Trends in school-neighbourhood inequalities and youth obesity: Repeated cross-sectional analyses of the public schools in the state of California

Abstract

Background: It is currently unknown whether the relationship between affluence of school neighbourhoods and prevalence of youth overweight/obesity is uniform across demographic subgroups and areal context in the United States. Methods: We examined association between school-neighbourhood income tertiles and school-level overweight/obesity (OVOB) prevalence, using data on body mass index of fifth, seventh, and nineth graders who attended public schools in California in 2001 and 2010 (n = 1 584 768), using multiple logistic regression models. Results: Overall, OVOB prevalence was higher in lower-income school neighbourhoods, with a steeper income-OVOB gradient for girls. Among boys, the gradient became steeper in 2010 than 2000. Among Asian and White girls, the negative gradients were steepest in rural areas. For African–American students in all areas and Latino boys in rural areas, there was less clear evidence of inverse income-OVOB gradients. Addition of fast-food restaurant availability to the models did not change the observed inverse school-neighbourhood income–obesity gradients. Conclusions: The findings suggest the needs to investigate reasons for this variability with consideration to combinations of sociodemographic, economic, and environmental risk factors that may contribute to disparities in childhood obesity.