Neighborhood safety and overweight status in children.

OBJECTIVE To determine if there is a relationship between parental perception of neighborhood safety and overweight at the age of 7 years. DESIGN Cross-sectional analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING Ten urban and rural US sites. PARTICIPANTS A total of 768 children selected via conditional random sampling with complete data at follow-up. MAIN OUTCOME MEASURES Parents reported demographics and perception of neighborhood safety by standardized questionnaire. Child overweight status was defined as a body mass index greater than or equal to the 95th percentile for age and sex from measured anthropometrics at the age of 7 years. The base model included relationship of the safety reporter to the child, sex, and baseline body mass index z score at the age of 4.5 years. Covariates tested included maternal marital status, education, and depressive symptoms; child race/ethnicity; participation in structured after-school activities; Home Observation for Measurement of the Environment total score; and neighborhood social cohesiveness. RESULTS The sample was 85% white, and 10% of the children were overweight. Neighborhood safety ratings in the lowest quartile were independently associated with a higher risk of overweight at the age of 7 years compared with safety ratings in the highest quartile (adjusted odds ratio, 4.43; 95% confidence interval, 2.03-9.65). None of the candidate covariates altered the relationship between perception of neighborhood safety and child overweight status. CONCLUSIONS Perception of the neighborhood as less safe was independently associated with an increased risk of overweight at the age of 7 years. Public health efforts may benefit from policies directed toward improving both actual and perceived neighborhood safety.