Prevalence of Childhood Obesity and Overweight Varies Among States

Laurie Barclay, MD

May 04, 2010

May 4, 2010 — The prevalence of childhood obesity and overweight varies significantly among US states, according to the results of a study reported online May 3 in the Archives of Pediatrics & Adolescent Medicine.

"During the past 3 decades, there has been a dramatic increase in childhood obesity in the United States," write Gopal K. Singh, PhD, and colleagues at the Health Resources and Services Administration, Maternal and Child Health Bureau, US Department of Health and Human Services, Rockville, Maryland. "The rate has more than tripled, and the current prevalence remains high among children across most age, sex, racial/ethnic, and socioeconomic groups.... Although sex and racial/ethnic inequalities are presented on a routine basis, geographic disparities in US childhood obesity are less well examined and trends in geographic disparities are even rarer or nonexistent."

Using a cross-sectional analysis of the 2003 and 2007 National Survey of Children's Health data, this study aimed to determine changes in state-specific obesity and overweight prevalence among US children and adolescents in the 50 states and the District of Columbia between 2003 and 2007.

The study population consisted of 46,707 and 44,101 children aged 10 to 17 years in 2003 and 2007, respectively. Bivariate and logistic regression analyses were used to calculate differences among states in prevalence and odds of obesity and overweight.

Among US children in 2007, prevalence of obesity was 16.4% and prevalence of overweight was 31.6%. The states varied dramatically in prevalence of childhood obesity, which was highest in Mississippi (21.9%) and lowest in Oregon (9.6%). The highest prevalence of childhood overweight was also in Mississippi (44.5%); the lowest was 23.1% in Utah.

Prevalence of obesity increased by 10% for all US children from 2003 to 2007, increasing by18% for girls, decreasing by 32% for children in Oregon, and doubling among girls in Arizona and Kansas. Compared with children in Oregon, those in Illinois, Tennessee, Kentucky, West Virginia, Georgia, and Kansas had more than twice the adjusted odds of being obese.

"Individual, household, and neighborhood social and built environmental characteristics accounted for 45% and 42% of the state variance in childhood obesity and overweight, respectively," the study authors write. "Substantial geographic disparities in childhood obesity and overweight exist, with an apparent shift toward higher prevalence in 2007 for several states. Marked geographic disparities indicate the potential for considerable reduction in US childhood obesity."

Limitations of this study include reliance on parental reports of children's height and weight, potential for nonresponse bias inherent to survey designs, inability to consider additional individual-level covariates such as children's dietary patterns and parental obesity status, and lack of direct area-based measures of the neighborhood environment.

"Documenting geographic and social group disparities in childhood obesity should be considered an essential component of a national surveillance system that routinely tracks progress toward meeting the overall health objective of reducing and/or eliminating health inequities across population subgroups," the study authors conclude. "Prevention programs for reducing disparities in childhood obesity should not only include behavioral interventions aimed at reducing children's physical inactivity levels and limiting their television viewing and recreational screen time but should also include social policy measures aimed at improving the broader social and physical environments that create obesogenic conditions that put children at risk for poor diet, physical inactivity and other sedentary activities."

The study authors have disclosed no relevant financial relationships.

Arch Pediat Adolesc Med. Published online May 3, 2010.