The Role of School Environments in Explaining Racial-Ethnic Disparities in Body Mass Index Among U.S. Adolescents

Published in: Journal of Adolescent Health, 2016

Posted on RAND.org on June 24, 2016

by Nancy Nicosia, Victoria Shier, Ashlesha Datar

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Research Question

  1. Can differences in school socioeconomic characteristics or food and physical activity environment explain the racial and ethnic disparities in body mass index among adolescents?

PURPOSE: Policymakers have focused substantial efforts on how school environments can be used to combat obesity. Given this intense focus, this article examined whether disparities in body mass index (BMI) noted among black and Hispanic adolescents relative to whites were explained by the well-documented differences in the school socioeconomic characteristics, and food and physical activity environment. METHODS: Data from the fifth- and eighth-grade waves of the Early Childhood Longitudinal Study--Kindergarten Class were analyzed. Unadjusted linear regression models of BMI percentile that included only indicators for child's race/ethnicity were estimated first followed by adjusted models that iteratively added sets of child, family, and ultimately school covariates. Separate models were estimated by grade and gender. School covariates included detailed indicators for the school socioeconomic characteristics, and the food and physical activity environments. RESULTS: For Hispanic boys and girls and for black boys, substantial shares of the disparities in BMI were explained by differences in birth weight, BMI at school entry, and current child and family characteristics. Substantial disparities in BMI remained among black girls relative to white girls. Characteristics of the child's school during fifth and eighth grade--specifically, the schools' socioeconomic characteristics as well as measures of the food and physical activity environment--did not explain the disparities for any of the demographic groups. CONCLUSIONS: Differences in the school environment had little additional explanatory power suggesting that interventions seeking to reduce BMI disparities should focus on early school years and even before school entry.

Key Findings

  • School characteristics at fifth and eighth grades have little impact on the magnitude of estimated racial and ethnic disparities.
  • A substantial proportion of the disparities among Hispanic boys and girls and Black boys are explained by child characteristics, such as birth weight and BMI at Kindergarten.
  • Evidence from this cohort study does not support an association between school policies regarding food and physical activity and behaviors linked to obesity.

Recommendation

  • Interventions seeking to reduce disparities should focus on early childhood years, before school entry.

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