Neighborhood Socioeconomic Disadvantage and Childhood Body Mass Index Trajectories From Birth to 7 Years of Age.

Samuli Rautava,Jaana Pentti,Hanna Lagström,Päivi Rautava,Ichiro Kawachi,Olli Turta,Mika Kivimäki,Jamie Pearce,Jussi Vahtera

doi:10.1097/ede.0000000000001420

Abstract

The epidemic of increasing childhood overweight and obesity is a major global health concern, with local contextual factors identified as possible contributors. Robust research is needed to establish an evidence base supporting health policy decisions to reverse the trend. We aimed to examine the association between neighborhood socioeconomic disadvantage and trajectories of body mass index (BMI) from birth to age 7. The present study included 11,023 children born within the Southwest Finland Birth Cohort who were free of severe conditions affecting growth with adequate exposure and growth data. We obtained child growth data until school age from municipal follow-up clinics. We based cumulative childhood neighborhood socioeconomic disadvantage on the average annual income, unemployment, and level of education in a residential area defined using a geographic grid at a spatial resolution of 250 m by 250 m. Cumulative neighborhood socioeconomic disadvantage was associated with distinct childhood BMI z score trajectories from birth to age 7. Despite being born in the lowest BMI z scores, children growing up in disadvantaged neighborhoods subsequently exhibited a trajectory of increasing BMI z scores starting at 4 years of age, ending up with a higher risk of overweight at the end of the follow-up (30%) as compared with children living in more affluent neighborhoods (22%). The corresponding risk of obesity was 5 % for those in affluent neighborhoods and 9 % and those in disadvantaged neighborhoods. Cumulative exposure to neighborhood socioeconomic disadvantage is independently associated with unfavorable BMI development and obesity in childhood.

Highlights

With the prevalence of overweight and obesity increasing worldwide, the obesity pandemic constitutes a major public health concern 1
Overweight is rapidly becoming more prevalent amongst children, and children who are overweight tend to manifest with obesity as adults 2 and exhibit increased blood pressure and unfavorable lipid profiles later in life 3
A We hypothesized that cumulative neighborhood socioeconomic disadvantage is associated with unfavorable childhood body mass index (BMI) trajectories from birth to school age

Summary

Introduction

With the prevalence of overweight and obesity increasing worldwide, the obesity pandemic constitutes a major public health concern 1. The association between neighborhood socioeconomic disadvantage, overweight and obesity is well established, but mostly in studies of adults 7 E childhood neighborhood socioeconomic disadvantage is associated with increased risk of obesity in C school age 15, adolescence, 16 and early adulthood [13,17]. The specific age at which the effect of neighborhood socioeconomic disadvantage on child overweight and obesity risk might become. A We hypothesized that cumulative neighborhood socioeconomic disadvantage is associated with unfavorable childhood body mass index (BMI) trajectories from birth to school age. The prospective register-based data and annual measurements of height and weight enabled us to assess the BMI trajectories at different exposure levels while controlling for maternal risk factors and parental socioeconomic status (SES). Our results will aid in targeting preventive measures to specific neighborhoods and age-groups, which is likely to improve the efficacy of the interventions

Methods

Findings

C Manual