Racial Differences in Factors Influencing Childhood Overweight and Obesity in the US

Background: Childhood overweight and obesity in the US has persisted as a serious public health concern despite efforts to address it. Children today are now estimated to live shorter life expectancy than their parents due to the consequences of childhood overweight and obesity. The earlier focus on healthy diets and an increase in physical activity have proved inadequate in reversing the trend. Using the social ecologic model (SEM), this study assessed the ecological and behavioral influences on childhood overweight and obesity among Non-Hispanic white, Non-Hispanic black, and Hispanic children. Methods: The study data were derived from the 2016 National Survey of Children’s Health (NSCH). The total sample size was 48,721, after excluding participants below the 5th BMI percentile. Risk factors at each level of SEM were identified following the literature review on the topic. Descriptive, bivariate, and multivariate analyses were completed using the purposeful selection method of model building. Separate multivariate logistic regression models were completed for children in the three racial/ethnic groups in the study. Results: Parental concern about the child’s weight was the most important predictor for overweight and obesity among children in all races/ethnicities. Children receiving government assistance and the presence of a cigarette smoker in the household were the second and third strongest predictors for overweight and obesity among Non-Hispanic white children. While living 150 percent below the federal poverty level was the second most important predictor among Non-Hispanic black and Hispanic children. Being bullied in school and having greater than 1-hour screen time in a day were the third most important predictors among Non-Hispanic black and Hispanic children respectively. Conclusion: Parental concern about a child’s weight remained a key factor in predicting overweight or obesity among children in all races/ethnicities. While the family poverty level was significantly the next most important underlining factor in childhood overweight and obesity determination among children in the minority racial/ethnic groups. Policies aimed at addressing family poverty especially among children in the minority racial/ethnic groups could lead to a reduction in childhood overweight and obesity rates