Félice Lê-Scherban1,2, Jeffrey Moore3, Irene Headen4,5, Levon Utidjian6,7, Yuzhe Zhao4, Christopher B Forrest7. 1. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3215 Market Street, 5th Floor, Philadelphia, PA, 19104, USA. f.lescherban@drexel.edu. 2. Drexel Urban Health Collaborative, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA. f.lescherban@drexel.edu. 3. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3215 Market Street, 5th Floor, Philadelphia, PA, 19104, USA. 4. Drexel Urban Health Collaborative, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, 19104, USA. 5. Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market Street, 4th Floor, Philadelphia, PA, 19104, USA. 6. Division of General Pediatrics, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA. 7. Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, 2716 South Street, Suite 11-473, Philadelphia, PA, 19104, USA.
Abstract
BACKGROUND: Children belonging to the same birth cohort (i.e., born in the same year) experience shared exposure to a common obesity-related milieu during the critical early years of development-e.g., secular beliefs and feeding practices, adverse chemical exposures, food access and nutrition assistance policies-that set the stage for a shared trajectory of obesity as they mature. Fundamental cause theory suggests that inequitable distribution of recent efforts to stem the rise in child obesity may exacerbate cohort-based disparities over time. METHODS: Data were from electronic health records spanning 2007-2016 linked to birth records for children ages 2-19 years. We used hierarchical age-period-cohort models to investigate cohort effects on disparities in obesity related to maternal education. We hypothesized that maternal education-based disparities in prevalence of obesity would be larger among more recent birth cohorts. RESULTS: Sex-stratified models adjusted for race/ethnicity showed substantial obesity disparities by maternal education that were evident even at young ages: prevalence among children with maternal education < high school compared to maternal college degree was approximately three times as high among girls and twice as high among boys. For maternal education < high school, disparities compared to maternal college degree were higher in more recent birth cohorts. Among girls, this disparity cohort effect was evident at younger ages (at age 4, the disparity increased by 4 [0.1-8] percentage points per 5 birth years), while among boys it was larger at older ages (at age 16, the disparity increased by 7 [1-14] percentage points per 5 birth years). CONCLUSIONS: There may be widening maternal education-based disparities in child obesity by birth cohort at some ages.
BACKGROUND: Children belonging to the same birth cohort (i.e., born in the same year) experience shared exposure to a common obesity-related milieu during the critical early years of development-e.g., secular beliefs and feeding practices, adverse chemical exposures, food access and nutrition assistance policies-that set the stage for a shared trajectory of obesity as they mature. Fundamental cause theory suggests that inequitable distribution of recent efforts to stem the rise in child obesity may exacerbate cohort-based disparities over time. METHODS: Data were from electronic health records spanning 2007-2016 linked to birth records for children ages 2-19 years. We used hierarchical age-period-cohort models to investigate cohort effects on disparities in obesity related to maternal education. We hypothesized that maternal education-based disparities in prevalence of obesity would be larger among more recent birth cohorts. RESULTS: Sex-stratified models adjusted for race/ethnicity showed substantial obesity disparities by maternal education that were evident even at young ages: prevalence among children with maternal education < high school compared to maternal college degree was approximately three times as high among girls and twice as high among boys. For maternal education < high school, disparities compared to maternal college degree were higher in more recent birth cohorts. Among girls, this disparity cohort effect was evident at younger ages (at age 4, the disparity increased by 4 [0.1-8] percentage points per 5 birth years), while among boys it was larger at older ages (at age 16, the disparity increased by 7 [1-14] percentage points per 5 birth years). CONCLUSIONS: There may be widening maternal education-based disparities in child obesity by birth cohort at some ages.
Authors: Cynthia L Ogden; Margaret D Carroll; Hannah G Lawman; Cheryl D Fryar; Deanna Kruszon-Moran; Brian K Kit; Katherine M Flegal Journal: JAMA Date: 2016-06-07 Impact factor: 56.272
Authors: Nikos Stratakis; Erika Garcia; Aruna Chandran; Tingju Hsu; Akram Alshawabkeh; Izzuddin M Aris; Judy L Aschner; Carrie Breton; Allison Burbank; Carlos A Camargo; Kecia N Carroll; Zhanghua Chen; Erika C Claud; Dana Dabelea; Anne L Dunlop; Amy J Elliott; Assiamira Ferrara; Jody M Ganiban; James E Gern; Diane R Gold; William A Gower; Irva Hertz-Picciotto; Margaret R Karagas; Catherine J Karr; Barry Lester; Leslie D Leve; Augusto A Litonjua; Yunin Ludena; Cindy T McEvoy; Rachel L Miller; Noel T Mueller; Thomas G O'Connor; Emily Oken; T Michael O'Shea; Frederica Perera; Joseph B Stanford; Katherine Rivera-Spoljaric; Andrew Rundle; Leonardo Trasande; Rosalind J Wright; Yue Zhang; Yeyi Zhu; Kiros Berhane; Frank Gilliland; Lida Chatzi Journal: Epidemiology Date: 2022-01-01 Impact factor: 4.860