The Association Between Obesity, Socio-Economic Status, and Neighborhood Environment: A Multi-Level Analysis of Spokane Public Schools
Socio economic inequities in obesity have been attributed to individuals’ psychosocial and behavioral characteristics. School environment, where children spend a large part of their day, may play an important role in shaping their health. This study aims to assess whether prevalence of overweight and obesity among elementary school students was associated with the school’s social and built environments. Analyses were based on 28 public elementary schools serving a total of 10,327 children in the city of Spokane, Washington. Schools were classified by percentage of students eligible for free and reduced meals (FRM). Crime rates, density of arterial roads, healthy food access, and walkability were computed in a one-mile walking catchment around schools to characterize their surrounding neighborhood. In the unadjusted multilevel logistic regression analyses, age, sex, percentage of students eligible for FRM, crime, walkability, and arterial road exposure were individually associated with the odds of being overweight or obese. In the adjusted model, the odds of being overweight or obese were higher with age, being male, and percentage of students eligible for FRM. The results call for policies and programs to improve the school environment, students’ health, and safety conditions near schools.
KeywordsSchool environment Obesity Socioeconomic status Health equity
OA and PM: Conceptualization. OA, PM and SA: Methodology. SA: Software. OA and PM: Validation. RL: Resources. AC: Data Curation. OA, SA and PM: Writing-Original Draft Preparation. PM, RL, SA, AC and OA: Writing-Review & Editing.
This research was supported with funding from the Health Equity Research Center, a strategic research initiative of Washington State University.
Compliance with Ethical Standards
The Washington State University Office of Research Assurances determined that this study satisfied the criteria for Exempt Research.
Conflict of interest
Conflict of Interest: The authors declare that they have no conflict of interest.
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