Abstract
In the last few years, diabetes mellitus and obesity revealed to be one of the fastest‐growing chronic diseases in youth in the United States. The number of new diabetes cases is dramatically increasing, and, for the moment, effective therapy does not exist. Experts believe that one of the causes of this increase is the decline in exercise behavior. The California Education Code requires local educational agencies (LEAs) to administer the FITNESSGRAM, the Physical Fitness Test (PFT), to Californian students of public schools. This test evaluates six fitness areas, and experts defined that a passing result on all six areas of the test represents a fitness level that offers some protection against the diseases associated with physical inactivity. We consider 2015–2016 data provided by the California Department of Education (CDE): for each Californian county (m=57), we aim at estimating the county‐level proportion of students with a score equal to six. To account for the heterogeneity of the phenomenon and the presence of outlying counties, we extend the standard area‐level model by specifying the random effects as a symmetric α‐stable (SαS) distribution that can accommodate different types of outlying observations. The model can accurately estimate the county‐level proportion of students with a score equal to six. Results highlight some interesting relationships with social and economic situations in each county. The performance of the proposed model is also investigated through an extensive simulation study.
Highlights
Childhood obesity continues to be one of the most significant health threats to kids and teens across developed countries
The national Youth Risk Behavior Surveillance (YRBS) alerted that in 2011 only 28.7% of nationwide students in the United States were physically active for a total of at least 60 min per day on each of the 7 days before the survey (Eaton et al, 2012)
Note: Model performances are measured according to average absolute deviation (AAD), average squared deviation (ASD), average absolute relative deviation (ARB), average squared relative deviation (ASRB), deviance information criterion (DIC), and coverage rate (CR)
Summary
Childhood obesity continues to be one of the most significant health threats to kids and teens across developed countries. A passing result in all six areas (6/6) of the test represents a fitness level that offers some protection against the diseases associated with physical inactivity (California Department of Education, 2015). We consider data for 2015–2016 provided by the California Department of Education (CDE), and we propose a small area model for estimating the county-level proportion of students with a score equal to six. In order to accommodate counties variability, we extend the standard area-level model by specifying for the random effects a symmetric α-stable (SαS) distribution that can capture different types of outlying observations.
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