A systematic review of neighbourhood economic context on child obesity and obesity-related behaviours.

Childhood obesity is of great importance given a third of children in the USA are overweight or obese. Previous research has examined neighbourhood economic context in relation to children's obesity and obesity-rated behaviours. However, different definitions and measures of neighbourhood context make it difficult to compare findings and make definitive conclusions. This review is to synthesize studies assessing the associations between neighbourhood economic context and children's obesity or obesity-related behaviours. The review included 39 studies investigating the relationship between residential neighbourhood economic context and children's obesity, dietary habits or physical activity after controlling for family-level economic status. Studies reported mixed results in the relationship between neighbourhood economic indicators and child obesity outcomes. Of reviewed studies, 60% showed an inverse association between higher neighbourhood economic status and obesity, and 33% and 14% showed positive associations between higher neighbourhood economic status and healthy dietary habits or physical activity. Several studies suggested gender, age, race/ethnicity, individual-level economic status, rurality and social connectedness as moderators in the neighbourhood-obesity association. Findings suggest that, in order to move towards causal inferences and inform interventions, future research should examine neighbourhood impacts longitudinally and test theory-driven mediators and moderators to clarify the mechanisms by which neighbourhoods influence child obesity.