PDB62 INTERACTION OF HOUSEHOLD AND NEIGHBORHOOD SOCIOECONOMIC STATUS IN THE CHILDHOOD OBESITY EPIDEMIC IN THE UNITED STATES

Abstract

To determine if the association between neighborhood socioeconomic status (SES) and childhood overweight or obesity varies across household SES levels. Second, determine if having higher household or neighborhood SES mitigates any negative effect of having lower levels in the other SES dimension. We used the first-grade round of 2012 Early Childhood Longitudinal Study (ECLS-K). Household SES was defined based on income, education and occupation. Neighborhood SES was defined by the percent of households living in poverty in the child’s school district. Utilizing sampling weights and accounting for sample design, log-binomial regression models were fitted to estimate the association between neighborhood SES and obesity prevalence and to test whether this association varied by household SES. Predicted probabilities of overweight/obesity were estimated for each combination of household and neighborhood SES. In adjusted models, low neighborhood SES was associated with increased prevalence of overweight/obesity (RR:1.84, 95%CI 1.48, 2.29). This association varied significantly by household SES (p-value of the interaction = 0.002). The multiplicative interaction indicated that having low neighborhood SES was associated with increased probability of overweight/obesity among children from high SES-households (Prevalence Ratio (PR)neighborhood SES:1.87, 95%CI 1.51,2.30) but having low neighborhood SES did was not associated with additionally increased probability of obesity for children from low SES-household (PRneighborhood SES:1.10, 95%CI 0.92,1.32). Children with either low SES-households or low neighborhood SES had the highest predicted probabilities of overweight/obesity, but the effects were not multiplicative. There is statistical evidence of interaction between the two dimensions of SES. However, lower SES in either of them is enough to place children at high risk of overweight or obesity. Higher levels in one dimension do not mitigate the association between low resources on the other dimension and childhood overweight/obesity.