Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children?

Aim: We compared the effects of parental education and household income on children's body mass index (BMI) in Hispanic White (HW) and non-Hispanic White (NHW) families. Methods: In this cross-sectional study, we borrowed data from the Adolescent Brain Cognitive Development (ABCD) study and analyzed data of 5100 children between the ages of 9 and 10. The independent variables were parental education and household income. The primary outcome was BMI value. Ethnicity was the moderating variable. Confounders were age, sex, and family structure. Three mixed-effects regression models were used for data analysis. Results: Overall, higher parental education and household income were associated with lower BMI levels in children. While an interaction was found between ethnicity and parental education, no interaction was noted between ethnicity and household income regarding BMI. The interaction indicated weaker protective effects of high parental education on BMI in HW children than NHW children. Household income showed similar protective effects on children's BMI in HW and NHW families. Conclusion: Parental education but not household income loses some of its protective effects on childhood BMI among HW families compared to NHW families. Distal social determinants of health may be more vulnerable to the MDRs (minorities' diminished returns) than proximal ones. As a result, closing the income gap may be a good strategy towards closing the childhood BMI gap between highly educated HW and NHW families. Policies that raise the minimum wage and those that help HW families save money (e.g., earned income tax policies) maybe more promising strategies to eliminate the ethnic gap in BMI than increasing the education level of ethnic minority families. Keywords: body mass index (BMI); children; ethnicity; obesity; socioeconomic status