National, State and Local Disparities in Childhood Obesity
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Transcript of National, State and Local Disparities in Childhood Obesity
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 significantHigher than U.S., not significantSignificantly 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 29.634.4
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