Educational outcomes associated with childhood obesity in the United States: cross-sectional results from the 2011-2012 National Survey of Children's Health.

Felicia R Carey,Anna V Wilkinson,Gopal K Singh,H Shelton Brown Iii

doi:10.1186/1479-5868-12-s1-s3

Abstract

BackgroundPast research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. However, there is emerging evidence that childhood obesity may have more immediate effects on school-related outcomes. We examine a range of educational attainment indicators to examine the possible pathway between obesity status and academic performance, while investigating the proximal effects of childhood obesity on health and utilization of health services, and whether these variables attenuate the relationship between obesity status and educational outcomes.MethodsData for the current study come from the 2011-2012 National Survey of Children’s Health, which details the impacts of childhood obesity on a range of outcomes among a nationally representative sample of children and adolescents aged 10-17 years (N=45,255). Educational outcomes (school absences, school problems, repeating a grade and school engagement) were modeled by logistic regression as a function of BMI, overall health status, health care utilization, and a range of sociodemographic variables.ResultsBMI status was significantly associated with all educational outcomes (p<0.001 for all), overall health status (p<0.001), and health care utilization (p=0.016). Prior to adjustment for covariates, obese children were significantly more likely to have school absences and school problems, to repeat a grade, and to have lower school engagement than non-overweight children. After adjustment for sociodemographic and health/healthcare variables, these outcomes remained significant for all but repeating a grade. The odds of having school problems, repeating a grade, and low school engagement that were associated with obesity were attenuated by the addition of sociodemographic variables into the model, while the addition of health and health care variables in the model decreased the odds of school absences.ConclusionsThis study provides evidence that increased weight status in children is associated with poorer educational outcomes. While recognizing that these are cross-sectional data, we suggest that 1) health-related and sociodemographic factors should be a focus point of intervention, and 2) a socio-structural approach including Coordinated School Health intervention is crucial to reducing childhood obesity and improving educational outcomes in this population.

Highlights

Past research examining the effects of childhood obesity has largely focused on its projected effects into adulthood
6.6% (n=2,893) of children were reported as having missed more than two weeks of school, 31.1% (n=12,393) were reported as having school problems, 10.6% (n=3,741) were reported as having repeated a grade, and 22.4% (n=9,468) of children were reported as having low school engagement
School problems displayed a positive association with increasing body mass index (BMI) status, with 36.0% of overweight children reported having a problem at school in comparison with 28.3% of their non-overweight peers, and obese children showing the highest prevalence of school problems at 38.5%

Summary

Introduction

Past research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. There is emerging evidence that childhood obesity may have more immediate, direct effects as well, on school and health related outcomes, which themselves can, in turn, have lifetime effects. Evidence from both cross-sectional and longitudinal studies suggests that obese children encounter more behavioral problems in school than non-obese children, such as internalizing problems (e.g., low self-esteem, sadness, acting withdrawn), externalizing problems (e.g., arguing, fighting, disobedience), and school discipline problems (e.g., detentions and suspensions) [6,7,8], with the presence of these behavioral problems increasing significantly with increased weight status [9]. Some of the effects of weight status on academic outcomes may be more pronounced in girls than in boys [6,11]

Methods

Results

Discussion

Conclusion