Dataset Information

Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood.

ABSTRACT: BACKGROUND:High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its comorbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Few studies have assessed the relationship between neighborhood food environments and obesity in this population. METHODS:Electronic health records from 2 pediatric primary care clinics serving predominately low-income, black, and Hispanic children were used to create a cohort of 3724 2- to 5-year olds, encompassing 7256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1-5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. RESULTS:Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272; 95% confidence interval: 0.041-0.503; P = .021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000-0.012, P = .024). CONCLUSIONS:Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association.

SUBMITTER: Johnson KA

PROVIDER: S-EPMC7324231 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood.

Johnson Katherine Abowd KA Jones-Smith Jessica J Curriero Frank C FC Cheskin Lawrence J LJ Benjamin-Neelon Sara E SE Perin Jamie J Caicedo Mariana Rincon MR Thornton Rachel L J RLJ

Academic pediatrics 20191126 6

<h4>Background</h4>High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its comorbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Few studies have assessed the relationship between neighborhood food environments and obesity in this population.<h4>Methods</h4>Electronic health records from 2 pediatric primary care clinics serving pr ...[more]

PMID: 31783182

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Project description:ImportanceNeighborhood environment is an important factor associated with population disparities in obesity. However, few studies have examined whether and in what ways long-term trajectories of neighborhood conditions may be associated with weight outcomes. Moreover, there is a lack of research focusing on multidimensional and nuanced measures that make distinctions between multiple types of neighborhood change (eg, gentrification vs overall growth).ObjectiveTo examine the association between long-term neighborhood economic trajectories and changes in weight status among Black and White adults residing in predominantly low-income communities in the southeastern US.Design, setting, and participantsThis study was a longitudinal analysis of participants in the Southern Community Cohort Study. Five types of neighborhood economic trajectories (stability, growth, displacement, abandonment, and poverty concentration) were measured using data from the US Census and the American Community Survey from 2000 to 2016. Data were analyzed from December 12, 2021, to July 16, 2022. A total of 33 621 Black and White adults in the southeastern US were included in the analytic sample.ExposureNeighborhood economic trajectory.Main outcomes and measuresSubstantial weight gain and substantial weight loss (ie, gaining or losing ≥10% of baseline weight) between baseline (March 2002 to September 2009) and follow-up (November 2008 to January 2013) periods were assessed using self-reported information.ResultsAmong 33 621 participants, the mean (SD) age was 53.4 (8.8) years; 22 116 participants (65.8%) were women, 21 782 (64.8%) were Black, and 11 839 (35.2%) were White. Compared with residents in neighborhoods with stable trajectories, those in neighborhoods with growth trajectories that did not displace original residents were less likely to experience substantial weight gain (odds ratio [OR], 0.75; 95% CI, 0.58-0.97), whereas those in neighborhoods with poverty concentration trajectories were more likely to experience substantial weight gain (OR, 1.08; 95% CI, 1.00-1.17). These patterns appeared stronger among Black participants (eg, substantial weight gain in poverty concentration group: OR, 1.10 [95% CI, 1.00-1.22]; in growth group: OR, 0.76 [95% CI, 0.56-1.02]) compared with White participants (eg, substantial weight gain in poverty concentration group: OR, 1.03 [95% CI, 0.90-1.18]; in growth group: OR, 0.84 [95% CI, 0.52-1.36]). Differences in patterns were also observed among men (eg, substantial weight gain in poverty concentration group: OR, 1.02 [95% CI, 0.88-1.17]; in growth group: OR, 0.58 [95% CI, 0.35-0.96]) compared with women (eg, substantial weight gain in poverty concentration group: OR, 1.12 [95% CI, 1.02-1.23]; in growth group: OR, 0.83 [95% CI, 0.62-1.12]). However, none of the interaction terms between Black vs White participants and men vs women were statistically significant. Neighborhood trajectory was not associated with substantial weight loss (poverty concentration group: OR, 1.00 [95% CI, 0.93-1.09]; abandonment group: OR, 1.01 [95% CI, 0.84-1.15]; displacement group: OR, 1.04 [95% CI, 0.83-1.23]; growth group: OR, 0.88 [95% CI, 0.69-1.12]).Conclusions and relevanceIn this cohort study, neighborhood economic trajectories were associated with weight gain. These findings highlight the importance of using more nuanced and multidimensional measures of neighborhood change in public health research.

