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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Relationships between County Health Rankings and child overweight and obesity prevalence: a serial cross-sectional analysis

Authors: Karissa Peyer, Greg J. Welk, Lisa Bailey-Davis, Senlin Chen

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The County Health Rankings (CHR) system provides health rankings for U.S. counties. These factors may have utility for evaluating and predicting health outcomes. This study examined the association between CHR factors and the prevalence of child overweight/obesity (OWOB) in the state of Pennsylvania over 3 years.

Methods

The prevalence of childhood OWOB was obtained for all Pennsylvania school districts for the 2009-10 through 2011-12 school years. Correlational and inferential statistical analyses were used to examine the associations between the prevalence of OWOB in grades K-6 (OWOB1) and 7-12 (OWOB2) and z-score for the overall CHR Health Factors rank, as well as for individual predictive factors (Health Behaviors, Clinical Care, Social and Economic Factors and Physical Environment).

Results

Low to moderate correlations (0.29–0.43) were found between OWOB1 and CHR factors. Weaker and less consistent correlations were found for adolescents. There was a significantly higher prevalence of OWOB in counties with poorer CHR scores.

Conclusions

County-level adult indicators of health are significantly associated with levels of child obesity. Future studies should examine the relationship between CHR and other health outcomes.
Literature
1.
Peppard PE, Kindig DA, Dranger E, Jovaag A, Remington PL. Ranking community health status to stimulate discussion of local public health issues: the Wisconsin County Health Rankings. Am J Public Health. 2008;98:209–12.CrossRefPubMedPubMedCentral
2.
Holzer J, Canavan M, Bradley E. County-level correlation between adult obesity rates and prevalence of dentists. J Am Dent Assoc. 2014;145:932–9.CrossRefPubMed
3.
Nayar P, Yu F, Apenteng BA. Frontier America’s health system challenges and population health outcomes. J Rural Heal. 2013;29:258–65.CrossRef
4.
Subramanian SV, Kawachi I. Income inequality and health: what have we learned so far? Epidemiol Rev. 2004;26:78–91.CrossRefPubMed
5.
Cutler DM, Lleras-muney A. Education and Health: Evaluating Theories and Evidence. 2006.CrossRef
6.
Egerter S, Braveman P, Sadegh-Nobari T, Grossman-Kahn R, Dekker M. Education Matters for Health. 2009.
7.
Dooley D, Fielding J, Levi L. Health and unemployment. Annu Rev Public Heal. 1996;17:449–65.CrossRef
8.
9.
Kennedy BP, Kawachi I, Glass R, Prothrow-stith D, Journal M, Kennedy P. Income distribution, socioeconomic status, and self rated health in the United States: Multilevel analysis. Br Med J. 1998;317:917–21.CrossRef
10.
Jarvandi S, Yan Y, Schootman M. Income disparity and risk of death: the importance of health behaviors and other mediating factors. PLoS One. 2012;7:e49929.CrossRefPubMedPubMedCentral
11.
Shea S, Stein AD, Basch CE, Freudenheim J, Lantingua R, Maylahn C, Strogatz DS, Novick L. Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease. Am J Epidemiol. 1991;134:567–82.CrossRefPubMed
12.
Arnetz B, Brenner S-O, Levi L, Hjelm R, Petterson I-L, et al. Neuroendocrine and immunologic effects of unemployment and job insecurity. Psychother Psychosom. 1991;55:76–80.CrossRefPubMed
13.
Brenner S-O, Starrin B. Unemployment and health in Sweden: public issues and private troubles. J Soc Issues. 1988;4:125–44.CrossRef
14.
Levi L, Brenner S-O, Hall E, Hjelm R, Salovaara H, et al. The psychological, social, and biochemical impacts of unemployment in Sweden. Int J Ment Health. 1984;13:18–34.CrossRef
15.
Dooley D, Catalano R, Hough R. Unemployment and alcohol disorder in 1910 and 1990: drift versus social causation. J Occup Organ Psychol. 1992;65:277–90.CrossRef
16.
Halford W, Learner E. Correlates of coping with unemployment in young Australians. Aust Psychol. 1984;19:333–44.CrossRef
17.
Lee A, Crombie I, Smith W, Tunstall-Pedoe H. Cigarette smoking and employment status. Soc Sci Med. 1991;33:1309–12.CrossRefPubMed
18.
Van Hulst A, Gauvin L, Kestens Y, Barnett TA. Neighborhood built and social environment characteristics: a multilevel analysis of associations with obesity among children and their parents. Int J Obes (Lond). 2013;37:1328–35.CrossRef
