The Recession is Associated with Increased Risk of Overweight and Obesity Among Children in California

Abstract

BackgroundCalifornians experienced a significant decrease in economic resources during the Recession, however, the effect of the Recession on children's weight status is virtually unexplored.ObjectiveTo assess the effect of the Recession on body mass index (BMI) z‐score and risk for child overweight (BMI 蠅85th percentile) and obesity (BMI 蠅95th percentile).MethodsWe used longitudinal anthropometric measurements from fitness testing of children aged 7‐18 years in California, between 2008 and 2012. The Recession was assessed using the combined value of county‐level annual unemployment rates and foreclosure rates (unemployment rate + foreclosure rate). Individual fixed‐effects regression models with clustered standard errors tested the association of county‐level recession indicators with BMI z‐score and overweight and obesity risk. All models included child age and allowed the association between the Recession and weight status to vary by baseline socioeconomic status (SES).ResultsChildren (N= 6,112,953) had an average BMI z‐score (standard deviation) of 0.53 (1.16), and overweight/obesity prevalence of 36.2%. Average unemployment (11.0%) and foreclosure (6.7%) were considerable. The Recession was associated with an increased BMI z‐score (β= 0.073; 95% CI: 0.066, 0.080) and increased risk of overweight (β = 0.012; 95% CI: 0.011, 0.013) and obesity (β = 0.008; 95% CI: 0.007, 0.009). Larger increases in BMI z‐score and overweight and obesity were seen among children in counties with higher baseline SES.ConclusionsComparing children to themselves over time, increasing county‐level Recession indicators were associated with greater gains in BMI z‐score and increased risk of overweight and obesity.