Parents' impressions of neighborhood safety linked to children's weight

Children who live in neighborhoods that their parents believe are unsafe are more likely to be overweight than those in neighborhoods perceived as safe, according to a study in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Almost 16 percent of 6- to 11-year-old children in the United States are overweight, defined as having a body mass index (BMI) of greater than or equal to the 95th percentile of national norms for age and sex, according to background information in the article. Children who are African-American or Hispanic, who watch large amounts of television or who have parents with high BMIs are more likely to be overweight, but little is known about how a child's neighborhood affects his or her risks. Few previous studies have looked specifically at the relationship between neighborhood safety and children's risk of being overweight.

Julie C. Lumeng, M.D., of the University of Michigan, Ann Arbor, and colleagues collected data from 768 children and families participating in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, a study of families in 10 diverse regions of the United States. The parents completed questionnaires that assessed how safe they thought their neighborhoods were at the time their children were in first grade. The ratings were divided into quartiles, with the first quartile perceived as the least safe and the fourth as safest. Their children's height and weight were measured in the laboratory when they were 4 ½ years old and again the spring of their first-grade year in school, when their mean (average) age was 7. BMI was calculated by dividing their weight in kilograms by the square of their height in meters.

The researchers found that 17 percent of children living in the first quartile of neighborhoods perceived as least safe by their parents were overweight, compared with 10 percent in the second quartile, 13 percent in the third quartile and only 4 percent of children living in the fourth, safest quartile. This relationship was not affected by any other variables that the researchers measured, including the education levels or marital status of the children's mothers, racial or ethnic backgrounds or participation in after-school activities.

"In effect, there may well be a relatively simple and straightforward relationship between living in a dangerous neighborhood and overweight; namely, in attempting to protect their children from harm, parents not only decrease the kind of physical activity that comes from playing outdoors in the neighborhood but inadvertently increase the likelihood of sedentary activity that comes from staying indoors," the authors report.

"Many areas of policy development related to the built environment and neighborhood safety have not traditionally been considered relevant to child health," they write. "However, such policies may have important implications for childhood overweight. For the individual physician, these results suggest the need to understand the character of a child's neighborhood when making recommendations for lifestyle and activity changes aimed at obesity prevention and treatment."

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(Arch Pediatr Adolesc Med. 2006;160:25-31. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by a grant from the Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Md., and a Fellow-to-Faculty Transition Award to Dr. Lumeng from the American Heart Association, Dallas.


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