19.
Evans GW, Kutcher R. Loosening the link between childhood poverty and adolescent smoking and obesity: The protective effects of social capital. Psychol Sci. 2011;22:3–7.CrossRefPubMed
20.
Phipps SA, Burton PS, Osberg LS, Lethbridge LN. Poverty and the extent of child obesity in Canada, Norway and the United States. Obes Rev. 2006;7:5–12.CrossRefPubMed
21.
Chatterji P, Lahiri K, Song J. The Dynamics of Income-Related Health Inequality among US Children, CESifo Working Paper: Social Protection, NO. 3572. 2011.
22.
Keane E, Layte R, Harrington J, Kearney PM, Perry IJ. Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One. 2012;7:e43503.CrossRefPubMedPubMedCentral
23.
Wells NM, Evans GW, Beavis A, Ong AD. Early childhood poverty, cumulative risk exposure, and body mass index trajectories through young adulthood. Am J Public Health. 2010;100:2507–12.CrossRefPubMedPubMedCentral
24.
25.
Metallinos-Katsaras E, Must A, Gorman K. A longitudinal study of food insecurity on obesity in preschool children. J Acad Nutr Diet. 2012;112:1949–58.CrossRefPubMed
26.
Grow HMG, Cook AJ, Arterburn DE, Saelens BE, Drewnowski A, Lozano P. Child obesity associated with social disadvantage of children’s neighborhoods. Soc Sci Med. 2010;71:584–91.CrossRefPubMedPubMedCentral
27.
Moraeus L, Lissner L, Yngve A, Poortvliet E, Al-Ansari U, Sjöberg A. Multi-level influences on childhood obesity in Sweden: societal factors, parental determinants and child’s lifestyle. Int J Obes (Lond). 2012;36:969–76.CrossRef
28.
Lazzeri G, Pammolli A, Pilato V, Giacchi MV. Relationship between 8/9-yr-old school children BMI, parents’ BMI and educational level: a cross sectional survey. Nutr J. 2011;10:76.CrossRefPubMedPubMedCentral
29.
Brug J, van Stralen MM, te Velde SJ, Chinapaw MJM, De Bourdeaudhuij I, Lien N, Bere E, Maskini V, Singh AS, Maes L, Moreno L, Jan N, Kovacs E, Lobstein T, Manios Y. Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS One. 2012;7:e34742.
30.
Kristiansen H, Júlíusson PB, Eide GE, Roelants M, Bjerknes R. TV viewing and obesity among Norwegian children: the importance of parental education. Acta Paediatr. 2013;102:199–205.CrossRefPubMed
31.
England TN. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337:869–73.CrossRef
32.
Durmuş B, Arends LR, Ay L, Hokken-Koelega AC, Raat H, Hofman A, Steegers EAP, Jaddoe VWV. Parental anthropometrics, early growth and the risk of overweight in pre-school children: the Generation R Study. Pediatr Obes. 2013;8:339–50.
33.
Linabery AM, Nahhas RW, Johnson W, Choh AC, Towne B, Odegaard AO, Czerwinski SA, Demerath EW. Stronger influence of maternal than paternal obesity on infant and early childhood body mass index: the Fels Longitudinal Study. Pediatr Obes. 2013;8:159–69.
34.
Birbilis M, Moschonis G, Mougios V, Manios Y. Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics. Eur J Clin Nutr. 2013;67:115–21.CrossRefPubMed
35.
Svensson V, Jacobsson JA, Fredriksson R, Danielsson P, Sobko T, Schiöth HB, Marcus C. Associations between severity of obesity in childhood and adolescence, obesity onset and parental BMI: a longitudinal cohort study. Int J Obes (Lond). 2011;35:46–52.
36.
Xu L, Dubois L, Burnier D, Girard M, Prud’homme D. Parental overweight/obesity, social factors, and child overweight/obesity at 7 years of age. Pediatr Int. 2011;53:826–31.CrossRefPubMed
37.
Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J. 2011;15:1166–75.CrossRefPubMed
38.
Glass T, McAtee M. Behavioral science at the crossroads in public health: extending horizons, envisioning the future. Soc Sci Med. 2006;62:1650–71.CrossRefPubMed
39.
Hsieh S, Klassen A, Curriero F, Caulfield L, Cheskin L, Davis J, Goarn M, Weigensberg M, Spruijt-Metz D. Built environment associations with adiposity parameters among overweight and obese Hispanic youth. Prev Med Rep. 2015;2:406–12.
40.
Lamichhane A, Puett R, Porter D, Bottai M, Mayer-Davis E, Liese A. Associations of built food environment with body mass index and waist circumference among youth with diabetes. Int J Behav Nutr Phys Act. 2012;9:81.CrossRefPubMedPubMedCentral
41.
Jennings A, Welch A, Jones A, Harrison F, Bentham G, van Sluijs E, Griffin S, Cassiday A. Local food outlets, weight status, and dietary intake: associations in children aged 9-10 years. Am J Prev Med. 2011;40:405–10.
