National, State and Local Disparities in Childhood Obesity

Findings from the 2007 National Survey of Children’s Health

– Christina Bethell, Lisa Simpson, Scott Stumbo, Adam Carle, Narengeral Gombojav

Bethell, C. March 2, 2010 Page 00

Overweight Obesity Overweight/Obesity Combined0

5

10

15

20

25

30

35

15.7 14.8*

30.6

15.3 16.4

31.6

Combined Overweight/Obesity Stable But Obesity Increased Increase accounted for by selected subgroups

20032007

*2003 versus 2007 rates of obesity are significantly different (P<0.05)

2003 2007Publicly Insured 39.6% 43.2%*Poor (< 100% FPL) 39.8% 44.8%*Hispanic 37.7% 41.0%*

The Nation: 2003 vs. 2007

Significantly lower than U.S.

Lower than U.S., not significant

Higher than U.S., not significant

Significantly higher than U.S.

Low: UT/MN: 23.1%

High: MS: 44.4

Variation Across States

Both Across and Within State Disparities Widened

Within State Disparities

ID Privately Insured

IDPublicly Insured

MNPrivately Insured

MNPublicly Insured

0

5

10

15

20

25

30

35

40

45

50

27.6 27.2

18.4

48.0

State with the lowest overall rate had the highest insurance disparity

ID=27.5MN=23.1

AK<100% FPL

AK>400% FPL

AZ<100% FPL

AZ>400% FPL

0.0

10.0

20.0

30.0

40.0

50.0

60.0

32.027.6

53.3

14.1

Lower Rate Does Not Mean Lower Dispar-ity

AK=33.9AZ=30.6

Within State Disparities

Never/Rarely/

Sometimes Engaged

Usually or Always

Engaged

None 1-5 days 6-10 days 11 or more days

No Yes0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.038.2b

29.7 31.9b 29.6

34.4

43.841.5

School Engagement Missed School Days Repeated a Grade

bStatistically significant differences exist in estimated prevalence across child subgroups for this variable based on a chi square test and p< .01.

Independent Impact on School Outcomes

Higher Odds of Poorer School Outcomes for Overweight or Obese Children

(Adjusted for Health Status, SES, etc.)

Not Being Engaged in School

1.32 greater odds

Missing 2 or more weeks of school in year

1.59 greater odds

Repeated a grade in school

1.42 greater odds

31.0

0

20

40

60

80

100

84.5

15.5

Neighborhood does not have park or recreation center

Neighborhood has park and/ or recreation center

0

10

20

30

40

50

60

70

80

90

100

57.8

33.2

9.0

UninsuredPublicPrivate

While being publicly insured and not having access to a park or recreation center independently predicts overweight/obesity in children, most overweight or obese children are still privately insured and have neighborhood amenities

A National Issue