Rachel Sylvester

The Relationship between Childhood Obesity, Low Socioeconomic Status, and Race/Ethnicity: Lessons from Massachusetts

BACKGROUND Previous studies have shown race/ethnicity, particularly African American and/or Hispanic status, to be a predictor of overweight/obese status in children. However, these studies have failed to adjust for low socioeconomic status (SES). This study assessed whether race/ethnicity remained an independent predictor of childhood obesity when accounting for variations in SES (low-income) among communities in Massachusetts. METHODS This study was based on 2009 summarized data from 68 Massachusetts school districts with 111,799 students in grades 1, 4, 7, and 10. We studied the relationship between the rate of overweight/obese students (mean = 0.32; range = 0.10-0.46), the rate of African American and Hispanic students (mean = 0.17; range = 0.00-0.90), and the rate of low-income students (mean = 0.27; range = 0.02-0.87) in two and three dimensions. The main effect of the race/ethnicity rate, the low-income rate, and their interaction on the overweight and obese rate was investigated by multiple regression modeling. RESULTS Low-income was highly associated with overweight/obese status (p < 0.0001), whereas the effect of race/ethnicity (p = 0.27) and its interaction (p = 0.23) with low-income were not statistically significant. For every 1% increase in low-income, there was a 1.17% increase in overweight/obese status. This pattern was observed across all African American and Hispanic rates in the communities studied. CONCLUSIONS Overweight/obese status was highly prevalent among Massachusetts students, varying from 10% to 46% across communities. Although there were higher rates of overweight/obese status among African American and Hispanic students, the relationship disappeared when controlling for family income. Our findings suggest low SES plays a more significant role in the nations childhood obesity epidemic than race/ethnicity.

HEALTH BEHAVIORS PREDICTS CARDIOVASCULAR RISK PROFILE IN MIDDLE-SCHOOL CHILDREN

Lifestyle behaviors related to diet, physical activity (PA) and sedentary behavior (SB) are associated with increased cardiovascular (CV) risk in adults; however, less is known about adolescents. We examined PA, SB and diet in association with CV risk factors among middle school students. Data from

Differences in Cardiovascular Disease Risk Factors and Health Behaviors between Black and Non-Black Students Participating in a School-Based Health Promotion Program

Purpose: To compare cardiovascular disease (CVD) risk factors of black and non-black children participating in Project Healthy Schools (PHS), a school-based wellness program. Design: Participants were surveyed and participated in physiological screenings pre- and post-PHS intervention. Setting: Middle schools in 4 Michigan communities of varying socioeconomic status. Participants: A total of 3813 sixth-grade students comprised the survey sample, and 2297 sixth-grade students comprised the screening sample. Intervention: Project Healthy Schools is a school-based intervention designed to reduce the risk of obesity and CVD in children through the promotion of healthy eating and physical activity. Measures: Physical examination, blood test, and self-reported survey data on dietary habits, physical activity, and sedentary behaviors were collected pre- and post-PHS. Analysis: Paired and independent t tests were used for physiologic variables. Wilcoxon sign-rank and rank-sum tests were used for survey variables. Results: At baseline, blacks had a higher percentage of overweight/obese students (43% vs 34%; P < .0001) and demonstrated poorer health habits than non-blacks; however, non-blacks had poorer lipid profiles. At follow-up (post-PHS intervention), both groups demonstrated significant improvements in physiological measures and health behaviors. Conclusion: Despite disparities between the groups at both baseline and follow-up, changes seen post-PHS intervention were beneficial in both groups. These results suggest that early intervention for risk factor modification is possible and may be of great importance in the prevention of CVD, particularly in high-risk groups.