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Abstract

Purpose: To evaluate the relationship between county-level socioeconomic environment and the propensity to be overweight or obese by race/ethnic group in a sample of fourth grade children the Texas public school system.

Methods: The data used come from the School Physical Activity and Nutrition (SPAN) surveillance study – a surveillance study of school-aged children in Texas. The outcome variable used was Body Mass Index (BMI) categorized as underweight/normal/healthy, overweight, and obese. Exposure variables were derived from county-level Hispanic and Black concentration and socioeconomic data using the Human Security Index (HSI) as a framework. We made comparisons between Non-Hispanic White, Black and Hispanic children enrolled in the fourth grade. We used bivariate and regression analysis using jackknife variance estimates.

Results: Hispanic and Black children were more likely to be obese and overweight than non-Hispanic White children. Hispanic and Black children were more likely to live in counties with higher economic, educational and social stress than non-Hispanic White children. In the logistic regression analysis comparing the odds of overweight or obese to underweight/healthy/normal weight, both Hispanic and Black children continued to have a higher odds of overweight and obesity than non-Hispanic White children. In separate regression analyses for each race/ethnic group (ie, Hispanic, Black, and White students) the county-level educational and social stress variables had a significant association with overweight and obesity in Hispanic children only. Hispanic ethnic concentration was associated with the odds of being overweight but not obese, while percent Black was associated with obesity in Hispanic children. There were no significant associations between socioeconomic or ethnic concentration and overweight or obese in Black children.

Discussion: The results from this study indicate that county-level effects on childhood obesity may be more than just socioeconomics and ethnic concentration. Future research should involve multiple levels of analysis, including census tract, school and home variables simultaneously, in order to understand how the environments children live in impact their risk for obesity and how these influences may vary by race/ethnicity.

Key Take Away Points

  • Childhood obesity disparities by race/ethnicity are persistent in Texas.
  • Mexican American and black children are more likely to live in environments that are socioeconomically insecure.
  • Socioeconomic insecurity at a county level did not explain differences in overweight or obesity by race/ethnicity.
  • Research on environment and obesity may need to include smaller levels of analysis such as census tract, school and home to explain differences by race and ethnicity.

Author Biography

Dr. Jennifer Salinas is an Assistant Professor at the University of Texas Health Science Center at Houston School of Public Health. She received her PhD from the University of Texas at Austin in Sociology/Demography. She also holds a MSW from the University of Pennsylvania.

Manasi Shah is a doctoral student in epidemiology at the University of Texas, School of Public Health. Hailing from India and having worked on projects both in infectious and chronic diseases, her research interests are varied. She is currently focusing on characterizing modifiable risk factors for colorectal cancer prevention with a special focus on inflammation and the gut microbiome.

Jennifer L. Gay, PhD is an Assistant Professor in the Department of Health Promotion and Behavior at the University of Georgia. She is also the co-chair of the Council on Interventions for the International Society of Physical Activity and Health. Her research centers on built environment and contextual influences of physical activity among vulnerable populations.

Ken Sexton is a professor of environmental health sciences and his research focuses on risk-based decision making, exposure to hazardous chemicals, and environmental aspects of health disparities.

Eileen Nehme, MPH is a doctoral candidate in epidemiology at the UT School of Public Health Austin Regional Campus, and a Dell Health Scholar with the Michael & Susan Dell Center for Healthy Living. Her research focuses on physical activity and nutrition environments and active transportation in youth and adults.

Dr. Mandell is a Medical Research Specialist and Research Team Lead within the Division of Family and Community Health at the Texas Department of State Health Services. She is the consulting or lead researcher on a variety of studies including those focused on childhood obesity prevention, child death prevention, the relation between maternal oral health and birth outcomes, childhood oral health surveillance, and preventing premature and low birth weight births.

Dr. Hoelscher is a John P. McGovern Professor in Health Promotion, With Tenure, University of Texas School of Public Health, Austin Regional Campus, UTHealth. She also serves as the Director of the Michael & Susan Dell Center for Advancement of Healthy Living and Professor of Health Promotion/Behavioral Sciences at UTSPH Austin Regional Campus.

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