美国按收入划分的儿童超重和肥胖差异：使用三个具有全国代表性的数据集进行的流行病学研究
Disparities in childhood overweight and obesity by income in the United States: an epidemiological examination using three nationally representative datasets.
机构信息
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Public Health Research Center, 921 Assembly St. rm 130, Columbia, SC, 29201, USA.
出版信息
Int J Obes (Lond). 2019 Jun;43(6):1210-1222. doi: 10.1038/s41366-019-0331-2. Epub 2019 Feb 4.
BACKGROUND/OBJECTIVES: Overweight and obesity (OWOB) is a global epidemic. Adults and adolescents from low-income households are at higher risk to be OWOB. This study examined the relationship between income and OWOB prevalence in children and adolescents (518 years) in the United States (US) within and across race/ethnicities, and changes in this relationship from 1971 to 2014.
SUBJECTS/METHODS: A meta-analysis of a nationally representative sample (N = 73,891) of US children and adolescents drawn from three datasets (i.e., National Health and Nutrition Examination Survey, National Longitudinal Survey of Youth, & the Early Childhood Longitudinal Program) which included 14 cross-sectional waves spanning 1971-2014 was conducted. The exposure was household income-to-poverty ratio (low income = 0.00-1.00, middle income = 1.01-4.00, high income >4.00) with prevalence of overweight or obesity (body mass index ≥ 85th percentile) as the outcome.
RESULTS
Children and adolescents from middle-income and high-income households were 0.78 (95% CI = 0.72, 0.83) and 0.68 (95% CI = 0.59, 0.77) times as likely to be OWOB compared to children and adolescents in low-income households. Separate analyses restricted to each racial/ethnic group showed children and adolescents from middle- and high-income households were less likely to be OWOB compared to their low-income peers within the White, Hispanic, and Other race/ethnic groups. Children and adolescents from low-income households who were Black were not more likely to be OWOB than their high- and middle-income counterparts. Analyses within each income stratum indicated that race/ethnicity was not related to the prevalence of OWOB in low-income households. However, racial/ethnic differences in OWOB were evident for children and adolescents in middle- and high-income households. Disparities in the prevalence of OWOB between low-income children and adolescents and their middle- and high-income counterparts have increased from 1971 to 2014.
CONCLUSIONS
Income and OWOB are related in US children and adolescents. Racial/ethnic differences in the prevalence of OWOB emerge in middle- and high-income households. Disparities in OWOB prevalence are growing.
背景/目的：超重和肥胖（OWOB）是一种全球性的流行疾病。来自低收入家庭的成年人和青少年患 OWOB 的风险更高。本研究在美国（美国）内和跨种族/族裔检查了儿童和青少年（5-18 岁）的收入与 OWOB 患病率之间的关系，并检查了从 1971 年到 2014 年这种关系的变化。
受试者/方法：对来自三个数据集（即国家健康与营养检查调查，国家青年纵向调查和早期儿童纵向计划）的具有代表性的全国性样本（N = 73891）进行了荟萃分析，该样本包括 1971 年至 2014 年期间的 14 个横断面波。暴露是家庭收入与贫困比例（低收入= 0.00-1.00，中等收入= 1.01-4.00，高收入> 4.00），超重或肥胖（体重指数≥第 85 百分位）为结局。
结果
与低收入家庭的儿童和青少年相比，中低收入和高收入家庭的儿童和青少年患 OWOB 的可能性分别低 0.78（95％CI = 0.72，0.83）和 0.68（95％CI = 0.59，0.77）倍。对每个种族/族裔群体分别进行的分析表明，与低收入同龄人相比，中高收入家庭的白种人，西班牙裔和其他种族/族裔群体中的儿童和青少年患 OWOB 的可能性较小。低收入家庭中的黑人儿童和青少年患 OWOB 的可能性并不高于其高收入和中等收入同龄人。在每个收入阶层内的分析表明，种族/族裔与低收入家庭 OWOB 的患病率无关。然而，中高收入家庭的儿童和青少年中存在 OWOB 的种族/族裔差异。从 1971 年到 2014 年，低收入儿童和青少年与中高收入同龄人之间 OWOB 的患病率差异有所增加。
结论
在美国儿童和青少年中，收入与 OWOB 相关。 OWOB 的患病率在中高收入家庭中出现种族/族裔差异。 OWOB 患病率的差异正在扩大。
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