Project description:BackgroundIndividual characteristics associated with weight loss after bariatric surgery are well established, but the neighborhood characteristics that influence outcomes are unknown.ObjectivesThe objective of this study was to determine if neighborhood characteristics, including social determinants and lifestyle characteristics, were associated with weight loss after bariatric surgery.SettingSingle university healthcare system, United States.MethodsIn this retrospective cohort study, all patients who underwent primary bariatric surgery from 2008 to 2017 and had at least 1 year of follow-up data were included. Patient-level demographics and neighborhood-level social determinants (area deprivation index, urbanicity, and walkability) and lifestyle factors (organic food use, fresh fruit/vegetable consumption, diet to maintain weight, soda consumption, and exercise) were analyzed. Median regression with percent total body weight (%TBW) loss as the outcome was applied to examine factors associated with weight loss after surgery.ResultsOf the 647 patients who met inclusion criteria, the average follow-up period was 3.1 years, and the mean %TBW loss at the follow-up was 22%. In adjusted median regression analyses, Roux-en-Y gastric bypass was associated with greater %TBW loss (11.22%, 95% confidence interval [8.96, 13.48]) compared to sleeve, while longer follow-up time (-2.42% TBW loss per year, 95% confidence interval [-4.63, -0.20]) and a preoperative diagnosis of diabetes (-1.00% TBW loss, 95% confidence interval [-1.55, -0.44]) were associated with less. None of the 8 neighborhood level characteristics was associated with weight loss.ConclusionsPatient characteristics rather than neighborhood-level social determinants and lifestyle factors were associated with weight loss after bariatric surgery in our cohort of bariatric surgery patients. Patients from socioeconomically deprived neighborhoods can achieve excellent weight loss after bariatric surgery.

Project description:BACKGROUND:School neighborhood food environment is recognized as an important contributor to childhood obesity; however, large-scale and longitudinal studies remain limited. This study aimed to examine this association and its variation across gender and urbanicity at multiple geographic scales. METHODS:We used the US nationally representative Early Childhood Longitudinal Study-Kindergarten cohort data and included 7530 kindergarteners followed up from 1998 to 2007. The Census, road network, and Dun and Bradstreet commercial datasets were used to construct time-varying measurements of 11 types of food outlet within 800-m straight-line and road-network buffer zones of schools and school ZIP codes, including supermarket, convenience store, full-service restaurant, fast-food restaurant, retail bakery, dairy product store, health/dietetic food store, candy store, fruit/vegetable market, meat/fish market, and beverage store. Two-level mixed-effect and cluster-robust logistic regression models were performed to examine the association. RESULTS:A higher body mass index (BMI) in 2007 was observed among children experiencing an increase of convenience stores in school neighborhoods during 1998-2007 (β = 0.39, p < 0.05), especially among girls (β = 0.50) and urban schoolchildren (β = 0.41), as well as among children with a decrease of dairy product stores (β = 0.39, p < 0.05), especially among boys (β = 1.86) and urban schoolchildren (β = 0.92). The higher obesity risk was associated with the increase of fast-food restaurants in urban schoolchildren (OR = 1.27 [95% CI = 1.02-1.59]) and of convenience stores in girls (OR = 1.41 [95% CI = 1.09-1.82]) and non-urban schoolchildren (OR = 1.60 [95% CI = 1.10-2.33]). The increase of full-service restaurants was related to lower obesity risk in boys (OR = 0.74 [95% CI = 0.57-0.95]). The decrease of dairy product stores was associated with the higher obesity risk (OR = 1.68 [95% CI = 1.07-2.65]), especially boys (OR = 2.92 [95% CI = 1.58-5.40]) and urban schoolchildren (OR = 1.67 [95% CI = 1.07-2.61]). The schoolchildren exposed to the decrease of meat/fish markets showed the lower obesity risk (OR = 0.57 [95% CI = 0.35-0.91]), especially urban schoolchildren (OR = 0.53 [95% CI = 0.32-0.87]). Results from analyses within 800-m straight-line buffer zones of schools were more consistent with our theory-based hypotheses than those from analyses within 800-m road-network buffer zones of schools and school ZIP codes. CONCLUSIONS:National data in the USA suggest that long-term exposure to the food environment around schools could affect childhood obesity risk; this association varied across gender and urbanicity. This study has important public health implications for future school-based dietary intervention design and urban planning.

Dataset Information

Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood.

Publications

Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood.

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