Dataset Information

Association of Neighborhood Geographic Spatial Factors With Rates of Childhood Obesity.

ABSTRACT: Importance:Childhood obesity is a principal public health concern. Understanding the geographic distribution of childhood obesity can inform the design and delivery of interventions. Objective:To better understand the causes of spatial dependence in rates of childhood obesity across neighborhoods. Design, Setting, and Participants:This cohort study used data from a legislatively mandated body mass index screening program for public school children in Arkansas from the 2003-2004 through 2014-2015 academic years. Spatial autoregressive moving average (SARMA) models for panel data were used to estimate spatial dependency in childhood obesity at 2 levels of spatial aggregation. Data were analyzed from August 2017 to February 2018. Exposures:The SARMA models included geographic fixed effects to capture time-invariant differences in neighborhood characteristics along with controls for the mean age of children and the proportion of children by race/ethnicity, school meal status, and sex. Main Outcomes and Measures:The proportion of obese schoolchildren in Arkansas neighborhoods by year, defined at larger (census tract) and smaller (census block group) spatial scales. Results:The geographic aggregations were based on 935?800 children with a mean (SD) age of 132 (39) months. Of these children, 51% were male; 65% were white, 21% were black, 10% were Hispanic, 2% were Asian, and the remainder were of other or unidentified race/ethnicity. In models without geographic fixed effects, there was evidence of positive and significant spatial autocorrelation in obesity rates across tracts (? = 0.511; 95% CI, 0.469-0.553) and block groups (? = 0.569; 95% CI, 0.543-0.595). When geographic fixed effects were included, spatial autocorrelation diminished at the census tract level (? = 0.271; 95% CI, 0.147-0.396) and disappeared at the census block group level (? = -0.075; 95% CI, -0.264 to 0.114). Conclusions and Relevance:Because block groups are smaller than tracts, children in neighboring block groups were more likely to attend the same schools and interact through neighborhood play. Thus, geographic-based social networks were more likely to span block group boundaries. The lack of evidence of spatial autocorrelation in block group-level models suggests that social contagion may be less important than differences in neighborhood context across space. Caution should be used in interpreting significant spatial autocorrelation as evidence of social contagion in obesity.

SUBMITTER: Fang D

PROVIDER: S-EPMC6324267 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Association of Neighborhood Geographic Spatial Factors With Rates of Childhood Obesity.

Fang Di D Thomsen Michael R MR Nayga Rodolfo M RM Goudie Anthony A

JAMA network open 20180803 4

<h4>Importance</h4>Childhood obesity is a principal public health concern. Understanding the geographic distribution of childhood obesity can inform the design and delivery of interventions.<h4>Objective</h4>To better understand the causes of spatial dependence in rates of childhood obesity across neighborhoods.<h4>Design, setting, and participants</h4>This cohort study used data from a legislatively mandated body mass index screening program for public school children in Arkansas from the 2003- ...[more]

PMID: 30646092

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Project description:Leukemia is the most common childhood cancer in industrialized countries, and the increasing incidence trends in the US suggest that environmental exposures play a role in its etiology. Neighborhood socioeconomic status (SES) has been found to be associated with many health outcomes, including childhood leukemia. In this paper, we used a Bayesian index model approach to estimate a neighborhood deprivation index (NDI) in the analysis of childhood leukemia in a population-based case-control study (diagnosed 1999 to 2006) in northern and central California, with direct indoor measurements of many chemicals for 277 cases and 306 controls <8 years of age. We considered spatial random effects in the Bayesian index model approach to identify any areas of significantly elevated risk not explained by neighborhood deprivation or individual covariates, and assessed if groups of indoor chemicals would explain any elevated spatial risk areas. Due to not all eligible cases and controls participating in the study, we conducted a simulation study to add non-participants to evaluate the impact of potential selection bias when estimating NDI effects and spatial risk. The results in the crude model showed an odds ratio (OR) of 1.06 and 95% credible interval (CI) of (0.98, 1.15) for a one unit increase in the NDI, but the association became slightly inverse when adjusting for individual level covariates in the observed data (OR = 0.97 and 95% CI: 0.87, 1.07), as well as when using simulated data (average OR = 0.98 and 95% CI: 0.91, 1.05). We found a significant spatial risk of childhood leukemia after adjusting for NDI and individual-level covariates in two counties, but the area of elevated risk was partly explained by selection bias in simulation studies that included more participating controls in areas of lower SES. The area of elevated risk was explained when including chemicals measured inside the home, and insecticides and herbicides had greater effects for the risk area than the overall study. In summary, the consideration of exposures and variables at different levels from multiple sources, as well as potential selection bias, are important for explaining the observed spatial areas of elevated risk and effect estimates.

