Childhood Overweight and Neighborhood Effects: A Study of Alameda County Using The California Health Interview Survey

Background and Purpose: Many health conditions (such as diabetes and heart disease) disproportionately affect individuals in lower socioeconomic groups. These conditions lead to higher morbidity and premature mortality, making the issue of health disparities an important one to address. While some of the risk factors and pathways for childhood overweight are known, such as decreased physical activity and higher caloric diet, other contributing factors are still under exploration. One of the most promising areas of inquiry within social epidemiology is contextual level analysis of health outcomes—that is, how do neighborhoods and communities, in both their physical and social structures, influence health statuses and outcomes for individuals. This study examines the role of aggregate-level socioeconomic status and social capital for neighborhoods in Alameda County upon childhood overweight.

Methods: This secondary data analysis merged data from the 2003 and 2005 waves of the California Health Interview Survey, resulting in 713 children ages 5-11. In order to estimate separate effects of individual/household and neighborhood socioeconomic status and social cohesion/capital, logistic regression models and random effects logistic regression models were used.

Results: Our findings did not support clustering of childhood overweight by ZIP code; however, we did find a strong relationship between household level poverty and childhood overweight with the poorest children 9 times more likely to be overweight than those children in the highest income bracket. While there was no effect modification of social capital on ZIP code level socioeconomic status, it was an effect modifier between household income levels and childhood overweight.

Conclusions and Implications: This study contributed to the literature by providing evidence that household level poverty remains more predictive of childhood overweight than neighborhood level socioeconomic status. It is nonetheless important to consider how schools, communities, and neighborhoods can support the healthy development of children, including creating access to nutritious, whole foods, opportunities for recreation and exercise, and regular primary care.