The Association between Residential Environments and Prevalence of Obesity among Maryland Children Enrolled in Medicaid Open Access
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The 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.