Persistent disparities in obesity risk among public schoolchildren from childhood through adolescence

Danhong Chen, Michael R. Thomsen, Rodolfo M. Nayga, Judy L. Bennett

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Introduction: Arkansas is among the poorest states and has high rates of childhood obesity. In 2003, it became the first state to systematically screen public schoolchildren for unhealthy weight status. This study aims to examine the socioeconomic disparities in Body Mass Index (BMI) growth and the risk of the onset of obesity from childhood through adolescence. Methods: This study analyzed (in 2015) the data for a large cohort of Arkansas public schoolchildren for whom BMIs were measured from school years 2003/2004 through 2009/2010. A linear growth curve model was used to assess how child-level sociodemographics and neighborhood characteristics were associated with growth in BMI z-scores. Cox regression was subsequently used to investigate how these factors were associated with the onset of obesity. Because children might be classified as obese in multiple years, sensitivity analysis was conducted using recurrent event Cox regression. Results: Survival analysis indicated that the risk of onset of obesity rose sharply between ages of 5 and 10 and then again after age 15. The socioeconomic disparities in obesity risk persisted from kindergarten through adolescence. While better access to full service restaurants was associated with lower risk of the onset of obesity (Hazard Ratio (HR) = 0.98, 95% CI = 0.97-0.99), proximity to fast food restaurants was related to increased risk of the onset of obesity (HR = 1.01, 95% CI = 1.00-1.01). Conclusions: This analysis stresses the need for policies to narrow the socioeconomic gradient and identifies important time periods for preventative interventions in childhood obesity.

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalPreventive Medicine
Publication statusPublished - 2016 Aug 1

Bibliographical note

Funding Information:
This work was funded by the Agriculture and Food Research Initiative Competitive Grant No. 2011-68001-30014 from the USDA National Institute of Food and Agriculture. This work is also partly supported by the Arkansas Biosciences Institute , Research Council of Norway Grant # 233800 , and the National Research Foundation of Korea ( NRF-2014S1A3A2044459 ).

Publisher Copyright:
© 2016 Elsevier Inc.


  • BMI growth
  • Food environment
  • Health disparities
  • Onset of obesity

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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