Search results

Obesity in children in many developing countries has increased substantially over the last several decades. This change has implications for population health and human capital due to the strong persistence in weight through adulthood and the large social costs of a growing number of unhealthy individuals. As suggested by many educational interventions, targeting health status during early childhood may be more efficient and equitable due to accumulation of effects. Thus, examining the primary sources of obesity and obesity disparities is important, including focuses on school, family, and community factors, among others. Recent evidence has suggested that racial differences in obesity status occur before school age and are difficult to explain. However, this chapter shows that with nationally representative data, the differences can be explained and point to poverty, family structure, and home language rather than race as focal factors for future interventions. Suggestive evidence is also provided that parental investments in physical activities are associated with early-childhood weight status.

Over the past three decades, the U.S. economy experienced a sharp increase in the labor-force participation of women, causing a similar increase in the demand for non-parental child care. Concurrent with these developments has been a dramatic rise in the prevalence of childhood obesity, prompting the question as to what extent the increase in child-care utilization is responsible for the growth in obesity. This chapter examines the impact of various child-care arrangements on school-age children's weight outcomes using panel data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K). An advantage of the ECLS-K for our purposes is that it tracks children's child-care arrangements between Kindergarten and the 5th grade. Our fixed-effects' results suggest that non-parental child-care arrangements are not strongly associated with children's weight outcomes. Our findings are robust to numerous sensitivity and subgroup analyses.

The purpose of this study is to explore rural children’s own perspectives on health, well-being, and nutrition to better understand how they approach, navigate, and make sense of these topics.

This study uses a qualitative ethnographic research design theoretically informed by the “new” Sociology of Childhood and methodologically informed by constructivist grounded theory. This ongoing study with fifth-grade students in an elementary school in a small rural school district in central Illinois consists of ethnographic observations conducted at the school, in-depth interviews with students, and participatory tools that seek to involve students more fully in the process of data collection.

Preliminary findings of this pilot study suggest that many aspects often discussed in the context of childhood obesity, especially in rural settings, including knowledge or education about healthy eating, increasing physical activity levels, or access to healthy foods, are complex and multifaceted and do not easily lend themselves to standard interventions. Findings also indicate that children’s ideas about healthy eating deviate from their own eating practices.

Conceptualized as a grounded theory study, the research is not intended to be generalizable or reproducible. Instead, the study seeks to develop hypotheses directly from the field and study participants’ views and voices. These perspectives will inform a more in-depth study of childhood obesity in rural settings planned for 2019.

Findings from this pilot study will inform innovative, informed interventions that are guided by children’s own experiences and perspectives. Study findings will also be of benefit to practicing pediatricians and other child health professionals as they understand how to better think about and address challenges of health and weight management of patients and their families.

Increasing physical activity can reduce obesity risk among adolescents. This study analyses how behaviours, ethnicity and various sociocultural characteristics may influence the likelihood of engaging in active commute and other healthy activities. The authors analyse data from the 2010 National Youth Physical Activity and Nutrition Survey. The sample included US Hispanic high school students from 9th to 12th grade. Quasi-Poisson regression was used to understand the association between 24 possible variables and the number of days physically active at least 60 minutes per day. This study will present findings by race and ethnicity: non-Hispanic whites and blacks, as well as Hispanics. The research findings uncover that walking is the most predominant physical activity among Hispanics, especially from school to home, which indicates engagement in active transportation. This study shows the need for tailoring physical activity and health programmes by race and ethnicity. Interventions that encourage active commute can be effective for adolescents to achieve physical activity guidelines – at least 60 minutes per day.

Questions have arisen as to whether the school environment is currently a contributing factor to the increase in childhood obesity, and whether changes in school policies could help curb the increase. In this chapter, we discuss key aspects of the literature on the role of the school food environment, and the role of the school activity environment in effecting the caloric intake and expenditure of children. We also simulate the effect of a range of reasonable changes in weekly minutes spent being active in school, and changes in weekly calories consumed in school.

