Prenatal, Perinatal, Early Life, and Sociodemographic Factors Underlying Racial Differences in the Likelihood of High Body Index in Early Childhood

Published In: American Journal of Public Health, v. 102, no. 11, Nov. 2012, p. 2057-2067

Posted on RAND.org on October 16, 2012

by Margaret M. Weden, Peter Brownell, Michael S. Rendall

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OBJECTIVE: We investigated early childhood disparities in high body mass index (BMI) between Black and White US children. METHODS: We compared differences in Black and White children's prevalence of sociodemographic, prenatal, perinatal, and early life risk and protective factors; fit logistic regression models predicting high BMI (≥ 95th percentile) at age 4 to 5 years to 2 nationally representative samples followed from birth; and performed separate and pooled-survey estimations of these models. RESULTS: After adjustment for sample design–related variables, models predicting high BMI in the 2 samples were statistically indistinguishable. In the pooled-survey models, Black children's odds of high BMI were 59% higher than White children's (odds ratio [OR] = 1.59; 95% confidence interval [CI]= 1.32, 1.92). Sociodemographic predictors reduced the racial disparity to 46% (OR = 1.46; 95% CI = 1.17, 1.81). Prenatal, perinatal, and early life predictors reduced the disparity to nonsignificance (OR = 1.18; 95% CI = 0.93, 1.49). Maternal prepregnancy obesity and short-duration or no breastfeeding were among predictors for which racial differences in children's exposures most disadvantaged Black children. CONCLUSIONS: Racial disparities in early childhood high BMI were largely explained by potentially modifiable risk and protective factors.

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