TY - JOUR
T1 - Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood
AU - Johnson, Katherine Abowd
AU - Jones-Smith, Jessica
AU - Curriero, Frank C.
AU - Cheskin, Lawrence J.
AU - Benjamin-Neelon, Sara E.
AU - Perin, Jamie
AU - Caicedo, Mariana Rincon
AU - Thornton, Rachel L.J.
N1 - Funding Information:
Funding: Dr. Johnson was supported by Johns Hopkins Center for a Livable Future—Lerner Fellowship and the Johns Hopkins Bloomberg School of Public Health Sommer Scholarship. This research was supported by a grant from the Center for Behavior and Health at the Johns Hopkins Bayview Medical Center, with additional funding and support from the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities funded by the National Heart, Lung, and Blood Institute (grant ID# P50HL0105187 ). Dr. Thornton was also supported by the National Heart, Lung, and Blood Institute (grant ID# K23HL121250-01A1 ).
Funding Information:
The authors would like to thank Katie Washington Cole, Jacky Jennings, Laura Cobb, Nakiya Showell, Sarah Flessa and Amanda Behrens Buczynski for their contributions to this research. They would also like to thank the Johns Hopkins Center for a Livable Future and Sommer Scholarship for their financial support of this research. Funding: Dr. Johnson was supported by Johns Hopkins Center for a Livable Future?Lerner Fellowship and the Johns Hopkins Bloomberg School of Public Health Sommer Scholarship. This research was supported by a grant from the Center for Behavior and Health at the Johns Hopkins Bayview Medical Center, with additional funding and support from the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities funded by the National Heart, Lung, and Blood Institute (grant ID# P50HL0105187). Dr. Thornton was also supported by the National Heart, Lung, and Blood Institute (grant ID# K23HL121250-01A1). Research support: The funding source had no involvement in the decision to submit for publication.
Publisher Copyright:
© 2020 Academic Pediatric Association
PY - 2020/8
Y1 - 2020/8
N2 - Background: High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its comorbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Few studies have assessed the relationship between neighborhood food environments and obesity in this population. Methods: Electronic health records from 2 pediatric primary care clinics serving predominately low-income, black, and Hispanic children were used to create a cohort of 3724 2- to 5-year olds, encompassing 7256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1–5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. Results: Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272; 95% confidence interval: 0.041–0.503; P =.021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000–0.012, P =.024). Conclusions: Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association.
AB - Background: High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its comorbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Few studies have assessed the relationship between neighborhood food environments and obesity in this population. Methods: Electronic health records from 2 pediatric primary care clinics serving predominately low-income, black, and Hispanic children were used to create a cohort of 3724 2- to 5-year olds, encompassing 7256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1–5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. Results: Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272; 95% confidence interval: 0.041–0.503; P =.021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000–0.012, P =.024). Conclusions: Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association.
KW - Special Supplemental Nutrition Program for Women, Infants and Children
KW - childhood obesity
KW - health disparities
KW - neighborhood food environment
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U2 - 10.1016/j.acap.2019.11.013
DO - 10.1016/j.acap.2019.11.013
M3 - Article
C2 - 31783182
AN - SCOPUS:85078822535
VL - 20
SP - 784
EP - 792
JO - Academic Pediatrics
JF - Academic Pediatrics
SN - 1876-2859
IS - 6
ER -