Dissertations & Theses (Open Access)

Date of Award

Fall 12-2018

Degree Name

Master of Public Health (MPH)

Advisor(s)

Bijal Balasubramanian, Mbbs, Phd

Second Advisor

Sarah E. Messiah, Phd, Mph

Abstract

Background

The prevalence of unhealthy weight (defined as a body mass index ≥ 85th %ile for age and sex) among children and adolescents in the United States remains unacceptably high. In parallel, the prevalence of mental health issues in youth is rising as well. Current research shows a strong association between overweight/obesity and poor mental health outcomes. Specifically, youth of unhealthy weight have higher rates of anxiety and depression. The objective of this study is to evaluate the specific the current (2016-17) population-level prevalence of unhealthy weight, mental health issues and the sociodemographic (e.g. sex, age, race, ethnicity, household income) differences in (1) both of these health issues independently, and (2) as they relate to each other.

Methods

This is a retrospective, cross-sectional study utilizing the National Survey of Children’s Health (NSCH), a representative sample of all youth in the United States ages 10 to 17. The NSCH is designed to produce national and state-level data on the physical and emotional health of American children 10 - 17 years old. A total of 35,221 youth were included in this survey from 2016-2017. Descriptive statistics will be generated to determine the population prevalence of unhealthy weight and mental health issues by age, sex and race/ethnicity. Bivariate analyses including Chi square analyses were generated to explore relationships between healthy/unhealthy weight and the prevalence/non-prevalence of reported depression or anxiety. Finally, logistic regression models were generated to compute the odds of having mental health outcome (depression or anxiety) by healthy/unhealthy weight, and each sociodemographic characteristic. All statistical analysis were performed using Stata 15.

Results

The prevalence of unhealthy youth and the prevalence of depression or anxiety in youth vary by age, sex, race/ethnicity, food insecurity, parental divorce, and parental concern about their child’s weight. After adjusting for these characteristics, overweight youth had 1.32 odds (95% CI: 0.62-2.81) of current depression or anxiety as compared to healthy weight youth. Obese youth had 0.74 odds (95% CI: 0.31-1.76) of current depression or anxiety as compared to healthy weight youth.

Conclusions

The results of this study will be used to inform programs and interventions focused both on unhealthy weight and/or mental health issues in youth. Future research could build on these conclusions to rigorously test whether certain socioeconomic groups have better outcomes as a result of targeted intervention strategies. Finally, as this is a cross-sectional study, a causal relationship cannot be inferred.

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