Li Y, Robinson L E, Carter W M, Gupta R
Department of Geology and Geography, Auburn University, Auburn, AL, USA.
School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.
Child Care Health Dev. 2015 Sep;41(5):668-76. doi: 10.1111/cch.12204. Epub 2014 Oct 16.
Childhood obesity has been rising rapidly in the USA. The rate is higher among those at a lower socioeconomic status and racial/ethnic minority groups. In Alabama, nearly half of the children from rural African American families are overweight or obese. Studies suggest that children's eating behaviours and weight could be influenced by surrounding food environments. The purpose of this paper is to assess the community food environment and examine the associations with childhood obesity in Alabama's Black Belt region.
This research uses both qualitative and quantitative methods. Weight status of 613 African American students in four elementary schools in a rural county of Alabama was assessed. We examined community food environments around children's home through GIS (Geographic Information System) and statistical methods. The interrelations between children's weight and community food environments are explored with multi-level models.
Approximately 42.1% of surveyed children were overweight or obese, much higher than the national average, 30.6%. In Model 1, convenience stores (3.44; P < 0.01), full service restaurants (8.99; P < 0.01) and supermarkets (-37.69; P < 0.01) were significantly associated with the percentile of body mass index. Fast food stores (-0.93; P = 0.88) were not related to children's weight. In Model 2, the additions of sociodemographic factors and school effects cause significant changes of the relationships between children's weight and four types of food outlets. The percentage of African American population (90.23, P < 0.01) and school (6.68, P < 0.01) were positively associated with children's weight; while median household income (-39.6; P < 0.01) was negatively related to it.
Children's weight is influenced by community food environments, sociodemographic factors and school context. Findings suggest that policymakers and planners need to improve community food environments of low-income minority communities. Parents and schools should pay more attention to reduce the negative impacts of food environments on children.
美国儿童肥胖率一直在迅速上升。社会经济地位较低的人群以及种族/族裔少数群体中的肥胖率更高。在阿拉巴马州，近一半来自农村非裔美国家庭的儿童超重或肥胖。研究表明，儿童的饮食行为和体重可能会受到周围食物环境的影响。本文的目的是评估阿拉巴马州黑带地区的社区食物环境，并研究其与儿童肥胖之间的关联。
本研究采用定性和定量方法。对阿拉巴马州一个农村县四所小学的613名非裔美国学生的体重状况进行了评估。我们通过地理信息系统（GIS）和统计方法研究了儿童家庭周围的社区食物环境。使用多层次模型探讨了儿童体重与社区食物环境之间的相互关系。
约42.1%的受访儿童超重或肥胖，远高于全国平均水平30.6%。在模型1中，便利店（3.44；P<0.01）、全套服务餐厅（8.99；P<？0.01）和超市（-37.69；P<0.01）与体重指数百分位数显著相关。快餐店（-0.93；P = 0.88）与儿童体重无关。在模型2中，加入社会人口统计学因素和学校影响后，儿童体重与四种类型食品店之间的关系发生了显著变化。非裔美国人口比例（90.23，P<0.01）和学校（6.68，P<0.01）与儿童体重呈正相关；而家庭收入中位数（-39.6；P<0.01）与儿童体重呈负相关。
儿童体重受社区食物环境、社会人口统计学因素和学校环境的影响。研究结果表明，政策制定者和规划者需要改善低收入少数族裔社区的社区食物环境。家长和学校应更加关注减少食物环境对儿童的负面影响。
