Geographic and Multilevel Influences of School Environments on the Development of Obesity and Physical Activity Among School Children in a U.S.-Mexico Border Community

Childhood obesity, especially in Hispanic populations, is the most serious public health challenge of the 21st century (World Health Organization, 2014). Identifying risk factors at the individual, school and neighborhood level will help prevent the development of poor health outcomes such as diabetes and heart disease. The purpose of this study was to determine the associations between neighborhood deprivation, the retail food environment, obesity and physical fitness in children residing in El Paso, Texas. The study population included children in grades three through eight attending school in the El Paso Independent School District from 2009 to 2013. Approximately 42,000 student records across 58 elementary and 17 middle schools were included in the analysis. Neighborhoods were defined geographically as the area within a one-half mile radius of a school. The retail food environment was characterized by store type density at a one-half mile radius of the school. Annual FitnessGram® testing in schools was used to evaluate obesity and physical fitness. Linear regression and ANOVA were used for the analyses. Curl-ups and BMI percentile were inversely rated (β = -0.13, p = 0.01). The PACER Run (Needs Improvement) was directly related to BMI percentile (β = 1.66, p = 0.03). High convenience store density was related with high BMI percentiles (β = 1.41, p = 0.02). Levels of neighborhood deprivation directly varied with BMI percentile means (F = 10.38, p = 0.00) and inversely with push-up passing percentage (F = 4.25, p = 0.01). Levels of neighborhood deprivation varied directly with convenience store (F = 3.69, p = 0.02) and unhealthy specialty store (F = 6.96, p = 0.00) densities. These findings suggest that school and neighborhood environments are related to obesity and physical fitness in children. Additional research should include factors of the built environment such as access to parks. Future recommendations may include healthier land use policies and zoning ordinance aimed at decreasing obesity in children