Obesity among US urban preschool children:Relationships to race,ethnicity, and socioeconomic status

Objectives: To determine whether there are racial/ethnic differences in the prevalence of obesity among preschool children and to determine whether these differences are explained by socioeconomic factors. Design: Cross-sectional assessment. Setting:Twenty large US cities, from 2001 to 2003. Participants: Of the 4898 children enrolled at birth in the Fragile Families and Child Well-being Study, we analyzed data for the 2452 who, at the age of 3 years, had their height and weight measured during amaternal survey. Main Exposures: Three socioeconomic indicators were the main exposures -maternal education, household income, and children's food security status, as assessed by the US Household Food Security Survey Module. Main Outcome Measure: Obesity, defined as a body mass index at the 95 th percentile or higher for age and sex. Results: Of the mothers,41.0%had education beyond high school, 52.9%of households had an income above the federal poverty threshold, and 79.5%of the children were food secure. The prevalence of obesity was 25.8%among Hispanics (any race), 16.2%among blacks,and 14.8%among whites. Compared with whites, the odds of obesity were significantly higher in Hispanics (odds ratio,2.00; 95%confidence interval, 1.46-2.73), but not in blacks(odds ratio, 1.10; 95%confidence interval, 0.82-1.48). Neither of these odds ratios changed meaningfully after adjusting for all 3 socioeconomic indicators (Hispanics:odds ratio, 1.86[95%confidence interval, 1.33-2.60]; and blacks: odds ratio,1.07 [95%confidence interval, 0.78-1.47]). Conclusion: In a sample of preschool children drawn from 20 large US cities, the high prevalence of obesity among Hispanics relative to blacks or whites was not explained by racial/ethnic differences in maternale ducation, household income, or food security.