Abstract EP17: Associations Between Neighborhood Child Opportunity And Cardiovascular Fitness For New York City Public School Youth

Abstract

Introduction: Fewer than 1/4th of US youth meet physical activity guidelines, leading to physical fitness-related cardiovascular disease disparities tracking into adulthood. Neighborhood opportunity may serve as a critical modifiable factor to reduce youth cardiovascular health-related disparities. The present analysis uses the Child Opportunity Index (COI), a comprehensive measure of children’s neighborhood opportunity, to examine associations between neighborhood context and multiple youth cardiovascular fitness outcomes. Methods: Data were drawn from the NYC FITNESSGRAM (n = 300,000), comprising of fitness data from New York City (NYC) public school youth (grades K-12). Generalized linear mixed models were run to estimate overall and sex-stratified associations between overall COI and individual COI indicators (greenspace, healthy food, walkability, commute time) and youth cardiovascular fitness (body mass index (BMI) percentiles, curl-ups, push-ups, PACER, and sit and reach). Geographically weighted regression (GWR) models explored spatial variation of COI-fitness associations across NYC. Results: Overall COI was associated with improved youth cardiovascular fitness outcomes, with the strongest magnitude of effects across aerobic capacity and muscular strength and endurance measures (PACER: β: 0.15, 95% CI: 0.14, 0.15, curl-ups: β: 0.13, 95% CI: 0.12, 1490.13, and push-ups: β: 0.13, 95% CI: 0.12, 0.13). Greenspace was positively associated with muscular endurance (curl-ups: β: 1.13, 95% CI:0.76, 1.50; push-ups: β: 1.53, 95% CI: 1.21, 1.84), and walkability and commuting time were positively associated with aerobic capacity (PACER: β: 2.11, 95% CI: 1.72, 2.50; β: 2.03, 95% CI: 1.87, 2.19, respectively). Stratified models showed strengthened COI-fitness associations among girls versus boys. GWR models were largely consistent with findings from multilevel models, except for overall COI-BMI associations, which varied in magnitude and direction across regions in NYC. Conclusion: Neighborhood opportunity was associated with multiple measures of youth cardiovascular fitness, though geographic models demonstrate that certain associations vary in magnitude and direction across NYC. Continued research on neighborhood factors and cardiovascular fitness may better inform public health efforts to reduce health disparities modifiable through comprehensive place-based interventions.