Conrey Shannon C, Burrell Allison R, Brokamp Cole, Burke Rachel M, Couch Sarah C, Niu Liang, Mattison Claire P, Payne Daniel C, Staat Mary A, Morrow Ardythe L
University of Cincinnati College of Medicine, Department of Environmental and Public Health, Cincinnati, Ohio, USA.
Cincinnati Children's Hospital Medical Center, Department of Infectious Disease, Cincinnati, Ohio, USA.
Int Public Health J. 2022;14(3):263-276.
Nearly 14% of American children aged 2-5 have obesity, with higher rates in children from lower-income and Black families. While evidence connects neighborhood socioeconomic environment (SEE) and obesity in adults and adolescents, little is known of this relationship in young children. We compared measures of SEE and family-level socio-demographic factors as predictors of obesity at age two.
Family-level data from the PREVAIL Cohort, a CDC-funded birth cohort in Cincinnati, Ohio, were collected prenatally from the mothers. Residential addresses were geocoded and assigned validated measures of census tract-level SEE, including USDA food desert indicators and the Deprivation Index. Family-level and ecological SEE were compared as predictors of obesity (BMI ≥1.65) at age two in terms of proportional differences, relative risk, and model fit statistics.
Residing outside of Deprivation Index High SEE neighborhoods was significantly associated with higher proportion (20.0% 5.9%; χ = 4.36, = 0.037) and increased risk of obesity in univariable (RR = 3.4, 95%CI: 1.26-13.86) and multivariable models (RR = 3.5, 95%CI: 1.06-11.71). There were no differences in proportion or risk of obesity by USDA food desert indicators or family-level factors. Models using categorical Deprivation Index performed better than the family-level and the USDA food desert variables in terms of model fit.
In the PREVAIL Cohort, only category of Deprivation Index was a significant predictor of obesity in two-year-old children. Future studies are needed to evaluate the Deprivation Index as a generalizable tool to identify neighborhoods at higher risk for obesity.
近14%的2至5岁美国儿童患有肥胖症，低收入家庭和黑人家庭的儿童肥胖率更高。虽然有证据表明邻里社会经济环境（SEE）与成年人和青少年的肥胖症有关，但对于幼儿中这种关系却知之甚少。我们比较了SEE指标和家庭层面的社会人口因素，作为两岁时肥胖症的预测指标。
PREVAIL队列的家庭层面数据来自俄亥俄州辛辛那提市一个由疾病控制与预防中心资助的出生队列，在产前从母亲那里收集。对居住地址进行地理编码，并分配经过验证的普查区层面SEE指标，包括美国农业部食品荒漠指标和贫困指数。将家庭层面和生态SEE作为两岁时肥胖症（BMI≥1.65）的预测指标，比较其比例差异、相对风险和模型拟合统计量。
居住在贫困指数高SEE社区之外与肥胖症比例较高（20.0%对5.9%；χ² = 4.36，P = 0.037）以及在单变量（RR = 3.4，95%CI：1.26 - 13.86）和多变量模型（RR = 3.5，95%CI：1.06 - 11.71）中肥胖风险增加显著相关。美国农业部食品荒漠指标或家庭层面因素在肥胖症比例或风险方面没有差异。就模型拟合而言，使用分类贫困指数的模型比家庭层面和美国农业部食品荒漠变量表现更好。
在PREVAIL队列中，只有贫困指数类别是两岁儿童肥胖症的显著预测指标。未来需要开展研究，以评估贫困指数作为一种可推广工具来识别肥胖风险较高社区的情况。