Past studies have shown wide variation in the obesity rates of Asian American ethnic subgroups. However, whether weight-related behaviors that occur during acculturation are associated with obesity disparities among Asian American ethnic subgroups is unknown. This study examines the differences in body mass index (BMI) across Asian American ethnic subgroups and assesses how acculturation and weight-related behaviors influence these differences. The linear regression models employed in this study use data pools from 2011 to 2014 released by the California Health Interview Survey (CHIS). The sample comprises 3,248 foreign-born Asian Americans aged 18–59 years. Asian Americans who spoke fluent English had significantly lower BMIs than those who spoke poor English, but English fluency did not explain body size disparities among Asian American ethnic subgroups. Filipino Americans had the highest average BMI (25.89 kg/m²) and obesity rate (53.12%), and they were particularly prone to engage in unhealthy weight-related behaviors, such as consuming fast food, drinking soda, and engaging in sedentary lifestyles. However, weight-related behaviors did not explain their high risk of obesity compared to other Asian American ethnic subgroups. The results underscore the potential for misinterpretation when pan-ethnic labels, such as Asian American, collapse the unique experiences of different immigrant origin groups. Future research may investigate whether other factors that affect the acculturation process, such as attitudes, self-identity, beliefs, or experiences with racism and discrimination, explain obesity disparities among Asian American ethnic subgroups.

Only a handful of studies have examined social interactions between parents and children around food choice, though these have important implications for health. Moreover, we know very little about how socioeconomic status might influence these exchanges, including the nature and outcomes of children’s requests for specific foods and drinks.

Data are from a survey of 401 families with children ages 2-17. Using formal mediation models to decompose direct and indirect effects, we test three potential mechanisms of socioeconomic differences in caregivers’ propensity to indulge children’s requests for specific foods or drinks: (1) Children’s food-seeking behaviors; (2) Caregivers’ nutritional attitudes and values; and (3) Caregiver social control and monitoring of children’s diets. We also present a symbolic indulgence explanation, which is not empirically testable using our data, but is consistent with qualitative evidence (Pugh, 2009).

We find significant SES differences in the frequency and nature of children’s requests for foods, nutritional attitudes and values, and opportunities for caregiver monitoring of children’s eating habits, but these mechanisms explain little of the association between socioeconomic status and caregiver responses.

Limitations of this study include the non-probability sample and the inability to demonstrate the meaning and intention underlying SES effects. Nonetheless, our findings provide information about how SES does and does not influence parent-child interactions around food choice, which has important implications for developing effective policies and interventions for improving children’s diets.

In light of null findings regarding alternative explanations, children’s requests for unhealthy food and parents’ willingness to grant them may be related to cultural practices around parenting that differ by social class. Consequently, culture may be an important yet under-emphasized mechanism contributing to socioeconomic disparities in children’s dietary habits and health.

In this chapter, we discuss whether early-childhood investments in low-income children could lead to a lasting impact on health outcomes. We note that such investments could improve adolescent and adult health by increasing child health, increasing educational attainment, or influencing parents' behaviors. Model preschool programs, such as the High/Scope Perry Preschool Program and the Carolina Abecedarian Program, have been successful in increasing the educational attainment and health behaviors of low-income children. The Head Start program, which is the largest public investment in low-income, preschool-aged children in the United States, has also improved child health and educational attainment.

Although there is extensive research on the impact of Head Start participation, there has been little research on the impact on risky behaviors in adolescence. Using data from the Panel Study of Income Dynamics (PSID) and its Child Development Supplements (CDS), we examine the impact of Head Start participation on smoking, alcohol use, and drug use throughout adolescence and the extent to which varying degrees of selection on unobservables influence this relationship.

The role of the school nurse has evolved. It has expanded from administering first aid and promoting hand washing to key participation in program planning for health and educational outcomes for the school-aged child. Nurses provide leadership in promoting a healthy and safe school environment, case management of chronically ill children, collaboration between family and school, and referral to essential community resources. Additionally, the school nurse is a valuable resource on the multidisciplinary special education team. The school nurse is the health care expert in the school and is in a unique position to meet the actual and potential needs of all students – including those with special needs.