Ethnic disparities in teen exercise: Do schools play a role?

School-based obesity interventions may need to be tailored by gender

A study of 17,000 U.S. adolescents finds that black and Hispanic girls are less physically active than white girls, but that this difference is attributable to the schools they attend: black, white and Hispanic girls attending the same school have no difference in physical activity. In contrast, among boys, blacks and Hispanics were more physically active than whites attending the same schools. The researchers, led by Tracy Richmond, MD, in the Division of Adolescent Medicine at Children's Hospital Boston, report and discuss their findings in the June issue of Pediatrics.

Richmond and colleagues carefully analyzed data from the National Longitudinal Study of Adolescent Health, a school-based study of 7th-to-12th graders.

"Obesity is a growing problem in all adolescents, but it affects racial and ethnic minorities disproportionately," Richmond says. "Since physical activity is one protective factor against obesity that we can influence, we wanted to know whether schools might help determine physical activity levels."

Their key findings are as follows:

  • On average, black and Hispanic adolescents had a higher body mass index (BMI) than white adolescents.
  • Overall, adolescent girls were less physically active than boys, reporting fewer physical activities per week.
  • Overall, black and Hispanic girls reported less activity than white girls an average of 5.4, 5.2 and 6.0 activities per week, respectively. In contrast, among boys, the number of activities per week was similar for blacks (7.6), Hispanics (7.5) and whites (7.6).
  • Most adolescents attended schools that were racially segregated: nearly 40 percent of whites attended schools whose student bodies were more than 94 percent white, while about 80 percent of both blacks and Hispanics attended schools whose populations were less than 66 percent white.
  • Black and Hispanic adolescents attended schools with lower median incomes (blacks, $30,000; Hispanics, $32,500; whites, $45,000).
  • In general, black and Hispanic girls attended poorer schools in which all girls had lower physical activity levels. But when school factors were accounted for, there was no longer a racial/ethnic difference in physical activity among girls.
  • Among boys, there were only minimal racial/ethnic differences in physical activity levels overall. But within the same schools, both black and Hispanic boys had higher rates of physical activity than white boys.
  • Students with lower household incomes reported less physical activity. However, after taking into account the average household income of the schools' student body, individual household income was no longer significantly associated with physical activity in either males or females. "This suggests that poorer and richer students attending the same school have similar levels of physical activity," says Richmond.

In the case of boys, the finding of more physical activity among blacks and Hispanics than among whites at the same school could be seen as positive and health-promoting, the authors write, or it could also reflect minority males being differentially channeled into sports rather than academics.

The researchers note that they weren't able to assess whether their findings reflect differences in the schools themselves such as inequalities in gym facilities and programs or whether the school differences reflected social or cultural factors in the surrounding neighborhood or community that might influence teens' physical activity patterns. "The influence of schools clearly affects boys and girls differentially," Richmond says. "School-based policy interventions aimed at increasing physical activity may need to use different strategies for boys than for girls."

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The study was funded by the Robert Wood Johnson Foundation, the National Institute of Child Health and Human Development, and the Maternal and Child Health Leadership Education in Adolescent Health Training Program.

Founded in 1869 as a 20-bed hospital for children, Children's Hospital Boston today is the nation's leading pediatric medical center, the largest provider of health care to Massachusetts children, and the primary pediatric teaching hospital of Harvard Medical School. In addition to 347 pediatric and adolescent inpatient beds and comprehensive outpatient programs, Children's houses the world's largest research enterprise based at a pediatric medical center, where its discoveries benefit both children and adults. More than 500 scientists, including eight members of the National Academy of Sciences, nine members of the Institute of Medicine and 11 members of the Howard Hughes Medical Institute comprise Children's research community. For more information about the hospital visit: http://www.childrenshospital.org.


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