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Argenio KL, Day SE, D’Agostino EM, Neshteruk C, Wagner BE, Konty KJ. Increasing disparities in obesity and severe obesity prevalence among public elementary and middle school students in New York City, school years 2011-12 through 2019-20. PLoS One 2024; 19:e0302099. [PMID: 38748634 PMCID: PMC11095699 DOI: 10.1371/journal.pone.0302099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/26/2024] [Indexed: 05/19/2024] Open
Abstract
Recent national trends in the United States indicate a significant increase in childhood obesity, a major public health concern with documented physical and mental comorbidities and sociodemographic disparities. We aimed to estimate the prevalence of obesity and severe obesity among youth in New York City (NYC) before the COVID-19 pandemic and examine time trends overall and by key characteristics. We included all valid height and weight measurements of kindergarten through 8th grade public school students aged 5 to 15 from school years 2011-12 through 2019-20 (N = 1,370,890 unique students; 5,254,058 observations). Obesity and severe obesity were determined using age- and sex-specific body mass index percentiles based on the Centers for Disease Control and Prevention growth charts. Analyses were performed using multivariate logistic regression models with repeated cross-sectional observations weighted to represent the student population for each year and clustered by student and school. Among youth attending public elementary and middle schools in NYC, we estimate that 20.9% and 6.4% had obesity and severe obesity, respectively, in 2019-20. While consistent declines in prevalence were observed overall from 2011-12 to 2019-20 (2.8% relative decrease in obesity and 0.2% in severe obesity, p<0.001), increasing trends were observed among Black, Hispanic, and foreign-born students, suggesting widening disparities. Extending previous work reporting prevalence estimates in this population, nearly all groups experienced significant increases in obesity and severe obesity from 2016-17 to 2019-20 (relative change = 3.5% and 6.7%, respectively, overall; p<0.001). Yet, some of the largest increases in obesity were observed among those already bearing the greatest burden, such as Black and Hispanic students and youth living in poverty. These findings highlight the need for greater implementation of equity-centered obesity prevention efforts. Future research should consider the influence of the COVID-19 pandemic and changes in clinical guidance on childhood obesity and severe obesity in NYC.
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Affiliation(s)
- Kira L. Argenio
- New York City Department of Health and Mental Hygiene, Office of School Health, New York, New York, United States of America
| | - Sophia E. Day
- New York City Department of Health and Mental Hygiene, Office of School Health, New York, New York, United States of America
| | - Emily M. D’Agostino
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, North Carolina, United States of America
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Cody Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Brooke E. Wagner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Kevin J. Konty
- New York City Department of Health and Mental Hygiene, Office of School Health, New York, New York, United States of America
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Gonzalez CJ, Copeland M, Shapiro MF, Moody J. Associations of peer generational status on adolescent weight across Hispanic immigrant generations: A social network analysis. Soc Sci Med 2023; 323:115831. [PMID: 36931036 DOI: 10.1016/j.socscimed.2023.115831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Childhood obesity disproportionately impacts Hispanics in the United States (US), the nation's largest ethnic minority population. However, even among Hispanic children, those born in the US are at increased risk of developing obesity than those not born in the US (i.e. first-generation Hispanics). The objective of this study is to assess whether ethnic and generational differences in the friend networks of Hispanic adolescents moderate the association between immigrant generation and weight. METHODS We analyzed data from first-generation, second-generation, and third-generation Hispanic 12 to 19 year-old participants in Wave 1 of the Longitudinal Study of Adolescent to Adult Health (Add Health). Using multivariable linear regression, we examined the association between generational status and body mass index (BMI), and whether the ethnic and generational composition of friends moderated that association. RESULTS Higher generational status was associated with higher BMI. The ethnic and generational composition of friends was not independently associated with BMI among Hispanic adolescents. However, a social network with a greater proportion of second-generation Hispanics was positively associated with BMI among first-generation Hispanics, and negatively associated with BMI among second-generation Hispanics. CONCLUSIONS The generational status of peers in Hispanic adolescents' social networks, particularly the proportion that are second-generation Hispanic, moderates the positive association between immigrant generation and BMI. Moreover, this moderation effect is different across immigrant generations so that the proportion of second-generation adolescents within a social network is associated with higher BMI in first-generation Hispanic adolescents, but with lower BMI among those who are second-generation. These results were confirmed in sensitivity analyses. Our findings suggest that the generational composition of social networks alters the association between the generational status and weight of Hispanic adolescents, and thus that social factors within those networks may contribute to those associations.
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Affiliation(s)
- Christopher J Gonzalez
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA.
| | - Molly Copeland
- Department of Sociology, Michigan State University, East Lansing, MI, 48824, USA
| | - Martin F Shapiro
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - James Moody
- Department of Sociology, Duke University, Durham, NC, 27708, USA
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D'Agostino EM, Day SE, Konty KJ, Armstrong SC, Skinner AC, Neshteruk CD. Longitudinal Association between Weight Status, Aerobic Capacity, Muscular Strength, and Endurance among New York City Youth, 2010-2017. Child Obes 2022; 19:203-212. [PMID: 35758762 DOI: 10.1089/chi.2022.0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Child weight status is inversely associated with fitness, but less is known about this relationship across fitness domains. This study examined the longitudinal association between weight status and fitness domains in a large, diverse sample of children. Methods: Data were drawn from the New York City Fitnessgram (2010-2011 to 2017-2018). Height and weight were collected annually and converted to weight status using Centers for Disease Control and Prevention growth charts. Aerobic capacity, muscular strength, and endurance were measured as age and sex standardized z-scores based on the fitness performance tests. Repeated-measures multilevel models were run testing the association between weight status and 1-year lagged fitness domains. Results: The sample included 917,554 children (51.8% male, 39.3% Hispanic, 29.9% non-Hispanic Black, 13.9%, 4.7%, and 1.7% class I, II, and III obesity, respectively). For each fitness domain, fitness scores decreased with increasing weight status across all demographic categories, with the lowest fitness scores observed in children with the most severe obesity, and highest magnitude of effects for aerobic capacity, and particularly among boys, non-Hispanic Whites, and older youth. For example, compared with youth with healthy weight, youth with overweight had 0.28 standard deviation lower aerobic capacity performance [confidence interval (95% CI): -0.29 to -0.28], followed by class 1 obesity (β = -0.57, 95% CI: -0.58 to -0.57), class 2 obesity (β = -0.88, 95% CI: -0.88 to -0.88), and class 3 obesity (β = -1.19, 95% CI: -1.20 to -1.18). Conclusions: Compared with youth with healthy weight, youth at every other weight status had lower subsequent fitness, with the magnitude of the relationship increasing as weight status increased. Future research should examine interventions targeting aerobic capacity to reduce fitness disparities.
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Affiliation(s)
- Emily M D'Agostino
- Department of Orthopaedic Surgery, Duke University Medical School, Durham, NC, USA.,Department of Population Health Sciences, Duke University Medical School, Durham, NC, USA
| | - Sophia E Day
- New York City Department of Health and Mental Hygiene, Office of School Health, New York, NY, USA
| | - Kevin J Konty
- New York City Department of Health and Mental Hygiene, Office of School Health, New York, NY, USA
| | - Sarah C Armstrong
- Duke Clinical Research Institute, Duke University, Durham, NC, USA.,Department of Pediatrics, Duke University Medical School, Durham, NC, USA.,Duke Global Health Institute, Durham, NC, USA
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, USA.,Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Cody D Neshteruk
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, USA
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