Better neighborhood conditions lower obesity risk in youth


A recent study found that children were more likely to present with high BMI and obesity if they had low Child Opportunity Index scores early in life.

Individuals living in high-opportunity and low-vulnerability neighborhoods in the first few years of life are less likely to be obese during childhood and adolescence, according to a recent study.

Neighborhood quality has been associated with lifelong health, and children have been noted as being more vulnerable than adults. High prevalence of crime and poverty have been shown to increase the risk of high body mass index (BMI) for children. Childhood obesity can lead to chronic diseases such as diabetes type 2 in adulthood.

There is little data on the risk of obesity in children born and spending early life in vulnerable communities. To evaluate the impact of residing in low-income neighborhoods at vulnerable stages of life, investigators studied data from the Environmental Influences on Child Health Outcomes (ECHO) program.

ECHO consists of individual cohorts of children throughout the United States. For the study, data previously gathered from cohorts was used. Participants were included if they had resided in at least 1 geocoded address and had their weight and length or height taken during or after the address date.

Participants’ address data at birth, infancy, early childhood, and mid-childhood was collected. The Child Opportunity Index (COI) and Social Vulnerability Index (SVI) were used to measure neighborhood quality.

The COI divided neighborhood factors which influence childhood development into 3 groups. The first was education, the second health and environment, and the third social and economic. Overall COI scores were calculated for 72,195 Census tracts in total.

The SVI was developed by the Centers for Disease Control and Prevention. It divided neighborhood factors into 4 groups: household composition and disability, socioeconomic status, race and ethnicity and language status, and housing and transportation type.

Weight and length or height was measured at birth, infancy, early childhood, mid-childhood, and adolescence. These measurements were used to calculate BMI, which was defined as a BMI score equal or more than the 95th percentile for an individual’s age and sex group.

Covariates included annual household income during pregnancy, maternal education level during pregnancy, BMI prepregnancy, prenatal cigarette smoking, total gestational weight gain, sex and race of child, and child’s birth year. Data on pregnancy and birth characteristics was also gathered.

There were 20,677 children in the study, 52% of which were male, 62% White, and about 79% non-Hispanic. About 30% of children lived in areas with the most advantageous conditions. Very low COI was seen in 20.8% of children at birth, 20% in infancy, 18.9% in early childhood, and 16.9% in mid-childhood.

Children with high SVI scores often had high COI scores as well, with low SVI and COI scores seeing a similar correlation. High COI scores were associated with lower BMI and decreased risk of obesity at every stage of life.

The risk of children with a high COI at birth developing obesity by age 10 was calculated to be 0.21, compared to 0.46 for moderate COI at birth and 0.53 for low COI at birth. Similar patterns were found for SVI scores. Scores at birth were observed to have a greater impact on BMI and obesity risk than scores recorded later in life.

These results indicated that living in vulnerable, low-opportunity communities increases the risk of obesity. Investigators recommended further research on how policies can be implemented to alter neighborhood environments and reduce the prevalence of obesity.


Aris IM, Perng W, Dabelea D, Padula AM, Alshawabkeh A, Vélez-Vega CM, et al. Associations of neighborhood opportunity and social vulnerability with trajectories of childhood body mass index and obesity among US children. JAMA Netw Open. 2022;5(12):e2247957. doi:10.1001/jamanetworkopen.2022.47957

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