Abstract
Objective: Adults and children in rural settings are at greater risk for overweight and obesity than those in urban settings. Multiple studies have suggested that quality of life is lower for obese individuals. This study addresses the association of obesity with health-related Quality of Life (QOL) among youth in the rural Mississippi Delta. Methods: QOL data on children aged 3 - 17 years using the PedsQL were collected as part of a cross-sectional telephone survey in the Delta. Weight was grouped by AAP categorizations as underweight, normal, overweight (85 - 95th BMI percentile), obese (95 - 97th percentile), and extremely obese (> 97th percentile). Results: 437 youth participated. Multiple linear regression models were used to predict PedsQL component scores. Results showed main effects for age (p = 0.006), race (p < 0.001), and BMI group (p = 0.049) on psychosocial QOL. Older children ages 9 - 17, white and black children, and obese or extremely obese children scored lower on psychosocial QOL than younger children, other race, and non- obese. A strong age by weight group interaction (p = 0.014) showed that obesity and extreme obesity was associated with lower scores on psychosocial QOL only for older children ages 12 - 17. Conclusions: Investigating the QOL in this rural community where the majority of adults and children are obese aids in our understanding the relationship between sociocultural factors and HRQOL. In the context of an obese majority obesity and extreme obesity remain important contributions to reduced psychosocial (emotional, social, school performance) quality of life for adolescents but not for younger children).
Highlights
Obesity is more prevalent in rural areas than metropolitan ones [1,2,3], a finding that cannot be explained by demographic factors alone [4] even socioeconomic status [5]
Obesity in children and adolescents has been associated with significant disturbance in health-related quality of life [10]
Multiple linear regression models were used to predict PedsQL Psychosocial composite scores based on BMI percentile, age group (3 to 8, 9 to 11, and 12 to 17), race (Caucasian, African American, and “other”), sex, race by sex interaction, and BMI group by age group
Summary
Obesity is more prevalent in rural areas than metropolitan ones [1,2,3], a finding that cannot be explained by demographic factors alone [4] even socioeconomic status [5]. Obesity in children and adolescents has been associated with significant disturbance in health-related quality of life [10]. In clinic-based studies, obese youth have lower overall health-related quality of life (HRQOL) than normal weight youth and lower HRQOL in physical, social, school performance, and emotional domains [11]. Social context may help explain these discrepancies, and be a greater predictor of HRQOL in community samples than functional limitation, socioeconomic status, race, gender, or other factors [15]
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