Targeting Interventions for Ethnic Minority and Low-Income Populations

Abstract

Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers—and thus contribute to disparities in obesity rates. The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment—breast-feeding, television viewing, and parental behaviors—that may contribute to childhood obesity but be amenable to change through targeted intervention. Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical environments in which these communities exist.

Late Preterm Infants and Neurodevelopmental Outcomes at Kindergarten

“…LPIs have higher odds of severe impairment, and those who [22][23][24][25][26][27] Non-Englishspeaking families also tend to have reduced access to and utilization of high-quality pediatric health care, which identifies and helps with the effects of adverse physical and environmental exposures. 28,29 Our results expand on the current literature in several ways.…”

Is the Environment Near Home and School Associated with Physical Activity and Adiposity of Urban Preschool Children?

“…One proposed strategy involves making structural changes in the environments within which children live, 9 especially in areas where children have the greatest risk of sedentary behavior patterns, obesity, and related chronic diseases. 10 The characteristics of the environment that influence physical activity and body size may be similar for young children and their parents. A child's body size is strongly correlated with his or her parents' body size, 11,12 and parental weight change predicts childhood weight change.…”

Consistently Inconsistent: A Snapshot of Across- and Within-State Disparities in the Prevalence of Childhood Overweight and Obesity

“…6 The epidemic of childhood overweight and obesity is gaining significant attention from policy makers at the state and federal levels. Although a rich literature is emerging on disparities in childhood obesity, [7][8][9][10][11][12][13][14][15] less is known about the degree to which these disparities exist and vary across and within individual states. Examination of withinand across-state variation in childhood obesity rates is critical to shaping effective national and state-level policy and program responses to prevent and reduce overweight and obesity among children.…”