Gentrification and childhood obesity: Evidence from New York City public school students in public housing.

OBJECTIVE: The study objective was to determine the effect of gentrification on the weight outcomes of New York City public school students living in public housing. METHODS: In a prospective cohort of 19,022 New York City public school students in public housing followed during 2009-2017, weight outcomes of students living in public housing buildings in gentrified neighborhoods were compared to those living in consistently low-socioeconomic-status neighborhoods; assignment was quasi-random in each borough. RESULTS: Among the 42,182 student-year observations, gentrification did not increase weight outcomes significantly, for BMI z scores (0.037; 95% CI: -0.012 to 0.086), obesity (0.6 percentage points [pp]; 95% CI: -0.9 to 2.1), or overweight (1.3 pp; 95% CI: -0.7 to 3.2). However, heterogeneous effects by borough were found, where the gentrification in Manhattan increased students' BMI z scores by 0.19 (95% CI: 0.09-0.29), obesity by 3.4 pp (95% CI: 0.03-6.5), and overweight by 9.2 pp (95% CI: 6.3-12.1). No heterogeneity by race and ethnicity, gender, or age was found. CONCLUSIONS: With strong internal validity, this study shows that neighborhood gentrification differentially influenced children's health through obesity, based on borough of residence. Such findings could inform policies or interventions focused on subpopulations and geographies.

The link between gentrification, children's egocentric food environment, and obesity.

While advocates argue that gentrification changes the neighborhood food environment critical to children's diet and health, we have little evidence documenting such changes or the consequences for their health outcomes. Using rich longitudinal, individual-level data on nearly 115,000 New York City children, including egocentric measures of their food environment and BMI, we examine the link between neighborhood demographic change ("gentrification"), children's access to restaurants and supermarkets, and their weight outcomes. We find that children in rapidly gentrifying neighborhoods see increased access to fast food and wait-service restaurants and reduced access to corner stores and supermarkets compared to those in non-gentrifying areas. Boys and girls have higher BMI following gentrification, but only boys are more likely to be obese or overweight. We find public housing moderates the relationship between gentrification and weight, as children living in public housing are less likely to be obese or overweight.

The Effects of Owner-Occupied Housing on Student Outcomes: Evidence from NYC.

The view of owning a home as integral to the "American dream" is enshrined in numerous policies designed to promote homeownership. Whether or not these policies are worth their cost is unclear and depends, in part, on the extent to which owner-occupied housing (OOH) confers socially important benefits. Yet identifying the effects of OOH is complicated, not only due to standard concerns about selection, but also because OOH tends to be located in neighborhoods with better amenities (including schools) and is often synonymous with living in a single-family home. In this paper we use rich, longitudinal student-level data to examine whether students in OOH have better academic and health outcomes than those in renter occupied housing (ROH). We address concerns about selection using student fixed effects and a rich set of individual, building, and neighborhood controls. We find that that there is notable variation in both the characteristics and size of OOH and the types of students who live in OOH in NYC. While raw differences show that students who live in OOH have better outcomes-they are less likely to be chronically absent, obese, or overweight and have higher standardized test scores-much of this disparity is explained by differences in the students who select into OOH. In models where we account for selection into OOH and building type with rich controls and student fixed effects, we find small positive effects of moving into OOH on attendance and math scores with no consistent evidence of any impacts of OOH on BMI or obesity, suggesting that policies that promote homeownership might be oversold.

Exposure to local violent crime and childhood obesity and fitness: Evidence from New York City public school students.

This paper estimates the relationship between neighborhood violent crime and child and adolescent weight and fitness. It uses detailed data from the Fitnessgram assessments of public school students in New York City matched to point specific crime data geocoded to students' residential location. Our empirical approach compares the weight and fitness outcomes of students exposed to a violent crime on their residential H-block with those living in the same census tract but not exposed to violent crime in close proximity to their home. We find for adolescent girls, increases in BMI that range from 0.01 to 0.035 standard deviations and an increase in the probability of overweight of 0.5 to 1.7 percentage points. We find little evidence that BMI, obesity, and overweight change as a result of violent crime for adolescent boys, and younger children. Results are not explained by declines in physical fitness.

