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Obesity Among US Urban Preschool Children
Relationships to Race, Ethnicity, and Socioeconomic Status
Robert C. Whitaker, MD, MPH;
Sean M. Orzol, MPH
Arch Pediatr Adolesc Med. 2006;160:578-584.
Objectives To determine whether there are racial/ethnic differences in the prevalence of obesity among preschool children and to determine whether these differences are explained by socioeconomic factors.
Design Cross-sectional assessment.
Setting Twenty large US cities, from 2001 to 2003.
Participants Of the 4898 children enrolled at birth in the Fragile Families and Child Well-being Study, we analyzed data for the 2452 who, at the age of 3 years, had their height and weight measured during a maternal survey.
Main Exposures Three socioeconomic indicators were the main exposures—maternal education, household income, and children's food security status, as assessed by the US Household Food Security Survey Module.
Main Outcome Measure Obesity, defined as a body mass index at the 95th percentile or higher for age and sex.
Results Of the mothers, 41.0% had education beyond high school, 52.9% of households had an income above the federal poverty threshold, and 79.5% of the children were food secure. The prevalence of obesity was 25.8% among Hispanics (any race), 16.2% among blacks, and 14.8% among whites. Compared with whites, the odds of obesity were significantly higher in Hispanics (odds ratio, 2.00; 95% confidence interval, 1.46-2.73), but not in blacks (odds ratio, 1.10; 95% confidence interval, 0.82-1.48). Neither of these odds ratios changed meaningfully after adjusting for all 3 socioeconomic indicators (Hispanics: odds ratio, 1.86 [95% confidence interval, 1.33-2.60]; and blacks: odds ratio, 1.07 [95% confidence interval, 0.78-1.47]).
Conclusion In a sample of preschool children drawn from 20 large US cities, the high prevalence of obesity among Hispanics relative to blacks or whites was not explained by racial/ethnic differences in maternal education, household income, or food security.
Author Affiliations: Mathematica Policy Research, Inc, Princeton, NJ.
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