42.
Saelens BE, Sallis JF, Frank LD, Couch SC, Zhou C, Colburn T, Cain KL, Chapman J, Glanz K. Obesogenic neighborhood environments, child and parent obesity: the Neighborhood Impact on Kids study. Am J Prev Med. 2012;42:e57–64.
43.
Nau C, Schwartz B, Bandeen-Rouch K, Liu A, Pollack J, Hirsch A, Bailey–Davis L, Glass T. Community socioeconomic deprivation and obesity trajectories in children using electronic health records. Obesity. 2015;23:207–12.
44.
Bailey-Davis L, Horst M, Hillemeier MM, Lauter A. Obesity disparities among elementary-aged children: data from school-based BMI surveillance. Pediatrics. 2012;130:1102–9.CrossRefPubMed
45.
Dietz WH, Bellizzi MC. Introduction: the use of body mass index to assess obesity in children. Am J Clin Nutr. 1999;70:123S–5.PubMed
46.
Zhu W. Sadly, the earth is still round (p < 0.05). J Sport Heal Sci. 2012;1:9–11.CrossRef
47.
Ross CE, Mirowski J. Neighborhood disadvantage, disorder, and health. J Health Soc Behav. 2001;42:258–76.CrossRefPubMed
48.
Arndt S, Acion L, Caspers K, Blood P. How reliable are county and regional health rankings? Prev Sci. 2013;14:497–502.CrossRefPubMed
49.
Rosenberger RS, Phipps TT, Gurvitch R. A spatial analysis of linkages between health care expenditures, physical inactivity, obesity and recreation supply. J Leis Res. 2005;37:216–35.
50.
Ellen IG, Mijanovich T, Dillman K-N. Neighborhood effects on health: Exploring the links and assessing the evidence. J Urban Aff. 2001;23:391–408.CrossRef
51.
Dawson DA. Family Structure and Children’s Health: United States, 1988. Vital Health and Statistics, Series 10, No. 178. Data from the National Health Survey. Hyattsville, MD.
52.
Coiro MJ, Zill N, Bloom B. Health of Our Nation’s Children. Vital Health and Statistics, Series 10, No. 191. Data from the National Health Survey. Hyattsville, MD.
53.
54.
Oken E, Levitan EB, Gillman MW. Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis. Int J Obes (Lond). 2008;32:201–10.CrossRef
55.
Durmus B, Kruithof CJ, Gillman MH, Willemsen SP, Hofman A, Raat H, Eilers PHC. Parental smoking during pregnancy, early growth, and risk of obesity in preschool children : the Generation R Study. Am J Clin Nutr. 2011;94:164–71.
56.
Bouchery E. Utilization of Well-Child Care among Medicaid-Enrolled Children. Medicaid Policy Brief. Mathematica Policy Research, Brief 10. 2012.
57.
Schwartz B, Stewart W, Godby S, Pollak J, DeWalle J, Larson S, Mercer D, Glass T. Body mass index and the built and social environments in children and adolescents using electronic health records. Am J Prev Med. 2011;41:e17–28.
58.
Davis A, Bennett K, Befort C, Nollen N. Obesity and related health behaviors among urban and rural children in the United States: Data from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. J Pediatr Psychol. 2011;36:669–76.CrossRefPubMedPubMedCentral
59.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337:869–73.CrossRefPubMed
60.
Ochoa MC, Azcona C, Moreno-aliaga MJ, Marti PA. Influence of parental body mass index on offspring body mass index in a Spanish population. Rev Esp Obes. 2009;7:395–401.
61.
Agras WS, Hammer LD, McNicholas F, Kraemer HC. Risk factors for childhood overweight: A prospective study from birth to 9.5 years. J Pediatr. 2004;145:20–5.CrossRefPubMed
62.
Christoffel KK, Wang X, Binns HJ. Early origins of child obesity: Bridging disciplines and phases of development - September 30-October 1, 2010. Int J Environ Res Public Health. 2012;9:1227–62.CrossRefPubMedPubMedCentral
63.
Ihmels MA, Welk GJ, Eisenmann JC, Nusser SM, Myers EF. Prediction of BMI change in young children with the family nutrition and physical activity (FNPA) screening tool. Ann Behav Med. 2009;38:60–8.CrossRefPubMed
64.
Ihmels MA, Welk GJ, Eisenmann JC, Nusser SM. Development and preliminary validation of a Family Nutrition and Physical Activity (FNPA) screening tool. Int J Behav Nutr Phys Act. 2009;6:14.CrossRefPubMedPubMedCentral
Metadata
Title
Relationships between County Health Rankings and child overweight and obesity prevalence: a serial cross-sectional analysis
Authors
Karissa Peyer
Greg J. Welk
Lisa Bailey-Davis
Senlin Chen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3091-0

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