The Relationship between School Infrastructure and School Nutrition Program Participation and Policies in New York City.

School nutrition programs (SNP) provide much needed access to fruits, vegetables, and other healthy foods at low or no cost. Yet, the infrastructure of school kitchens and cafeteria vary across schools, potentially contributing to systematic barriers for SNP operation and equity. The purpose of this paper is to examine the association between school infrastructure and outcomes including meal participation, untraditional lunch periods, and having an open campus. Regression analyses were conducted using administrative data for 1804 schools and school nutrition manager survey data (n = 821) in New York City (NYC). Co-location was significantly associated with open campus status (OR = 2.84, CI: 1.11, 7.26) and high school breakfast participation (ß = -0.056, p = 0.003). Overcrowding was associated with breakfast (elementary: ß = -0.046, p = 0.03; middle: ß = 0.051, p = 0.04; high: ß = 0.042, p = 0.04) and lunch participation (elementary: ß = -0.031, p = 0.01) and untraditional lunchtimes (elementary: OR = 2.47, CI: 1.05, 5.83). Higher enrollment to cafeteria capacity ratios was associated with breakfast (elementary: ß = -0.025, p = 0.02) and lunch (elementary: ß = -0.015, p = 0.001; high: ß = 0.014, p = 0.02) participation and untraditional lunchtimes (middle: OR = 1.66, CI: 1.03, 2.68). Infrastructure characteristics are an important source of variation across NYC schools that may hinder the equity of school nutrition programs across the city.

Relationship between retail food outlets near public schools and adolescent obesity in New York City.

Using objectively-measured height and weight data from academic years 2009-2013 (n = 1,114,010 student-year observations), we estimated the association between the food outlet in closest proximity to schools and the likelihood of obesity among New York City public high school students. Obesity risk was higher for students with a corner store as the nearest option to schools, regardless of whether other food outlet types were located within a quarter mile or a half mile of schools (i.e., benchmarks for zoning policies). Policymakers may want to consider introducing healthier food options near schools, in conjunction with programs to support changes within corner stores.

Does Proximity to Fast Food Cause Childhood Obesity? Evidence from Public Housing.

We examine the causal link between proximity to fast food and the incidence of childhood obesity among low-income households in New York City. Using individual-level longitudinal data on students living in public housing linked to restaurant location data, we exploit the naturally occurring within-development variation in distance to fast food restaurants to estimate the impact of proximity on obesity. Since the assignment of households to specific buildings is based upon availability at the time of assignment to public housing, the distance between student residence and retail outlets-including fast food restaurants, wait-service restaurants, supermarkets, and corner stores-is plausibly random. Our credibly causal estimates suggest that childhood obesity increases with proximity to fast food, with larger effects for younger children who attend neighborhood schools.

Childhood Obesity and the Food Environment: A Population-Based Sample of Public School Children in New York City.

OBJECTIVE: This study aimed to examine the relationship between proximity to healthy and unhealthy food outlets around children's homes and their weight outcomes. METHODS: A total of 3,507,542 student-year observations of height and weight data from the 2009-2013 annual FitnessGram assessment of New York City public school students were used. BMI z scores were calculated, student obesity or obesity/overweight was determined using Centers for Disease Control and Prevention growth charts, and these data were combined with the locations of four food outlet types (fast-food restaurants, wait-service restaurants, corner stores, and supermarkets) to calculate distance to the nearest outlet. Associations between weight status outcomes and distance to these food outlet types were examined using neighborhood (census tract) fixed effects. RESULTS: Living farther than 0.025 mile (about half of a city block) from the nearest fast-food restaurant was associated with lower obesity and obesity/overweight risk and lower BMI z scores. Results ranged from 2.5% to 4.4% decreased obesity. Beyond this distance, there were generally no impacts of the food environment and little to no impact of other food outlet types. CONCLUSIONS: Proximity to fast-food restaurants was inversely related to childhood obesity, but no relationships beyond that were seen. These findings can help better inform policies focused on food access, which could, in turn, reduce childhood obesity.

School Climate and the Impact of Neighborhood Crime on Test Scores.

