Assessing disparities in Pennsylvania schools' readiness for federal school local wellness policy regulations

Background: Child obesity is a significant public health problem in the U.S. In 2012, 31.8% of U.S. children were overweight or obese, and 17% were obese. Additionally, minority, low-income, and rural children are more likely to be overweight or obese compared to their white, wealthier, and urban/suburban counterparts. Additionally, child obesity increases one’s risk for heart disease, diabetes, and other serious chronic conditions later in life. Despite persistent disparities in child obesity, however, few studies have examined relationships between school-level demographic factors and evidence-based obesity prevention policies. \ud \ud Methods: I merged data from the 2014 CDC School Health Profiles Study with 2013-2014 National Center for Education Statistics demographic data for Pennsylvania public schools. Descriptive statistics were used to determine prevalence of evidence-based obesity prevention practices, and multivariable logistic regression were used to determine: a) Prevalence of evidence-based obesity prevention practices and b) Disparities in such practices by school-level urbanicity, socioeconomic status (SES), and racial/ethnic composition. \ud \ud Results: Schools with higher proportions of minority and low-income students had fewer evidence-based practices, although these associations were not statistically significant. Schools with >20% minority students had nearly 3 times greater odds of classroom physical activity breaks compared to schools with <6% minority students (OR: 2.96, p=0.03), but lower odds of interscholastic sports (OR: 0.161, p=0.02). Schools with >50% low-income students reported lower odds of offering salad bars compared to schools with