Associations Between Age of Onset of Pediatric Overweight/Obesity, a Child's Sociodemographic Characteristics, and Characteristics of a Child's Home Census Tract

Purpose To identify associations between age of onset of overweight/obesity, a child's sociodemographic characteristics, and characteristics of a child's home census tract. Design Retrospective electronic health record review of children with overweight/obesity. Setting Three primary care centers associated with a free-standing, tertiary-care pediatric institution in Cincinnati. Subjects Patients born between August 1, 2013 and July 31, 2014, who had a body mass index (BMI) >= 85th percentile before 5 years of age (n = 794). Measures Primary outcome was the patient's age at the first encounter when BMI was >= 85th percentile. Patient-level predictors were sex, age, race/ethnicity, health insurance, and number of moves captured in the health record. Census tract-level predictors were density of bus stops, presence of grocery stores, and a Socioeconomic Deprivation Index. Analysis Multivariable linear regression models assessed for independent associations between age of onset of overweight/obesity and predictors. Results Patients were 55.8% female, 73.6% black, and 79.1% publicly insured. Each additional move per year was associated with onset of overweight/obesity occurring 4.05 months earlier (P < .0001). No significant associations between age of onset of overweight/obesity and census tract-level density of bus stops (P = .82), presence of grocery stores (P = .39), and socioeconomic deprivation (P = .53) were demonstrated. Conclusion Public policy efforts toward improving access to grocery stores or public transportation may not be sufficient to prevent childhood obesity. Population-level interventions related to improving housing may also reduce obesity.