Does school climate ameliorate or exacerbate the impact of neighborhood violent crime on test scores? Using administrative data from the New York City Department of Education and the New York City Police Department, we find that exposure to violence in the residential neighborhood and an unsafe climate at school lead to substantial test score losses in English language arts (ELA). Middle school students exposed to neighborhood violent crime before the ELA exam who attend schools perceived to be less safe or to have a weak sense of community score 0.06 and 0.03 standard deviations lower, respectively. We find the largest negative effects for boys and Hispanic students in the least safe schools, and no effect of neighborhood crime for students attending schools with better climates.

Disparities in food access around homes and schools for New York City children.

Demographic and income disparities may impact food accessibility. Research has not yet well documented the precise location of healthy and unhealthy food resources around children's homes and schools. The objective of this study was to examine the food environment around homes and schools for all public school children, stratified by race/ethnicity and poverty status. This cross-sectional study linked data on the exact home and school addresses of a population-based sample of public school children in New York City from 2013 to all corner stores, supermarkets, fast-food restaurants, and wait-service restaurants. Two measures were created around these addresses for all children: 1) distance to the nearest outlet, and 2) count of outlets within 0.25 miles. The total analytic sample included 789,520 K-12 graders. The average age was 11.78 years (SD ± 4.0 years). Black, Hispanic, and Asian students live and attend schools closer to nearly all food outlet types than White students, regardless of poverty status. Among not low-income students, Black, Hispanic, and Asian students were closer from home and school to corner stores and supermarkets, and had more supermarkets around school than White students. The context in which children live matters, and more nuanced data is important for development of appropriate solutions for childhood obesity. Future research should examine disparities in the food environment in other geographies and by other demographic characteristics, and then link these differences to health outcomes like body mass index. These findings can be used to better understand disparities in food access and to help design policies intended to promote healthy eating among children.

The Effect of Breakfast in the Classroom on Obesity and Academic Performance: Evidence from New York City.

Participation in the federally subsidized school breakfast program often falls well below its lunchtime counterpart. To increase take-up, many districts have implemented Breakfast in the Classroom (BIC), offering breakfast directly to students at the start of the school day. Beyond increasing participation, advocates claim BIC improves academic performance, attendance, and engagement. Others caution BIC has deleterious effects on child weight. We use the implementation of BIC in New York City (NYC) to estimate its impact on meals program participation, body mass index (BMI), achievement, and attendance. While we find large effects on participation, our findings provide no evidence of hoped-for gains in academic performance, or of feared increases in obesity. The policy case for BIC will depend upon reductions in hunger and food insecurity for disadvantaged children, or its longer-term effects.

Neighborhoods, Schools and Obesity: The Potential for Place-Based Approaches to Reduce Childhood Obesity.

A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI) of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income). Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest.

Impacts of classifying New York City students as overweight.

US schools increasingly report body mass index (BMI) to students and their parents in annual fitness "report cards." We obtained 3,592,026 BMI reports for New York City public school students for 2007-2012. We focus on female students whose BMI puts them close to their age-specific cutoff for categorization as overweight. Overweight students are notified that their BMI "falls outside a healthy weight" and they should review their BMI with a health care provider. Using a regression discontinuity design, we compare those classified as overweight but near to the overweight cutoff to those whose BMI narrowly earned them a "healthy" BMI grouping. We find that overweight categorization generates small impacts on girls' subsequent BMI and weight. Whereas presumably an intent of BMI report cards was to slow BMI growth among heavier students, BMIs and weights did not decline relative to healthy peers when assessed the following academic year. Our results speak to the discrete categorization as overweight for girls with BMIs near the overweight cutoff, not to the overall effect of BMI reporting in New York City.

Effect of a School-Based Water Intervention on Child Body Mass Index and Obesity.

