Longitudinal associations between neighborhood child opportunity and physical fitness for New York City public school youth.

Abstract

Neighborhood environments can support fitness-promoting behavior; yet, little is known about their influence on youth physical fitness outcomes over time. We examined longitudinal associations between neighborhood opportunity and youth physical fitness among NYC public school youth. The Child Opportunity Index (COI), a composite index of 29 indicators measuring neighborhood opportunity at the census tract-level, along with scores on four selected COI indicators were linked to NYC FITNESSGRAM youth at baseline. Fitness outcomes (measured annually, 2011 - 2018) included BMI, curl-ups, push-ups, and PACER laps. Unstratified and age-stratified adjusted three-level generalized liner mixed models, nested by census tract and time, estimated the association between COI and fitness outcomes. The analytic sample (n=204,939) lived in very low (41%) or low (30%) opportunity neighborhoods. Unstratified models indicate that overall COI is modestly associated with improved youth physical fitness outcomes. The strongest opportunity-fitness associations were observed for PACER. Stratified models show differences in associations across younger vs. older youth. We find that neighborhood factors are associated with youth fitness outcomes over time, with the strength of the associations dependent on age. Future implications include better informed place-based interventions tailored to specific life stages to promote youth health.