Kids from disadvantaged neighborhoods face a greater obesity risk. But boys and girls aren't impacted equally.

March 5, 2021

Obesity is more likely for girls from disadvantaged neighborhoods than for boys from the same areas. (AP Image/Carlos Osorio)

Children from disadvantaged neighborhoods are at greater risk of developing obesity during childhood, but the impact of a child’s neighborhood is strongest among girls, according to an analysis of over 200,000 children from one of America’s largest metropolitan areas.

In an article published Feb. 23 in Health & Place, researchers said that living in a high-crime neighborhood with low socioeconomic status puts girls at particular risk of obesity, uncovering a new element of the complex relationship between place, gender and health outcomes.

The findings could help researchers and policymakers better understand how social and physical environments impact particular groups of children differently, according to author Ashley Kranjac, and how to facilitate better outcomes for all kids.

Kranjac, with co-authors Catherine Boyd, Rachel Kimbro, Brady Moffett and Keila Lopez, set out to better understand how gender shapes the ways that a child’s environment impacts his or her health. 

Prior research on neighborhood context found evidence suggesting that when it comes to the risk of developing obesity, boys benefit more than girls from living in advantaged neighborhoods.

“This is what stood out to us since we wanted to know what about the neighborhood context is experienced differently by sex and how … this variation influence[s] the odds of obesity for children,” Kranjac told The Academic Times.

It’s difficult to drill down on the role gender plays in moderating child obesity outcomes by neighborhood circumstance, the researchers wrote, partly because doing so requires a large data set. 

Using medical and administrative records available from hospitals and clinics around the Houston metropolitan area, however, they compiled the information they needed to do just that. With information on the weight status and neighborhood backgrounds of over 200,000 children, the researchers had robust data to compare boys and girls ages 2 through 17.

The researchers categorized the 992 neighborhoods these children lived in according to a system that took into account key socioeconomic characteristics and other measures — including crime rates and "walkability" scores — known to impact obesity outcomes in kids. That way, Kranjac said, the researchers had greater insight into the complex ways in which a child’s environment can shape his or her health.

“This provides an advantage for assessing place and health effects, because overwhelming evidence indicates that high socioeconomic status confers far more advantages beyond the gains associated with higher income or educational attainment,” she said.

For example, Kranjac said, living in a community with higher socioeconomic status translates to higher levels of walkability and having neighbors with higher levels of education, which can influence a person's social connections.

"That, in turn, might matter for levels of political clout needed to, say, set aside a land area for green space or keep a neighborhood safe and free of crime,” she added.

The researchers first tested the relationship between neighborhood disadvantage and the odds of obesity among children to corroborate earlier studies showing a link between the two. 

Their analysis revealed that children living in the most disadvantaged neighborhoods — with the lowest median household income and education levels and the highest incidence of poverty and violent crime — were more than 2.5 times likelier than children in the most advantaged neighborhoods to develop obesity.

A separate regression model showed how this link broke down according to gender. As neighborhood disadvantage increased, the researchers found, girls saw a steeper rise in obesity than boys.

The reason girls in lower-opportunity, high-crime areas are most negatively impacted by their neighborhood context could stem from the dangers their parents perceive outside their homes, the researchers wrote. In places where girls or their parents feel at risk of harassment, violence or assault, girls may limit their physical activity more than their male counterparts and run a higher risk of obesity.

“Boys and girls probably experience neighborhoods differently due to gender socialization norms that may have a potentially stronger influence on girls, thus differentially influencing their likelihood of becoming obese,” Kranjac said.

She added that the influence of neighborhoods is probably stronger over time, "as the residential neighborhood plays an increasingly important role as children mature and spend more time playing outside of their homes and autonomously interacting with local institutions."

Policy measures aimed at improving quality of life could help head off some of the strains which put vulnerable children at risk of becoming an unhealthy weight, according to Kranjac.

“At the neighborhood level, this means looking to policies that target the physical and social infrastructures of disadvantaged neighborhoods by improving conditions in decaying communities that negatively impact obesity outcomes,” she said.

The study, “Neighborhoods matter; but for whom? Heterogeneity of neighborhood disadvantage on child obesity by sex,” published Feb. 23 in Health & Place, was authored by Ashley W. Kranjac, Chapman University; Catherine Boyd, Rice University; Rachel T. Kimbro and Brady S. Moffett, Baylor College of Medicine; and Keila N. Lopez, Baylor College of Medicine and Texas Children’s Hospital.

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