February 19, 2018
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CDC: ‘Complex’ relationship between childhood obesity and parental income, education level

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The prevalence of childhood obesity in the United States decreased with increasing level of parental education in 2011-2014; however, the association between obesity in youths and parental income varied by race and sex, according to an analysis published in the CDC’s Morbidity and Mortality Weekly Report.

“During 2011-2014, the relationships between childhood obesity and income and childhood obesity and education of household head were complex, differing depending upon the subgroup of the population,” Cynthia L. Ogden, PhD, of the division of health and nutrition examination surveys at the CDC, and colleagues wrote. “The prevalence of obesity among youths living in households headed by college graduates was lower than that among those living in households headed by less educated persons for each race. The same was not true for those living in the highest income group. Moreover, differences by income and education of household head are widening among females.”

Ogden and colleagues analyzed data from 6,878 participants aged 2 to 19 years in the 2011-2014 cycles of the National Health and Nutrition Examination Survey (NHANES), obtaining estimates of childhood obesity prevalence by household income and head of household education level (3,371 girls). Household income was defined using federal poverty level information and was categorized as up to 130% of federal poverty level (n = 3,131), more than 130% to up to 350% of federal poverty level (n = 1,974) and more than 350% of the federal poverty level (n = 1,256). Education was defined as high school graduate or less (n = 3,254), some college (n = 1,936) or college graduate (n = 643). Researchers determined linear and quadratic trends from 1999-2002 to 2011-2014 using 4-year NHANES survey cycles.

In 2011-2014, 17% of children had obesity. Childhood obesity prevalence was highest among the middle-income group, at 19.9%, followed by 18.9% for the lowest income group and 10.9% among the highest income group.

Among white, Asian and Hispanic girls, the prevalence of obesity was lower among the highest income group vs. middle and lowest income groups; however, the differences rose to statistical significance only for white girls, according to researchers. Income was not associated with obesity prevalence among black girls. Among boys, researchers observed a lower obesity prevalence among Asian boys vs. the lowest income group, and a lower obesity prevalence among Hispanic boys vs. both the middle- and lower-income groups.

Between the 1999-2002 and the 2011-2014 survey cycles, obesity prevalence among children increased in households headed by people with the least education and among girls in households headed by adults with some college education. The difference in childhood obesity prevalence between the lowest and highest head-of-household education groups increased over time for girls, but not boys, the researchers wrote.

“These findings demonstrate that lower levels of income are not universally associated with childhood obesity,” the researchers wrote. “The association is complex and differs by sex, race and Hispanic origin, and possibly over time. Differences by education are more consistent across subgroups than differences by income.”

The researchers noted that more progress is needed to reduce disparities in childhood obesity prevalence, one of the objectives of the CDC’s Healthy People 2020 initiative.by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.