The Association between Residential Environments and Prevalence of Obesity among Maryland Children Enrolled in Medicaid
Open AccessThe Association between Residential Environments and Prevalence of Obesity among Maryland Children Enrolled in MedicaidLee Hurt, MS, DrPHObjective: To investigate the influence of built environment factors on childhood obesity prevalence among a population at increased risk for obesity, Maryland Medicaid recipients.Methods: The study used data from a randomly sampled group of Maryland Medicaid recipients, ages 2-19 years. BMI percentiles for age were computed for 8,781 children with age, gender, weight, and height extracted from medical records during a Medicaid quality assurance review (2005-09). Each child's residential address was geocoded and the proximity to the following environmental risk factors was computed: food retailers, parks/recreation facilities, pedestrian deaths, traffic volume, land use, crime.Logistic regression models were used to determine associations between BMI status and the independent variables for the built environment.Results: Increased risk for overweight/obesity was found among some subgroups of children if their nearest food retailer was classified as unhealthy: children ages 12-19 years, AOR=2.43(CI:1.41,4.17), Hispanic children, AOR=2.67(CI:1.20-5.92), and male children, AOR=1.55(CI:1.06-2.26).Hispanic children were also at increased risk if they had a low ratio of healthy to unhealthy food retailers within walking distance, AOR=8.45(CI:1.92-37.13).High traffic volume was also associated with increased risk of overweight/ obesity in some groups: children ages 2-5 years, AOR=1.21(CI:1.04,1.41), non-Hispanic Whites, AOR=1.28(CI:1.07-1.53).No significant associations were found between risk for overweight/obesity and other environmental factors.Conclusions: Residential proximity to unhealthy food retailers was most strongly associated with prevalence of overweight/obesity, especially among Hispanic children.
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