Young children in urban areas: Links among neighborhood characteristics, weight status, outdoor play, and television watching
Research highlights
► The ratio of outdoor play to television watching is associated with BMI for five-year-old children. ► Higher neighborhood collective efficacy is associated with more outdoor play time. ► Children in public housing play outside more and watch more television, despite maternal concerns about safety.
Introduction
Despite trends indicating a recent stabilizing in the upward obesity trend for children and adolescents in the U.S., child overweight remains a significant public health issue, with 31.9% of children aged 2–19 overweight or obese (Ogden, Carroll, & Flegal, 2008), and significant disparities by socioeconomic status (SES) (Singh, Siahpush, & Kogan, 2010). One prominent explanation is that children are spending too little time playing outdoors and too much time watching television, and furthermore that low levels of outdoor play are due to mothers’ concerns about neighborhood safety. Although some studies have examined these hypotheses, very few have used nationally representative data, few have focused on young children, and few have attempted to integrate both objective and subjective measures of neighborhood quality (Foster and Giles-Corti, 2008, Grow et al., 2010, Sallis and Glanz, 2006), which is crucial for establishing a direct association between neighborhood context and young children’s activities. Our paper fills this gap by using data from a large, birth cohort study of urban children to address two questions: (1) are the activity patterns (outdoor play and television watching) of five-year-old children associated with their weight status, and (2) are children’s residential contexts, as assessed by both subjective and objective measures, associated with their activity patterns?
Section snippets
Children’s physical and sedentary activities and obesity
It is clear from experimental intervention studies that regular exercise is beneficial for older children’s weight status (Goran, Reynolds, & Lindquist, 1999). Moreover, children who spend more time engaged in sedentary activities like watching television or playing video games are more likely to be overweight (Escobar-Chaves and Anderson, 2008, Gable et al., 2007), although at least one study did not find a link between three-year-olds’ television viewing and body mass index (BMI) (Burdette &
Residential context and children’s physical activity
Recent scholarly attention in the U.S. has focused on neighborhood environments as determinants of adults’ weight status and physical activity. Generally, individuals in more disadvantaged neighborhoods have lower levels of physical activity and higher rates of obesity, controlling for individual-level SES (Boardman et al., 2005, Fisher et al., 2004, Humpel et al., 2002). These links may be due to safety concerns (crime; poorly lighted streets), the built environment (lack of parks,
Data
The Fragile Families and Child Wellbeing Study (FFCWS) follows a birth cohort of urban parents and their children (N = 4898), and when weighted it is representative of all births in large U.S. cities in 1998–1999. The study oversampled unmarried mothers, who make up about three-quarters of the sample, with the remaining one-quarter of mothers married at the time of the child’s birth. Follow-up interviews were conducted when the child was one, three, and five years old. Data for this paper are
Results
Table 1 presents descriptive statistics for the sample, consisting of the mean and standard deviation for each variable. The mean BMI percentile in the sample was 66.2, and in categorical terms (not shown) approximately 19% of the sample was overweight (between the 85th and 95th percentiles), and 16% were obese (≥95th percentile). On average, children played outside about 2 h per day, and watched more than two and a half hours of television per day. Mothers took their children to the playground
Discussion
Our analysis, one of the first to incorporate objective and subjective neighborhood characteristics when examining young children’s physical and sedentary activities, revealed some surprising findings. Despite most recent research documenting a negative association between SES and the likelihood of overweight for children (e.g. Danielzik, Czerwinski-Mast, Langnase, Dilba, & Muller, 2004), we found a nonlinear effect – the poorest and wealthiest children in our sample had the lowest BMIs, while
Acknowledgements
Preparation of this article was funded by the Robert Wood Johnson Foundation through its national program Active Living Research (ALR). The authors thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) through grants R01HD36916, R01HD39135, and R01HD40421, as well as a consortium of private foundations for their support of the Fragile Families and Child Wellbeing Study.
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