Vanessa M Oddo1, Lauren Hersch Nicholas2, Sara N Bleich3, Jessica C Jones-Smith1. 1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA. 3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Abstract
BACKGROUND: The recent economic recession represents an opportunity to test whether decreases in economic resources may have deleterious consequences on childhood overweight/obesity risk. METHODS: We investigated the association between indicators of changing macroeconomic conditions from 2008 to 2012 and overweight/obesity risk among school-aged children in California (n=1 741 712) using longitudinal anthropometric measurements. Multivariate regression, with individual and county fixed effects, was used to examine the effects of annual county-level unemployment and foreclosure rates on risk of child overweight/obesity, overall and among subgroups (race/ethnicity, sex, county-level median household income and county-level urban/rural status). RESULTS: From 2008 to 2012, ∼38% of children were overweight/obese and unemployment and foreclosure rates averaged 11% and 6.9%, respectively. A 1-percentage point (pp) increase in unemployment was associated with a 1.4 pp (95% CI 1.3 to 1.5) increase in overweight/obesity risk. Therefore, a child of average weight could expect a 14% increase in their body mass index z-score in association with a 1 pp increase in unemployment during the study period. We found some differences in the magnitude of the effects for unemployment among demographic subgroups, with the largest effects observed for unemployment among American Indians and Pacific Islanders. CONCLUSIONS: Comparing children to themselves over time, we provide evidence that increases in county-level unemployment are associated with increased overweight/obesity risk. Given that overweight among children with lower economic resources remains a challenge for public health, these findings highlight the importance of policy-level approaches, which aim to mitigate the impact of decreased resources as economic conditions change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: The recent economic recession represents an opportunity to test whether decreases in economic resources may have deleterious consequences on childhood overweight/obesity risk. METHODS: We investigated the association between indicators of changing macroeconomic conditions from 2008 to 2012 and overweight/obesity risk among school-aged children in California (n=1 741 712) using longitudinal anthropometric measurements. Multivariate regression, with individual and county fixed effects, was used to examine the effects of annual county-level unemployment and foreclosure rates on risk of child overweight/obesity, overall and among subgroups (race/ethnicity, sex, county-level median household income and county-level urban/rural status). RESULTS: From 2008 to 2012, ∼38% of children were overweight/obese and unemployment and foreclosure rates averaged 11% and 6.9%, respectively. A 1-percentage point (pp) increase in unemployment was associated with a 1.4 pp (95% CI 1.3 to 1.5) increase in overweight/obesity risk. Therefore, a child of average weight could expect a 14% increase in their body mass index z-score in association with a 1 pp increase in unemployment during the study period. We found some differences in the magnitude of the effects for unemployment among demographic subgroups, with the largest effects observed for unemployment among American Indians and Pacific Islanders. CONCLUSIONS: Comparing children to themselves over time, we provide evidence that increases in county-level unemployment are associated with increased overweight/obesity risk. Given that overweight among children with lower economic resources remains a challenge for public health, these findings highlight the importance of policy-level approaches, which aim to mitigate the impact of decreased resources as economic conditions change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Ralph Catalano; Sidra Goldman-Mellor; Katherine Saxton; Claire Margerison-Zilko; Meenakshi Subbaraman; Kaja LeWinn; Elizabeth Anderson Journal: Annu Rev Public Health Date: 2011 Impact factor: 21.981
Authors: Meg Bruening; Richard MacLehose; Katie Loth; Mary Story; Dianne Neumark-Sztainer Journal: Am J Public Health Date: 2012-01-19 Impact factor: 9.308
Authors: Samuel Klein; Lora E Burke; George A Bray; Steven Blair; David B Allison; Xavier Pi-Sunyer; Yuling Hong; Robert H Eckel Journal: Circulation Date: 2004-10-27 Impact factor: 29.690
Authors: Gilad Twig; Gal Yaniv; Hagai Levine; Adi Leiba; Nehama Goldberger; Estela Derazne; Dana Ben-Ami Shor; Dorit Tzur; Arnon Afek; Ari Shamiss; Ziona Haklai; Jeremy D Kark Journal: N Engl J Med Date: 2016-04-13 Impact factor: 91.245
Authors: Tabashir Z Nobari; Shannon E Whaley; Catherine M Crespi; Michael L Prelip; May C Wang Journal: Public Health Nutr Date: 2018-04-02 Impact factor: 4.022
Authors: Rosemary H Jenkins; Eszter P Vamos; David Taylor-Robinson; Christopher Millett; Anthony A Laverty Journal: Int J Behav Nutr Phys Act Date: 2021-04-29 Impact factor: 6.457
Authors: Atsushi Miyawaki; Charlotte Elizabeth Louise Evans; Patricia Jane Lucas; Yasuki Kobayashi Journal: BMJ Open Date: 2021-02-23 Impact factor: 2.692