An examination of associations between socioeconomic position and childhood overweight for black and white children in the United States.

Abstract

Child overweight is a major public health concern in the US. The objective of this research was to examine relationships between socioeconomic position (SEP) and child overweight (OW) and whether associations differ by race and sex for black and white children aged 2--12. Using data from the Panel Study of Income Dynamics and its 1997 Child Development Supplement, logistic regression models were used to examine associations between OW and several measures of SEP: maternal education; family income-to-needs ratios (INR) measured in 1996, during year of pregnancy, and long-term INR from birth through 1996; and measures of wealth: net worth, financial net worth, liquid wealth, balance of savings, and home equity and market value. Two measures of OW were considered: body mass index (BMI) &ge; 95<super>th</super> percentile of the sex-specific 2000 Centers for Disease Control (CDC) National Center for Health Statistics (NCHS) BMI-for-age growth charts and BMI &ge; 85<super>th</super> percentile. Associations between income and OW differed by maternal education, with black girls and white children having mothers with lower education having higher odds for OW than children having mothers with higher education and income in the fourth quartile. Black boys having mothers with 13 or more years of education had increased odds for OW. Patterns of association differed by race: 1996 INR was most strongly associated with OW among black children while long-term INR was most predictive of OW among white children. Long-term and cross-sectional 1996 poverty were not significantly associated with OW. Among white children, those in homes having INRs from 1.99--3.00 and mothers with low education had higher odds for OW. Among black girls, those having INRs greater than 1.14 and mothers with low education had increased odds for OW. Measures of SEP were most strongly associated with BMI &ge; 95<super> th</super> percentile, a measure of more severe child OW. Wealth was associated with child OW after controlling for income by maternal education. Associations differed by race and by sex: home market value, a measure of neighborhood context, was associated with OW among black and white boys while summary measures of wealth were significant predictors of OW among girls: balance of savings for black girls and financial net worth for white girls. Effects for income by maternal education for white children became non-significant in models including measures of wealth. Income and wealth were independently associated with OW among black children. This study shows the complexity of relationships between SEP and child overweight. Low maternal education was more strongly associated with child OW than poverty. Our findings suggest the importance of considering wealth and neighborhood factors.