Neighborhood Context Effects on Childhood Obesity: A Multilevel Analysis of Geocoded NSCH 2007

• Activity Number: 520
• Type: Contributed
• Date/Time: Wednesday, August 1, 2012 : 10:30 AM to 12:20 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Xingyou Zhang*+ and James B Holt and Stephen Onufrak and Hua Lu and Janet B. Croft
• Companies: CDC and CDC and CDC and CDC and CDC
• Keywords: National Survey of Children's Health (NSCH) ; Childhood obesity ; Neighborhood ; Multilevel Analysis ; Complex Survey

Abstract

Background Childhood obesity prevalence has tripled in the last three decades in US. This study examines associations between childhood obesity and local community environments to inform policy and environmental changes to prevent childhood obesity. Method A valid body mass index(BMI) was obtained from 2007 NSCH 44,096 children aged 10-17 in all states and DC (2,828 counties and 17,541 ZIP Codes). Obesity was defined by BMI = the 95th percentile. Data were merged at the ZIP code-level with the ESRI Tapestry dataset. A multilevel model included individual-level sex, age, race/ethnicity, household poverty, ZIP code-level life mode (neighborhood lifestyle) and urbanization and county-level urbanity and income, and state-level random effects. Results Overall prevalence of childhood obesity was 16.4%. At the ZIP Code-level, it ranged from 25.5% to 8.7% along income octiles; from 27.1% to 8.8% for 12 life mode groups; from 23.6% to 10.8% among 11 urbanization levels. Conclusions ZIP code-level geographic disparities in childhood obesity prevalence are very substantive. Thus local community environment changes should be taken into account for childhood obesity prevention.