Widening socio-economic disparities in early childhood obesity in Los Angeles County after the Great Recession

• Published in: Public health nutrition Vol. 21; no. 12; pp. 2301 - 2310
• Main Authors: Nobari, Tabashir Z, Whaley, Shannon E, Crespi, Catherine M, Prelip, Michael L, Wang, May C
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.08.2018
• Subjects: California; Centers for Disease Control and Prevention; Child, Preschool; Childhood; childhood obesity; Children; Control charts; Disease control; economic crises; Economic crisis; Economic Recession; Economics; educational status; Female; Food Assistance; Food programs; growth curves; household income; Humans; Impact analysis; Income; Infant; Infants; Los Angeles - epidemiology; Male; Nutrition; Nutritional epidemiology; Obesity; Observational studies; Pediatric Obesity - epidemiology; Prevention; Recessions; regression analysis; Research paper; Risk Factors; sociodemographic characteristics; Socioeconomic Factors; socioeconomic status; Socioeconomics; WIC Program; Widening; Los Angeles; Los Angeles County California; Los Angeles California; San Francisco California; California; United States > US; WIC; Childhood obesity; Great Recession; Socio-economic disparities
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980018000666

While economic crises can increase socio-economic disparities in health, little is known about the impact of the 2008-09 Great Recession on obesity prevalence among children, especially low-income children. The present study examined whether socio-economic disparities in obesity among children of pre-school age participating in a federal nutrition assistance programme have changed since the recession. A pre-post observational study using administrative data of pre-school-aged programme participants from 2003 to 2014. Logistic regression was used to examine whether the relationship between obesity prevalence (BMI≥95th percentile of the Centers for Disease Control and Prevention's growth charts) and three measures of socio-economic status (household income, household educational attainment, neighbourhood-level median household income) changed after the recession by examining the interaction between each socio-economic status measure and a 5-year time-period variable (2003-07 v. 2010-14), stratified by child's age and adjusted for child's sociodemographic characteristics. Los Angeles County, California, USA. Children aged 2-4 years (n 1 637 788) participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. The magnitude of the association of household income and household education with obesity increased after 2008-09 among 3- and 4-year-olds and 2- and 3-year-olds, respectively. However, the magnitude of the association of neighbourhood-level median household income with obesity did not change after 2008-09. Disparities in obesity by household-level socio-economic status widened after the recession, while disparities by neighbourhood-level socio-economic status remained the same. The widening household-level socio-economic disparities suggest that obesity prevention efforts should target the most vulnerable low-income children.