IMPORTANCE: Decreasing the amount of caloric beverages consumed and simultaneously increasing water consumption is important to promoting child health and decreasing the prevalence of childhood obesity. OBJECTIVE: To estimate the impact of water jets (electrically cooled, large clear jugs with a push lever for fast dispensing) on standardized body mass index, overweight, and obesity in elementary school and middle school students. Milk purchases were explored as a potential mechanism for weight outcomes. DESIGN, SETTING, AND PARTICIPANTS: This quasi-experimental study used a school-level database of cafeteria equipment deliveries between the 2008-2009 and 2012-2013 and included a sample of 1227 New York, New York, public elementary schools and middle schools and the 1,065,562 students within those schools. INTERVENTION: Installation of water jets in schools. MAIN OUTCOMES AND MEASURES: Individual body mass index (BMI) was calculated for all students in the sample using annual student-level height and weight measurements collected as part of New York's FITNESSGRAM initiative. Age- and sex-specific growth charts produced by the Centers for Disease Control and Prevention were used to categorize students as overweight and obese. The hypothesis that water jets would be associated with decreased standardized BMI, overweight, and obesity was tested using a difference-in-difference strategy, comparing outcomes for treated and nontreated students before and after the introduction of a water jet. RESULTS: This study included 1 065 562 students within New York City public elementary schools and middle schools. There was a significant effect of water jets on standardized BMI, such that the adoption of water jets was associated with a 0.025 (95% CI, -0.038 to -0.011) reduction of standardized BMI for boys and a 0.022 (95% CI, -0.035 to -0.008) reduction of standardized BMI for girls (P < .01). There was also a significant effect on being overweight. Water jets were associated with a 0.9 percentage point reduction (95% CI, 0.015-0.003) in the likelihood of being overweight for boys and a 0.6 percentage reduction (95% CI, 0.011-0.000) in the likelihood of being overweight for girls (P < .05). We also found a 12.3 decrease (95% CI, -19.371 to -5.204) in the number of all types of milk half-pints purchased per student per year (P < .01). CONCLUSIONS AND RELEVANCE: Results from this study show an association between a relatively low-cost water availability intervention and decreased student weight. Milk purchases were explored as a potential mechanism. Additional research is needed to examine potential mechanisms for decreased student weight, including reduced milk taking, as well as assessing impacts on longer-term outcomes.

Museums, zoos, and gardens: how formal-informal partnerships can impact urban students' performance in science.

BACKGROUND: Informal science education institutions (ISEIs) are critical partners in public science education, as they support the science efforts of school systems by providing authentic opportunities for scientific inquiry. This study reports findings from an evaluation of urban advantage (UA), a collaboration between the New York City Department of Education and eight ISEIs designed to improve science education in New York City (NYC) middle schools. Now in its 10th year, the program harnesses the resources and expertise of NYC's ISEIs to (a) enhance the science content knowledge of middle school science teachers, (b) develop teachers' skills at using inquiry-based approaches in their classrooms, and (c) improve the science achievement of middle school students. OBJECTIVES: We examine whether the UA program has led to increased student achievement on the eighth-grade New York State standardized science exam for students in participating schools; in supplemental analyses, we examine the effects on longer term (ninth-grade) outcomes. RESEARCH DESIGN: We use a difference-in-differences framework with school fixed effects to estimate the impact of attending a UA school in eighth grade on science achievement. MEASURES: Our key outcome is performance on New York State's eighth-grade intermediate-level science assessment; longer term outcomes include enrollment at specialized science, technology, engineering, and math high schools as well as taking and passing the high school (Regents) science exams. RESULTS: We find that attending a UA school increases student performance on the eighth-grade science exam by approximately 0.05 SD, and there is some evidence of small effects on Regents taking and passing rates.

Not just for poor kids: The impact of universal free school breakfast on meal participation and student outcomes.

This paper examines the impact of the implementation of a universal free school breakfast policy on meals program participation, attendance, and academic achievement. In 2003, New York City made school breakfast free for all students regardless of income, while increasing the price of lunch for those ineligible for meal subsidies. Using a difference-indifference estimation strategy, we derive plausibly causal estimates of the policy's impact by exploiting within and between group variation in school meal pricing before and after the policy change. Our estimates suggest that the policy resulted in small increases in breakfast participation both for students who experienced a decrease in the price of breakfast and for free-lunch eligible students who experienced no price change. The latter suggests that universal provision may alter behavior through mechanisms other than price, highlighting the potential merits of universal provision over targeted services. We find limited evidence of policy impacts on academic outcomes.