence and economic hardship: A county public health department response

National and regional studies have documented the disproportionate burden of the childhood obesity epidemic in low income populations. However, few data are available at the community-level, where prevention efforts are often most needed. To address this gap, the Los Angeles County Department of Public Health analyzed 2005 data from the California Physical Fitness Testing Program on measured height and weight among nearly 300,000 5th, 7th, and 9th grade students at public schools across the county. Children with a body mass index (BMI) at or above the 95th percentile for age and gender were classified as obese, and the prevalence of childhood obesity was calculated for 128 cities and unincorporated communities across the county. To examine the relationship between community-level childhood obesity and economic hardship, we classified each city and community using a census-derived economic hardship index. The obesity prevalence countywide was 23.0% and ranged from a low of 4.2% in the affluent City of Manhattan Beach to 37.4% in the economically disadvantaged City of Maywood, less than 20 miles away. Overall, greater economic hardship was strongly correlated with increased childhood obesity prevalence (correlation coefficient 0.83; p<.001). These findings suggest that local economic conditions and related factors exert an important influence on childhood obesity risk in the county. The Department's response to these and other health inequities will be described, including the establishment of the Policies for Livable Active Communities and Environments (PLACE) Program, a cadre of community liaisons, a health equity workgroup, and a more expansive policy agenda.