1
|
Ertel KA, Okuzono SS, Beyer LN, Pintro K, Cuevas AG, Slopen N. Neighborhood Opportunity and Obesity in Early Adolescence: Differential Associations by Sex. J Adolesc Health 2024; 75:314-322. [PMID: 38852089 DOI: 10.1016/j.jadohealth.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/26/2024] [Accepted: 04/04/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE Though research indicates that certain aspects of adverse neighborhood conditions may influence weight development in childhood and adolescence, it is unknown if the Child Opportunity Index (COI), a composite measure of 29 indicators of neighborhood conditions, is associated with weight outcomes in adolescence. We hypothesized that lower COI would be associated with higher overweight and obesity in cross-sectional and longitudinal modeling in a national sample of 9 year olds and 10 year olds and that this association would be different by sex. METHODS Using data from the Adolescent Brain Cognitive Development study (n = 11,857), we examined the cross-sectional association between COI quintile and overweight and obesity in 9 year olds and 10 year olds. Additionally, we used hazard ratios to examine incident overweight and obesity across three waves of data collection. RESULTS Due to the interaction between sex and COI (p < .05), we present sex-specific models. There was a stepwise bivariate association, in which higher COI was associated with lower obesity prevalence. This pattern held in multilevel models, with a stronger association in females. In models adjusted for individual and household characteristics, female adolescents in the lowest quintile COI neighborhoods had 1.81 (95% confidence interval: 1.32, 2.48) times the odds of obesity compared to those in the highest quintile. In longitudinal models, the COI was associated with incident obesity in females only: adjusted hazard ratio = 4.27 (95% confidence interval: 1.50, 12.13) for lowest compared to highest COI. DISCUSSION Neighborhood opportunity is associated with risk of obesity in pre-adolescence into mid-adolescence. Females may be particularly influenced by neighborhood conditions.
Collapse
Affiliation(s)
- Karen A Ertel
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts.
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Logan Nicole Beyer
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Kedie Pintro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Adolfo G Cuevas
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York; Center for Anti-racism, Social Justice, and Public Health, New York University School of Global Public Health, New York, New York
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Center on the Developing Child, Harvard University, Cambridge, Massachusetts
| |
Collapse
|
2
|
Blatt LR, Sadler RC, Jones EJ, Miller P, Hunter-Rue DS, Votruba-Drzal E. Historical Structural Racism in the Built Environment and Contemporary Children's Opportunities. Pediatrics 2024; 153:e2023063230. [PMID: 38192230 DOI: 10.1542/peds.2023-063230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES There are well-documented links between structural racism and inequities in children's opportunities. Yet, when it comes to understanding the role of the built environment, a disproportionate focus on redlining obscures other historical policies and practices such as blockbusting, freeway displacement, and urban renewal that may impact contemporary child development. We hypothesized that historical structural racism in Allegheny County, Pennsylvania's, built environment would be associated with fewer contemporary educational, socioeconomic, and health opportunities. We also hypothesized that these measures would explain more collective variance in children's opportunities than redlining alone. METHODS We used geospatial data from the US Census, Mapping Inequality Project, and other archival sources to construct historical measures of redlining, blockbusting, freeway displacement, and urban renewal in ArcGIS at the census tract level. These were linked with data from the Child Opportunity Index 2.0 to measure children's opportunities across domains of education, socioeconomic status, and health. We ran spatial regression analyses in Stata 18.0 to examine individual and collective associations between structural racism and children's opportunities. RESULTS Historical redlining, blockbusting, and urban renewal were largely associated with fewer contemporary educational, socioeconomic, and health opportunities, and explained up to 47.4% of the variance in children's opportunities. The measures collectively explained more variance in children's opportunities than redlining alone. CONCLUSIONS In support of our hypotheses, novel measures of structural racism were related to present-day differences in children's opportunities. Findings lay the groundwork for future research focused on repairing longstanding harm perpetuated by structural racism.
Collapse
|
3
|
Kumar A, Zhang S, Neshteruk CD, Day SE, Konty KJ, Armstrong S, Skinner AC, Lang JE, D'Agostino EM. The longitudinal association between asthma severity and physical fitness by neighborhood factors among New York City public school youth. Ann Epidemiol 2023; 88:37-42. [PMID: 37944678 DOI: 10.1016/j.annepidem.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/28/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE This paper aims to examine the association between asthma severity and one-year lagged fitness in New York City Public school youth by neighborhood opportunity. METHODS Using the Child Opportunity Index 2.0 and individual-level repeated measures NYC Office of School Health (OSH) fitness surveillance data (2010-2018), we ran multilevel mixed models stratified by neighborhood opportunity, adjusting for sex, race/ethnicity, grade level, poverty status, and time. Asthma severity was based on a physician-completed Asthma Medication Administration Form (MAF) from each school year and drawn from the Automated Student Health Record (ASHR). RESULTS Across all youth in grades 4-12 (n = 939,598; 51.7 % male; 29.9 % non-Hispanic Black, 39.3 % Hispanic; 70.0 % high poverty), lower neighborhood opportunity was associated with lower subsequent fitness. Youth with severe asthma and very low and low neighborhood opportunity had the lowest 1-year lagged fitness z-scores - 0.24 (95 % CI, -0.34 to -0.14) and - 0.26 (95 % CI, -0.32 to -0.20), respectively, relative to youth with no asthma and very high opportunity. CONCLUSIONS An inverse longitudinal relationship between asthma severity and subsequent fitness was observed. Study findings have implications for public health practitioners to promote physical activity and improved health equity for youth with asthma, taking neighborhood factors into account.
Collapse
Affiliation(s)
- Advika Kumar
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Sue Zhang
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Cody D Neshteruk
- 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 Armstrong
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, USA; 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
| | - Jason E Lang
- Duke Clinical Research Institute, Duke University, Durham, NC, USA; Department of Pediatrics, Duke University Medical School, Durham, NC, USA
| | - Emily M D'Agostino
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA; Department of Orthopaedic Surgery, Duke University Medical School, Durham, NC, USA.
| |
Collapse
|