Abstract P211: Response to a School-based Health Intervention in High- and Low-income Communities

Abstract

Introduction: Childhood obesity is associated with increased cardiovascular disease risk and is a major health issue in the United States. Previous studies show higher rates of obesity in low socioeconomic status (SES) communities. The efficacy of school-based interventions in these communities is not as well documented. Hypothesis: We hypothesized that low SES would be less healthy at baseline and show greater improvement than high SES. Methods: Project Healthy Schools (PHS) is a school-based intervention targeted at middle-school students in lower Michigan. We studied body mass index (BMI), blood pressure (BP), lipid profiles, resting and recovery heart rate (HR), and behavioral characteristics in 3147 middle-school students. Students were stratified into 2 groups: high SES and low SES. Ann Arbor (median family income=$53,377) students were included in the high SES cohort (n=1840) while Ypsilanti ($33,699) and Detroit ($27,862) were considered low SES (n=1307). Chi-square, Wilcoxon, and t-tests were conducted to compare baseline and baseline-to-follow-up data. Median household income was based on US Census Bureau data. Results: At baseline, those students in the low SES cohort performed significantly worse than the students in the high SES cohort in nearly every category, most notably: BMI, systolic and diastolic BP, resting and recovery HR, fried food consumption, exercise, and screen time. Upon follow-up, post-intervention examination, low SES improved recovery HR, screen time, fried meat and snacks, and sugary beverages significantly more than high SES. High SES improved fruit, BP, and total cholesterol significantly more than low SES. Conclusions: The PHS intervention was more efficacious in a number of categories in higher-risk, low SES communities. This suggests a need for the implementation of similar school-based programs in low SES areas.