Falbe Jennifer, Cotterman Carolyn, Linchey Jennifer, Madsen Kristine A
Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California.
Interdepartmental Group in Biostatistics, University of California, Berkeley, California.
Am J Prev Med. 2016 Aug;51(2):e45-e55. doi: 10.1016/j.amepre.2016.02.010. Epub 2016 Apr 5.
Because California is home to one in eight U.S. children and accounts for the highest Medicaid and Children's Health Insurance Program spending, childhood obesity trends in California have important implications for the entire nation. California's racial/ethnic diversity and large school-based data set provide a unique opportunity to examine trends by race/ethnicity, including understudied Asian and American Indian youth, which has not been possible using national data sets. This study examined racial/ethnic disparities in prevalence of high BMI from 2003 to 2012.
This observational study included 11,624,865 BMI records from repeated cross-sections of fifth-, seventh-, and ninth-graders who underwent California's school-based fitness testing. Analyses conducted in 2015 used logistic regression to identify trends in prevalence of high BMI (BMI ≥85th, 95th, and 97th percentiles) and differences in trends by race/ethnicity from 2003 to 2012.
African American and Hispanic girls and American Indian boys increased in prevalence of high BMI, whereas non-Hispanic white and Asian youth and Hispanic boys decreased in prevalence of high BMI (p-values<0.05) from 2003 to 2012. Over this period, African American, Hispanic, and American Indian youth had higher slopes for trends in high BMI than non-Hispanic white youth (p-values<0.05).
Based on California's statewide data, there is evidence that racial/ethnic disparities in prevalence of high BMI have widened over time. Minority youth have either decreased more slowly or increased in prevalence compared with non-Hispanic white youth. There continues to be an urgent need for policies and interventions that effectively reduce racial/ethnic obesity prevalence disparities.
由于加利福尼亚州是八分之一美国儿童的家园，且该州医疗补助和儿童健康保险计划的支出最高，因此加利福尼亚州儿童肥胖趋势对整个美国具有重要影响。加利福尼亚州的种族/族裔多样性以及庞大的学校数据集提供了一个独特的机会来按种族/族裔研究趋势，包括此前研究较少的亚裔和美国印第安青年，而这是使用全国数据集无法做到的。本研究调查了2003年至2012年期间高体重指数患病率的种族/族裔差异。
这项观察性研究纳入了来自接受加利福尼亚州学校健康体能测试的五年级、七年级和九年级学生重复横断面的11,624,865条体重指数记录。2015年进行的分析使用逻辑回归来确定2003年至2012年期间高体重指数（体重指数≥第85、第95和第97百分位数）患病率的趋势以及按种族/族裔划分的趋势差异。
从2003年到2012年，非裔美国女孩和西班牙裔女孩以及美国印第安男孩的高体重指数患病率有所上升，而非西班牙裔白人青年、亚裔青年以及西班牙裔男孩的高体重指数患病率则有所下降（p值<0.05）。在此期间，非裔美国青年、西班牙裔青年和美国印第安青年的高体重指数趋势斜率高于非西班牙裔白人青年（p值 <0.05）。
基于加利福尼亚州的全州数据，有证据表明高体重指数患病率的种族/族裔差异随时间推移有所扩大。与非西班牙裔白人青年相比，少数族裔青年患病率要么下降得更慢，要么有所上升。仍然迫切需要有效减少种族/族裔肥胖患病率差异的政策和干预措施。
