Urban-Rural Difference In Childhood Weight Change In The United States 公开
Liang, Wanwei (Spring 2024)
Abstract
Objective
The increasing obesity rate among children has been observed in the United States in recent decades. However, less is known about the effect of locality on children’s weight change utilizing a longitudinal cohort. This study assessed whether childhood weight change differed by locality in the US using a nationally representative sample of children.
Methods
We analyzed data on 7,403 children who enrolled in kindergarten during the 2010-11 school year from the Early Childhood Longitudinal Study-Kindergarten Class of 2011 (ECLS-K: 2011), a nationally representative sample of children at kindergarten age. This study used multinomial logistic regression models to predict children’s weight change from fall kindergarten to spring fifth grade: consistently obese, consistently not obese, from obese to not obese, and from not obese to obese in different locality groups. Demographic and socioeconomic status variables were included in the models as covariates. All analyses were adjusted by survey weights to generate nationally representative estimates.
Results
The overall obesity increased from kindergarten to fifth grade among all locality groups, with rural areas showing the highest prevalence of obesity: 13.5% in kindergarten and 23.9% in fifth grade. Town areas followed with a prevalence of 13.1% in kindergarten and 21.6% in fifth grade, while the city had 13.5% in kindergarten and 21.5% in fifth grade. The suburb had the least prevalence in both kindergarten (11.7%) and fifth grade (19.9%). Children in rural areas exhibited higher odds of being consistently obese from kindergarten to fifth grade (OR = 1.35, 95% CI: 1.02-1.77) and becoming obese (OR = 1.42, 95% CI: 1.05-1.91) compared to their city peers. No significant difference was found in the association between locality and children’s weight change among children living in suburban and town areas compared to the city.
Conclusions
There were differences in weight change from kindergarten to fifth grade among children in the city and rural areas. Children living in rural areas had higher odds of staying obese or transitioning to obese during the time from kindergarten to fifth grade compared to city areas. Additionally, they had slightly higher probabilities of becoming and staying obese than other locale groups.
Table of Contents
Table of Contents
I. Introduction
II. Background and Literature Review
2-1. Risk Factors for Childhood Obesity
i. Children’s Sex
ii. Race and Ethnicity
iii. Eating and Physical Patterns
iv. Genetic factors
v. Social determinants of health (SDOH)
vi. Psychological factors
2-2. Differences in Obesity Patterns Contributed by Urbanicity
i. Household socioeconomic status (SES)
ii. Food Environment
iii. Built Environment
2-3. Conceptual Framework
III. Methods
3-1. Data Collection
3-2. Study Population
3-3. Dependent Variable
3-4. Independent Variable
3-5. Covariates
3-6. Descriptive Methods
3-7. Analytic Methods
IV. Results
4-1. Socio-demographic and weight status change
4-2. The total prevalence of obesity in fall kindergarten and spring fifth grade
4-3. Comparing obesity and weight change in fall kindergarten with spring fifth grade
5-4. Odds of being consistently obese or weight change compared to being consistently not obese
V. Discussion
5-1. Strength and Limitations
VI. Conclusion
VII. Reference
VIII. Tables and figures
Table 1. Survey-adjusted Socio-demographic Characteristics and Weight Changes (from 2010 to 2016) of the US Children in ECLS-K: 2011 (n = 3,087,273)
Table 2. Survey-adjusted Total Prevalence of Obesity in Fall Kindergarten and Spring Fifth Grade, by Locality, Sex, Race, Employment Status, and Household Income
Table 3. Odds of Being Consistently Obese, Changed from Obese to Not Obese, and Changed from Not Obese to Obese among US Children from Fall Kindergarten (2010-11) to Spring Fifth Grade (2015-16)
Figure 2. Survey-adjusted Comparison of the Proportion of Children with Obesity in Fall Kindergarten and Spring Fifth Grade by Locality
Figure 3. Survey-adjusted Weight Category Transition from Fall Kindergarten to Spring Fifth Grade
Figure 4. Adjusted Predicted Probability of Weight Change by Locality
IX. Appendices
Table 1. Survey-unadjusted Socio-demographic Characteristics and Weight Changes (from 2010 to 2016) of the US Children in ECLS-K: 2011 (n = 7,403)
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