Effects of Contextual Economic Factors on Childhood Obesity
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To examine the association between changes in contextual economic factors on childhood obesity in the US.
We combined data from 2003, 2007, and 2011/2012 National Surveys of Children’s Health for 129,781 children aged 10–17 with 27 state-level variables capturing general economic conditions, labor supply, and the monetary or time costs of calorie intake, physical activity, and cigarette smoking. We employed regression models controlling for demographic factors and state and year fixed effects. We also examined heterogeneity in economic effects by household income.
Obesity risk increased with workforce proportion in blue-collar occupations, urban sprawl, female labor force participation, and number of convenience stores but declined with median household income, smoking ban in restaurants, and full service restaurants per capita. Most effects were specific to low income households, except for density of supercenters/warehouse clubs which was significantly associated with higher overweight/obesity risk only in higher income households.
Conclusions for Practice
Changes in state-level economic factors related to labor supply and monetary or time cost of calorie intake may affect childhood obesity especially for children in low-income households. Policymakers should consider these effects when designing programs aimed at reducing childhood obesity.
KeywordsObesity Children Adolescents Body Mass Index Economic factors
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Centers for Disease Control. (1989). The surgeon general’s 1989 report on reducing the health consequences of smoking: 25 years of progress. MMWR. Morbidity and Mortality Weekly Report, 38, 1.Google Scholar
- Courtemanche, C., Tchernis, R., & Zhou, X. (2017). Parental work hours and childhood obesity: Evidence using instrumental variables related to sibling school eligibility. Working paper no. 23376. Cambridge, MA: National Bureau of Economic Research.Google Scholar
- Freedman, D. S., Mei, Z., Srinivasan, S. R., Berenson, G. S., & Dietz, W. H. (2007). Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study. Journal of Pediatrics, 150(1), 12–17.e12. https://doi.org/10.1016/j.jpeds.2006.08.042.CrossRefGoogle Scholar
- Greene, W. (2002). The bias of the fixed effects estimator in nonlinear models. New York: Stern School of Business, New York University.Google Scholar
- Kutner, M., Greenburg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of america’s adults: Results from the 2003 national assessment of adult literacy. NCES 2006-483. Washington, DC: National Center for Education Statistics.Google Scholar
- Larson, N., Wall, M., Story, M., & Neumark-Sztainer, D. (2013). Home/family, peer, school, and neighborhood correlates of obesity in adolescents. Obesity, 21(9), 1858–1869.Google Scholar
- Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384(9945), 766–781. https://doi.org/10.1016/S0140-6736(14)60460-8.CrossRefGoogle Scholar
- Oddo, V. M., Nicholas, L. H., Bleich, S. N., & Jones-Smith, J. C. (2016). The impact of changing economic conditions on overweight risk among children in California from 2008 to 2012. Journal of Epidemiology and Community Health, 70(9), 874–880. https://doi.org/10.1136/jech-2015-207117.CrossRefPubMedCentralGoogle Scholar
- Ogden, C. L., Carroll, M. D., Fryar, C. D., & Flegal, K. M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief, 219(219), 1–8.Google Scholar
- Ogden, C. L., Carroll, M. D., Lawman, H. G., Fryar, C. D., Kruszon-Moran, D., Kit, B. K., et al. (2016). Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA, 315(21), 2292–2299. https://doi.org/10.1001/jama.2016.6361.CrossRefPubMedCentralGoogle Scholar
- Orzechowski, W., & Walker, R. (2010). The tax burden on tobacco: Historical compilation (Vol. 45). Arlington, VA: Orzechowski and Walker.Google Scholar
- Powell, L. M., Auld, M. C., Chaloupka, F. J., O’Malley, P. M., & Johnston, L. D. (2007a). Associations between access to food stores and adolescent body mass index. American Journal of Preventive Medicine, 33(4, Supplement), S301–S307. https://doi.org/10.1016/j.amepre.2007.07.007.CrossRefGoogle Scholar
- Powell, L. M., Johnston, L. D., Auld, M. C., O’Malley, P. M., & Chaloupka, F. J. (2007b). Access to fast food and food prices: Relationship with fruit and vegetable consumption and overweight among adolescents. In K. Bolin & J. Cawley (Eds.), The economics of obesity (Vol. 17, pp. 23–48). Bingley: Emerald Group Publishing Limited. https://doi.org/10.1016/s0731-2199(06)17002-8.CrossRefGoogle Scholar
- Yin, H. S., Sanders, L. M., Rothman, R. L., Shustak, R., Eden, S. K., Shintani, A., et al. (2014). Parent health literacy and “obesogenic” feeding and physical activity-related infant care behaviors. Journal of Pediatrics, 164(3), 577–583.e571. https://doi.org/10.1016/j.jpeds.2013.11.014.CrossRefGoogle Scholar