2019 Health Equity Summer Research Summit Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on June 18th, 2019

Abstract

Background and Purpose: Childhood obesity is one of the foremost threats to population health in the United States (US) leading to the emergence of co-morbidities and increased healthcare cost. We explore the influence of selected socio-demographic determinants of health (SDDOH) on overweight and obesity among US children.

Methods: We utilized the National Survey of Children’s Health (NSCH) 2016-17 dataset for this analysis. Overweight was defined as BMI ≥ 85^th to <95^th percentile for age and sex and obesity was defined as BMI >95^th percentile for age and sex. Based on the literature and pathway plausibility, we examined the following SDDOH as predictors of childhood or overweight in the US: age, gender, parent’s nativity, primary language, family structure, poverty level, parental highest education level and health insurance coverage. A survey log-binomial regression models was conducted to generate the prevalence ratio estimates to capture the associations between SDDOH and overweight or obesity.

Results: A total of 30.6 million children were surveyed out of which about 9.5 million were either overweight or obese, yielding an overall prevalence of 31.0%. The likelihood of obesity was elevated among non-Hispanic Black children (PR = 1.47; 95% CI = 1.24-1.81), children of single parents (PR = 1.32; 95% CI = 1.10-1.52), and younger age of the child (10-12 versus 16-17; PR = 1.32; 95% CI = 1.19-1.58). Parental attainment of college education (PR = 0.56; 95% CI = 0.40-0.78), private insurance coverage (PR = 0.71; 95% CI = 0.56-0.89), and being a female child (PR = 0.89; 95% CI = 0.76-1.07) were protective of overweight or obesity among US children.

Conclusions and Global Health Implications: SDDOH represent markers of overweight or obesity in children. We recommend the development of innovative individualized and community-customized interventions using SDDOH risk and protective pathways as guide to address current childhood overweight and obesity.