Obesity trends and the neighborhood environment in low-income preschool-aged children in Los Angeles County

While it is increasingly recognized that the neighborhood food environment may influence accessibility to healthy foods and hence obesity risk, there is a dearth of research on the contributions of neighborhoods to obesity development in early childhood. Preventive approaches in early childhood may be the most effective strategy for addressing the obesity crisis. The objectives of this paper are:1) to examine and map changes in obesity prevalence at the census tract level among low-income preschool-aged WIC Program participants in Los Angeles County between 2003 and 2009; and 2) to determine if these changes are correlated with changes in the neighborhood environment over the same period. Relevant child-level data were obtained from the California Integrated Statewide Information System. Census tract-level data describing social and food availability characteristics of neighborhoods were obtained from the census and the Los Angeles County Public Health Department. Obesity rates for all children increased from 16.2% in 2003 to 19.7% in 2009.From 2003-2009, obesity rates increased more quickly for children living in the poorest neighborhoods (by 27% from 16.9% to 21.4%) than for children living in the least poor neighborhoods (by 17% from 15.5% to 18.2%). Preliminary multiple regression analysis indicate that median neighborhood income was negatively associated (p<.001) and change in the density of small independent grocery stores was positively associated (p<.05) with change in obesity prevalence, after controlling for baseline values. Future analyses will examine the contributions of fast food restaurants and WIC-authorized stores to obesity rates in this low income preschool-aged population.