Poverty, ethnicity, and risk of obesity among low birth weight infants

a r t i c l e i n f o Keywords: Children's body mass index Body mass index trajectories Low birth weight infants Family and neighborhood poverty and children's BMI Ethnic differences and children's BMI The independent and joint effects of family and neighborhood poverty and ethnicity upon weight trajectories from age two to six-and-a-half were examined using data from the Infant Health and Development Program (N=985), an early intervention program for low birth weight children and families. At age two, family poverty was associated with higher body mass index (BMI), whereas neighborhood poverty and ethnicity were not. Over time, the BMI of toddlers from poor and near poor neighborhoods increased nonlinearly, while those from nonpoor neighborhoods remained stable. BMIs of Hispanic-American toddlers increased steadily over time, unlike African-American and Anglo-American toddlers. Although initially similar, over time African-American toddlers' BMIs increased more rapidly than Anglo-American toddlers. Family and neighborhood poverty and ethnicity were associated with BMI. More work is needed on how poverty and ethnicity contribute to differences in early weight gain in conjunction with sociocultural and environmental factors in the home and community. Health disparities in morbidity and mortality associated with socioeconomic status (SES) are a concern in the United States (US) as well as in other high-income countries (National Research Council, 2013). Gains in US life expectancy slowed from the 1980s to the current decade, relative to other developed nations, which has heightened attention to the origins of these disparities (Dow & Rehkopf, 2010; Martinson, Teitler, & Reichman, 2011). SES gradients for a range of chronic health conditions (cardiovascular disease, diabetes, and obesity) exist, with more educated or higher income adults having better health than less educated or lower income adults (Adler & Stewart, 2010). Similar gradients have been found between ethnicity and health outcomes, with European-American adults having better health than African-American, Hispanic-American, or Native-American adults (Russell, 2010). Often separate estimates of health conditions for SES and ethnicity are presented since research does not account for the co-variation among education, income, and ethnicity (Adler & Stewart, 2010). Concern about the origins of these health disparities has prompted research interest in the health of young children. Researchers believe that the origins of social inequalities in physical health start early, and that these early differences are associated with adult morbidity and mortality Since children in general are healthier than any other age group, relatively little is known about …