Racial-ethnic differences in childhood higher body mass index: insurance status explanatory model

Abstract

Purpose – The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese prevalence, and to determine whether or not insurance status explains the variance. Design/methodology/approach – A cross-sectional design was used to assess medical records of children in Nemours Healthcare System during 2011. The authors reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, prevalence of overweight/obese and other variables as well as race and ethnicity. χ2 statistic, Fischer's exact and logistic regression model were used to examine the data. Findings – Overall, the prevalence of higher BMI as overweight/obese was comparable to that of the US pediatric population, 33.4 percent. Compared to Caucasian/white, Asians were less likely to have higher BMI, prevalence odd ratio (POR)=0.79, 95 percent CI=0.70-0.90, but Blacks/African Americans (POR=1.22, 95 percent CI=1.18-1.27) and Some other Race were more likely to have higher BMI, POR=1.61, 95 percent CI=1.92-1.71. After controlling for insurance status, the racial disparities in higher BMI persisted; p<0.0001. Research limitations/implications – Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status. These findings are indicative of assessing sex, religious, dietary patterns, physical activities level, environmental resources, social media resources; and geographic locale as confounders in race/ethnicity and higher BMI association. Originality/value – Understanding the predisposing factors to obesity/overweight among diverse populations is essential in developing and implementing intervention programs in addressing this epidemic in our nation.