Project description:To our knowledge, few published studies have examined the influence of competitive food and beverage (CF&B) policies on student weight outcomes; none have investigated disparities in the influence of CF&B policies on children's body weight by school neighborhood socioeconomic resources.To investigate whether the association between CF&B policies and population-level trends in childhood overweight/obesity differed by school neighborhood income and education levels.This cross-sectional study, from July 2013 to October 2014, compared overweight/obesity prevalence trends before (2001-2005) and after (2006-2010) implementation of CF&B policies in public elementary schools in California. The study included 2?700?880 fifth-grade students in 5362 public schools from 2001 to 2010.California CF&B policies (effective July 1, 2004, and July 1, 2007) and school neighborhood income and education levels.Overweight/obesity defined as a body mass index at or greater than the 85th percentile for age and sex.Overall rates of overweight/obesity ranged from 43.5% in 2001 to 45.8% in 2010. Compared with the period before the introduction of CF&B policies, overweight/obesity trends changed in a favorable direction after the policies took effect (2005-2010); these changes occurred for all children across all school neighborhood socioeconomic levels. In the postpolicy period, these trends differed by school neighborhood socioeconomic advantage. From 2005-2010, trends in overweight/obesity prevalence leveled off among students at schools in socioeconomically disadvantaged neighborhoods but declined in socioeconomically advantaged neighborhoods. Students in the lowest-income neighborhoods experienced zero or near zero change in the odds of overweight/obesity over time: the annual percentage change in overweight/obesity odds was 0.1% for females (95% CI, -0.7 to 0.9) and -0.3% for males (95% CI, -1.1 to 0.5). In contrast, in the highest-income neighborhoods, the annual percentage decline in the odds of overweight was 1.2% for females (95% CI, 0.4 to 1.9) and 1.0% for males (95% CI, 0.3 to 1.8). Findings were similar for school neighborhood education.Our study found population-level improvements in the prevalence of childhood overweight/obesity that coincided with the period following implementation of statewide CF&B policies (2005-2010). However, these improvements were greatest at schools in the most advantaged neighborhoods. This suggests that CF&B policies may help prevent child obesity; however, the degree of their effectiveness is likely to depend on socioeconomic and other contextual factors in school neighborhoods. To reduce disparities and prevent obesity, school policies and environmental interventions must address relevant contextual factors in school neighborhoods.

Project description:ImportanceEarly-life socioeconomic adversity may be associated with poor cognitive health over the life course.ObjectiveTo examine the association of childhood and midlife neighborhood socioeconomic position (nSEP) with cognitive decline.Design, setting, and participantsThis cohort study included 5711 men and women enrolled in the community-based Atherosclerosis Risk in Communities (ARIC) Study with repeated cognitive data measured over a median 27.0 years (IQR, 26.0-27.9 years) (1990-2019). Statistical analysis was performed from December 2022 through March 2023.ExposureResidence addresses for ARIC Study cohort participants were obtained at midlife (1990-1993) and as recalled addresses at 10 years of age (childhood). A composite nSEP z score was created as a sum of z scores for US Census-based measures of median household income; median value of owner-occupied housing units; percentage of households receiving interest, dividend, or net rental income; percentage of adults with a high school degree; percentage of adults with a college degree; and percentage of adults in professional, managerial, or executive occupations. Childhood nSEP and midlife nSEP were modeled as continuous measures and discretized into tertiles.Main outcomes and measuresA factor score for global cognition was derived from a battery of cognitive tests administered at 5 in-person visits from baseline to 2019. The rate of cognitive decline from 50 to 90 years of age was calculated by fitting mixed-effects linear regression models with age as the time scale and adjusted for race, sex, birth decade, educational level, and presence of the apolipoprotein E ε4 allele.ResultsAmong 5711 ARIC Study participants (mean [SD] baseline age, 55.1 [4.7] years; 3372 women [59.0%]; and 1313 Black participants [23.0%]), the median rate of cognitive decline was -0.33 SDs (IQR, -0.49 to -0.20 SDs) per decade. In adjusted analyses, each 1-SD-higher childhood nSEP score was associated with a slower (β, -9.2%; 95% CI, -12.1% to -6.4%) rate of cognitive decline relative to the sample median. A comparable association was observed when comparing the highest tertile with the lowest tertile of childhood nSEP (β, -17.7%; 95% CI, -24.1% to -11.3%). Midlife nSEP was not associated with the rate of cognitive decline.Conclusions and relevanceIn this cohort study of contextual factors associated with cognitive decline, childhood nSEP was inversely associated with trajectories of cognitive function throughout adulthood.

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Association of Neighborhood Geographic Spatial Factors With Rates of Childhood Obesity.

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Association of Neighborhood Geographic Spatial Factors With Rates of Childhood Obesity.

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