Vital Signs: Obesity Among Low-Income, Preschool-Aged Children — United States, 2008–2011

From US CDC August 6, 2013

Abstract

Background: The prevalence of obesity among U.S. preschoolers has doubled in recent decades. Childhood obesity increases the risk for adult obesity and is associated with negative health consequences. Trends in the state-specific prevalence of obesity among low-income U.S. preschool children have not been examined since 2008. State-specific obesity prevalence surveillance helps determine the need for and impact of state and local obesity prevention strategies.

Methods: Measured weight and height data from approximately 11.6 million low-income children aged 2–4 years from 40 states, the District of Columbia, and two U.S. territories who participated in the Pediatric Nutrition Surveillance System during 2008–2011 were used to estimate state obesity prevalence. Obesity was defined as having an age- and sex-specific body mass index ≥95th percentile, according to the 2000 CDC growth charts. Logistic regression models adjusted for age, sex, and race/ethnicity were used to examine trends in the state-specific obesity prevalence.

Results: During 2008–2011, statistically significant downward trends in obesity prevalence were observed in 18 states and the U.S. Virgin Islands. Florida, Georgia, Missouri, New Jersey, South Dakota, and the U.S. Virgin Islands had the largest absolute decreases in obesity prevalence, each with a decrease of ≥1 percentage point. Twenty states and Puerto Rico experienced no significant change, and obesity prevalence increased significantly in three states.

Conclusions and Implications for Public Health Practice: Small but significant declines in obesity among low-income preschoolers were observed in 19 of 43 states/territories examined. Continued prevention efforts are needed to sustain and expand the implementation and evaluation of population-level interventions to prevent childhood obesity....

Results

During 2008–2011, a total of 19 states/territories reported significant downward trends in obesity prevalence among low-income preschoolers (Figure 1). Among them, the largest decline in obesity prevalence was in the U.S. Virgin Islands (AOR = 0.92; CI = 0.87–0.97), where there was a decrease in the prevalence of obesity from 13.6% in 2008 to 11.0% in 2011, an absolute decrease of 2.6 percentage points (Table 2). In five additional states (Florida, Georgia, Missouri, New Jersey, and South Dakota) the absolute decrease in obesity prevalence from 2008 to 2011 was ≥1 percentage point. Across the 19 states/territories with significant downward trends, the absolute decrease in obesity prevalence from 2008 to 2011 ranged from 0.3 to 2.6 percentage points. The relative decreases in obesity prevalence among the 19 states/territories ranged from 1.8% to 19.1%.

An additional 21 states/territories experienced no significant trend in obesity prevalence. Three states experienced a significant upward trend in obesity prevalence. The absolute increase in obesity prevalence from 2008 to 2011 for the three states ranged from 0.6 to 0.7 percentage points. The relative increase in obesity prevalence among the three states ranged from 5.2% to 6.4%.

In a secondary analysis of the 34 states/territories that had complete data on household income, household income was added to the logistic regression model. Among these states/territories, significance changed for only one state. Montana went from no significant trend to a significant decrease in the prevalence of obesity (AOR = 0.97, CI = 0.94–1.00).

In 2011, the prevalence of obesity among states/territories in the study ranged from 9.2% to 17.9% (Table 2). Ten states/territories had an obesity prevalence ≥15% (Figure 2), with the highest prevalence in Puerto Rico (17.9%). Six states/territories had an obesity prevalence <12%. The lowest obesity prevalence was in Hawaii (9.2%).

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