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      Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the USA

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      Journal of epidemiology and community health

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          Abstract

          Background

          Low-income and some racial and ethnic subpopulations are more likely to suffer from obesity. Inequities in the physical and social environment may contribute to disparities in paediatric obesity, but there is little empirical evidence to date. This study explored whether neighbourhood-level socioeconomic factors attenuate racial and ethnic disparities in obesity among youth in the USA and whether individual-level socioeconomic status (SES) interacts with neighbourhood deprivation.

          Methods

          This analysis used data from 17 100 youth ages 2–18 years participating in the 2001–2010 National Health and Nutrition Examination Survey linked to census tract-level socioeconomic characteristics. Multilevel logistic regression models were used to examine neighbourhood deprivation in association with odds of obesity (age-specific and sex-specific body mass index percentile ≥95).

          Results

          The unadjusted prevalence of obesity was 15% among non-Hispanic white children and 21% among non-Hispanic black and Mexican-American children. Adjustment for individual-level SES neighbourhood deprivation and the interaction between these two factors resulted in a 74% attenuation of the disparity in obesity between non-Hispanic black and non-Hispanic white children and a 49% attenuation of the disparity between Mexican-American and non-Hispanic white children. There was a significant interaction between individual-level SES and neighbourhood deprivation where higher individual-level income was protective for children living in low-deprivation neighbourhoods, but not for children who lived in high-deprivation areas. Conversely, area deprivation was associated with higher odds of obesity, but only among children who were above the poverty threshold.

          Conclusions

          Future research on disparities in obesity and other health outcomes should examine broader contextual factors and social determinants of inequities.

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          Author and article information

          Contributors
          Journal
          7909766
          4717
          J Epidemiol Community Health
          J Epidemiol Community Health
          Journal of epidemiology and community health
          0143-005X
          1470-2738
          22 November 2017
          26 September 2013
          February 2014
          28 November 2017
          : 68
          : 2
          : 123-129
          Affiliations
          Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
          Author notes
          Correspondence to: Dr Lauren M Rossen, Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd, Room 6114, Hyattsville, MD 20782, USA; lrossen@ 123456cdc.gov
          Article
          PMC5705001 PMC5705001 5705001 hhspa922119
          10.1136/jech-2012-202245
          5705001
          24072744
          b518807b-309e-4bc6-a545-aced5bc4cbc5
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