Examining the Long-term Association Between Neighborhood Socioeconomic Status and Obesity and Obesity-related Unhealthy Behaviors Among Children: Results From the Fragile Families and Child Wellbeing Study

Abstract

Abstract Background Literature has focused on neighborhood environments and their possible impacts on obesity and obesity-related behaviors. However, few longitudinal studies have examined the effect of neighborhood socioeconomic status (nSES) on childhood obesity. Purpose Investigate the longitudinal association between nSES and obesity and obesity-related unhealthy behaviors. Methods We obtained data from the Fragile Families and Child Wellbeing Study (N = 2,072). The main exposure was nSES (measured using an index of five variables representing wealth, income, education, and occupation from the Decennial Census 2000) at ages 3, 5, and 9. The outcome was children’s body mass index z-score (BMIz) at ages 5, 9, and 15. Three measures of obesity-related behaviors (i.e., child- or caregiver-reported soda/snack food intake, fast-food intake, and sedentary behaviors) at ages 5, 9, and 15 were included as mediators and outcomes. Cross-lagged path analyses were conducted. Results Higher nSES at a previous wave was associated with consuming less soda/snack foods (βs = −0.15 to −0.11 [varying by ages], p < .05) and fast-food intake (βs = −0.21 to −0.14 [varying by ages], p < .01), and less frequent sedentary behaviors (βs = −0.14 to −0.06 [varying by ages], p < .01), but not with BMIz (βs = −0.08 to 0.05 [varying by ages], p > .05). Unhealthy behaviors did not mediate the nSES–BMIz association at alpha .05. Conclusion Health policies need to target low-socioeconomic neighborhoods to shape healthy lifestyles in children. To develop effective interventions, future research needs to examine comprehensive potential mediators like obesity-related parenting skills, home environments, and built and social environments on the risk of childhood obesity and obesity-related behaviors.