Associations of Neighborhood Safety and Neighborhood Support with Overweight and Obesity in US Children and Adolescents.

ABSTRACT

OBJECTIVES: To examine the association of neighborhood safety and support with overweight and obesity and whether these associations vary with age, sex, and race/ethnicity among children and adolescents. DESIGN: Cross-sectional. SETTING: United States. MAIN OUTCOME MEASURES: Childhood overweight and obesity. METHODS: We used data from the 2011-12 National Survey of Children's Health, a representative sample of US children and adolescents, for the analyses (N=40,730). Using the age-sex adjusted growth chart, parent self-reported weight and height data were used to classify participants as overweight (those with body mass index [BMI] percentile [%] at or above the 85th%) and obese (those with BMI% at or above the 95th%). We used log-binomial regression to quantify the association of neighborhood safety and support with overweight and obesity among children and adolescents before and after adjusting for selected characteristics including physical activity and amount of time spent in sedentary activities. RESULTS: Children and adolescents living in non-supportive neighborhoods had a 21% (95%CI 1.10-1.33) higher probability of being obese than their peers living in supportive neighborhoods after controlling for age, sex, race/ethnicity, parent's education, poverty, asthma, physical activity and sedentary activities. Similarly, the probabilities of obesity associated with neighborhood safety and support were 1.30 (95%CI1.08-156) and 1.18 (95%CI1.01-1.38), respectively. However, these probabilities vary with race/ethnicity with higher probability being observed among non-Hispanic Whites and Hispanics for overweight and non-Hispanic Whites for obesity. CONCLUSIONS: Living in unsafe and non-supportive neighborhoods may be associated with overweight and obesity among US children and adolescents. Longitudinal studies, accounting for race/ethnicity, are needed to examine the importance of social context where children and adolescents live.