Socioeconomic Status and Other Factors Associated with Childhood Obesity

Amy S. Williams; Bin Ge; Greg Petroski; Robin L. Kruse; Jane A. McElroy; Richelle J. Koopman

doi:10.3122/jabfm.2018.04.170261

Article Figures & Data

Tables

View popup

Table 1.

Univariable Analyses of Factors Associated with Child Obesity in the Early Childhood Longitudinal Birth Cohort Data

Risk Factors	n	Population %	% Overweight or Obese (95% CI)	Odds Ratio (95% CI)
Categorical variables
Socioeconomic status (P < .0001)
Quintile 1 (lowest)	1263	19.91	44.94 (40.47–49.41)	REF
Quintile 2	1265	19.88	37.24 (33.57–40.90)	0.73 (0.57–0.92)
Quintile 3	1288	19.96	36.43 (32.23–40.63)	0.70 (0.55–0.90)
Quintile 4	1332	20.20	35.41 (31.92–38.91)	0.67 (0.53–0.86)
Quintile 5 (highest)	1622	20.06	27.09 (24.26–29.91)	0.46 (0.37–0.56)
Food security (P = .043)
Food secure	6034	89.71	35.45 (33.82–37.07)	0.61 (0.38–0.98)
Food insecure without hunger	547	8.03	40.98 (34.96–47.00)	0.77 (0.68–1.27)
Food insecure with hunger	171	2.26	47.39 (35.47–59.30)	REF
Parents who reside in household (P = .0078)
Biological mother and biological father	4705	68.96	34.61 (32.73–36.49)	0.80 (0.68–0.94)
Other household composition	2065	31.04	39.75 (36.53–42.97)	REF
Race/ethnicity (P < .0001)
White	2767	53.80	31.35 (29.03–33.66)	REF
Black	1056	13.88	40.32 (35.62–45.02)	1.48 (1.18–1.86)
Hispanic	1359	25.12	43.47 (39.76–47.18)	1.68 (1.39–2.04)
Asian	765	2.62	28.69 (22.82–34.57)	0.88 (0.67–1.16)
Native Hawaiian, Pacific Islander, Alaska, or American Indian	251	0.65	48.44 (36.96–59.92)	2.06 (1.28–3.30)
Other race (includes more than one race)	560	3.94	43.39 (36.77–50.00)	1.70 (1.26–2.24)
Child's sex (P = .28)
Female	3348	49.06	37.12 (35.13–39.10)	1.08 (0.94–1.25)
Male	3422	50.94	35.26 (32.63–37.89)	REF
Child was put to bed with bottle (P = .014)
Yes	2089	29.69	39.48 (36.12–42.84)	1.22 (1.04–1.43)
No	4675	70.31	34.80 (33.03–36.57)	REF
Parental rule about which kinds of food child can eat (P = .0039)
Yes	5142	76.77	34.74 (32.98–36.51)	0.77 (0.64–0.92)
No	1627	23.23	40.94(37.12–44.76)	REF
Current smoking (P = .0033)
Yes	1303	19.56	41.43 (37.36–45.49)	1.32 (1.10–1.60)
No	5462	80.44	34.89 (33.14–36.64)	REF
Amount of soda consumed by child (P = .034)
More than 7 per week	1839	26.99	39.23 (36.21–42.26)	1.03 (0.87–1.20)
Less than 6 time per week	3019	44.08	35.12 (32.97–37.28)	1.22 (1.03–1.45)
Never	1903	28.93	34.56 (31.54–37.58)	REF
Mother's hours work/week (P = .48)				0.4827
35 hours or more per week	2971	42.93	37.55 (35.20–39.90)	1.13 (0.95–1.35)
Less than 35 hours per week	1257	19.13	34.99 (31.02–38.96)	1.02 (0.83–1.24)
Looking for work	358	5.68	35.72 (28.24–43.21)	1.05 (0.75–1.64)
Not in the labor force	2071	32.27	34.66 (31.89–37.44)	REF
Parental rule about television watching (P = .041)
Yes	6274	93.82	35.77 (34.09–37.45)	0.73 (0.55–0.99)
No	466	6.18	43.16 (36.18–50.14)	REF
Neighborhood safety (P = .0005)
Very safe	4012	59.40	33.71 (31.77–35.66)	0.55 (0.33–0.91)
Fairly safe	2363	34.60	38.83 (35.83–41.82)	0.68 (0.41–1.15)
Very unsafe	115	4.30	45.32 (37.07–53.57)	0.89 (0.48–1.65)
Refuse	93	1.70	48.16 (35.15–61.16)	REF
Overall population			36.31 (34.62–37.79)

Risk Factors	Overweight/Obese (95% CI) N = 2246	Nonoverweight/Obese (95% CI) N = 4572	P Value
Continuous variables
Birth weight (grams)	3436.0 (3405.9–3466.1)	3248.4 (3224.0–3272.9)	<.0001
Hours TV watched per weekday	2.01 (1.92–2.10)	1.86 (1.79–1.93)	.0045
Days per week eat as a family	5.49 (5.38–5.59)	5.66 (5.58–5.74)	.046
Parent days per week exercises for 30 minutes	1.75 (1.61–1.90)	1.94 (1.83–2.06)	.047

Boldface indicates statistical significance (P < .05).
CI, confidential interval; REF, Reference category for odd ratios.

View popup

Table 2.

Multiple Logistic Regression Analysis of a Child Being Obese or Overweight at Kindergarten Entry

Variables	Parameter Estimate (SE)	Odds Ratio for Overweight/Obesity (95% CI)	P Value
Socioeconomic status (all compared to ref = 5th quintile, highest)			.0018
1st (lowest)	0.5384 (0.1360)	1.71 (1.31–2.23)
2nd	0.3049 (0.1080)	1.36 (1.10–1.68)
3rd	0.3222 (0.1321)	1.38 (1.07–1.79)
4th	0.3104 (0.1286)	1.36 (1.06–1.76)
Race (reference category = white)			<.0001
Black	0.4534 (0.1337)	1.57 (1.21–2.05)
Hispanic	0.4999 (0.1183)	1.65 (1.31–2.08)
Asian	0.1199 (0.1559)	1.13 (0.83–1.53)
Native American	0.6823 (0.2667)	1.98 (1.17–3.34)
Other (includes more than 1 race)	0.5558 (0.1542)	1.74 (1.29–2.36)
Birthweight (per 100 g)	0.000684 (0.000059)	1.07 (1.06–1.08)	<.0001
Current smoker (yes vs no)	0.3361 (0.0905)	1.40 (1.17–1.67)	.0002
Eat dinner as a family (days per week)	−0.038 (0.0189)	0.96 (0.93–0.99)	.0446
Interaction Effects^*
Race × SES			.4263
Birthweight × SES			.3946
Parental Smoking × SES			.5884
Eating dinner as a family × SES			.8809

CI, confidential interval; SE, standard error; SES, socioeconomic status.
↵* Main effect model included race, birthweight, rarental smoking, and eating dinner as a family and evaluated SES as interaction term.