Widening socio-economic disparities in early childhood obesity in Los Angeles County after the Great Recession

Objective: While economic crises can increase socio-economic disparities in health, little is known about the impact of the 2008-09 Great Recession on obesity prevalence among children, especially low-income children. The present study examined whether socio-economic disparities in obesity among children of preschool age participating in a federal nutrition assistance programme have changed since the recession. Design: A pre-post observational study using administrative data of pre-school-aged programme participants from 2003 to 2014. Logistic regression was used to examine whether the relationship between obesity prevalence (BMI >= 95th percentile of the Centers for Disease Control and Prevention's growth charts) and three measures of socio-economic status (household income, household educational attainment, neighbourhood-level median household income) changed after the recession by examining the interaction between each socioeconomic status measure and a 5-year time-period variable (2003-07 v. 2010-14), stratified by child's age and adjusted for child's sociodemographic characteristics. Setting: Los Angeles County, California, USA. Subjects: Children aged 2-4 years (n1637788) participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. Results: The magnitude of the association of household income and household education with obesity increased after 2008-09 among 3- and 4-year-olds and 2- and 3- year-olds, respectively. However, the magnitude of the association of neighbourhood-level median household income with obesity did not change after 2008-09. Conclusions: Disparities in obesity by household-level socio-economic status widened after the recession, while disparities by neighbourhood-level socio-economic status remained the same. The widening household-level socio-economic disparities suggest that obesity prevention efforts should target the most vulnerable low-income children.