Neighborhood context and racial/ethnic differences in young children's obesity: structural barriers to interventions.Soc Sci Med 2013; 95:97-105SS
Numerous studies in the last ten years have investigated racial/ethnic disparities in obesity for young children. Increasing attention is paid to the influence of neighborhood environments - social and physical-on a variety of young children's health outcomes. This work identifies resource-based and community-based mechanisms that impede on the maintenance of healthy weights for young children in socioeconomically depressed areas, and shows consistently higher rates of obesity in more deprived areas. None of this work, however, has explored whether area deprivation or the race/nativity composition of neighborhoods contributes to racial/ethnic disparities in young children's obesity. Utilizing restricted geo-coded data from the Early Childhood Longitudinal Study (Kindergarten) (N = 17,540), we utilize multilevel logistic regression models to show that neighborhood level measures do little to explain racial and ethnic differences in childhood obesity. However, living in neighborhoods with higher levels of poverty, lower levels of education, and a higher proportion of black residents is associated with increased child obesity risk after considering a host of relevant individual level factors. In addition, living in neighborhoods with a higher proportion of foreign-born residents is associated with reduced child obesity risk. Although well-intentioned childhood obesity intervention programs aimed at changing individual-level behaviors are important, our results highlight the importance of considering neighborhood structural factors for child obesity prevention.