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 Weden, Peter Brownell, Michael S. Rendall

Read More

Access further information on this document at American Public Health Association

This article was published outside of RAND. The full text of the article can be found at the link above.

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.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.