Associations of Neighborhood Safety and Neighborhood Support with Overweight and Obesity in US Children and Adolescents

Abstract

<p class="Pa7"><strong>Objectives: </strong>To examine the association of neighborhood safety and support with overweight and obesity and whether these associations vary with age, sex, and race/ ethnicity among children and adolescents.</p><p class="Pa7"><strong>Design: </strong>Cross-sectional.</p><p class="Pa7"><strong>Setting: </strong>United States.</p><p class="Pa7"><strong>Main Outcome Measure: </strong>Childhood over­weight and obesity.</p><p class="Pa7"><strong>Methods: </strong>We used data from the 2011-12 National Survey of Children’s Health, a rep­resentative sample of US children and ado­lescents, for the analyses (N=40,730). Using the age-sex adjusted growth chart, parent self-reported weight and height data were used to classify participants as overweight (those with body mass index [BMI] percen­tile [%] at or above the 85th%) and obese (those with BMI% at or above the 95th%). We used log-binomial regression to quantify the association of neighborhood safety and support with overweight and obesity among children and adolescents before and after adjusting for selected characteristics includ­ing physical activity and amount of time spent in sedentary activities.</p><p class="Pa7"><strong>Results: </strong>Children and adolescents living in non-supportive neighborhoods had a 21% (95%CI: 1.10-1.33) higher probability of being obese than their peers living in supportive neighborhoods after controlling for age, sex, race/ethnicity, parent’s education, poverty, asthma, physical activity and sedentary ac­tivities. Similarly, the probabilities of obesity associated with neighborhood safety and sup­port were 1.30 (95%CI:1.08-156) and 1.18 (95%CI:1.01-1.38), respectively. However, these probabilities vary with race/ethnicity with higher probability being observed among non-Hispanic Whites and Hispanics for over­weight and non-Hispanic Whites for obesity.</p><p><strong>Conclusions: </strong>Living in unsafe and non-sup­portive neighborhoods may be associated with overweight and obesity among US chil­dren and adolescents. Longitudinal studies, accounting for race/ethnicity, are needed to examine the importance of social context where children and adolescents live.</p><p><em>Ethn Dis.</em>2016;26(4):469-476; doi:10.18865/ ed.26.4.469</p>