Young children in urban areas: Links among neighborhood characteristics, weight status, outdoor play, and television watching

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Abstract

Although research consistently demonstrates a link between residential context and physical activity for adults and adolescents, less is known about young children’s physical activity. Using data from the U.S. Fragile Families and Child Wellbeing Study (N = 1822, 51% male), we explored whether outdoor play and television watching were associated with children’s body mass indexes (BMIs) at age five using OLS regression models, controlling for a wide array of potential confounders, including maternal BMI. We also tested whether subjective and objective neighborhood measures – socioeconomic status (from U.S. Census tract data), type of dwelling, perceived collective efficacy, and interviewer-assessed physical disorder of the immediate environment outside the home – were associated with children’s activities, using negative binomial regression models. Overall, 19% of the sample were overweight (between the 85th and 95th percentiles), and 16% were obese (≥95th percentile). Hours of outdoor play were negatively associated with BMI, and hours of television were positively associated with BMI. Moreover, a ratio of outdoor play to television time was a significant predictor of BMI. Higher maternal perceptions of neighborhood collective efficacy were associated with more hours of outdoor play, fewer hours of television viewing, and more trips to a park or playground. In addition, we found that neighborhood physical disorder was associated with both more outdoor play and more television watching. Finally, contrary to expectations, we found that children living in public housing had significantly more hours of outdoor play and watched more television, than other children. We hypothesize that poorer children may have more unstructured time, which they fill with television time but also with outdoor play time; and that children in public housing may be likely to have access to play areas on the grounds of their housing facilities.

Research highlights

► The ratio of outdoor play to television watching is associated with BMI for five-year-old children. ► Higher neighborhood collective efficacy is associated with more outdoor play time. ► Children in public housing play outside more and watch more television, despite maternal concerns about safety.

Introduction

Despite trends indicating a recent stabilizing in the upward obesity trend for children and adolescents in the U.S., child overweight remains a significant public health issue, with 31.9% of children aged 2–19 overweight or obese (Ogden, Carroll, & Flegal, 2008), and significant disparities by socioeconomic status (SES) (Singh, Siahpush, & Kogan, 2010). One prominent explanation is that children are spending too little time playing outdoors and too much time watching television, and furthermore that low levels of outdoor play are due to mothers’ concerns about neighborhood safety. Although some studies have examined these hypotheses, very few have used nationally representative data, few have focused on young children, and few have attempted to integrate both objective and subjective measures of neighborhood quality (Foster and Giles-Corti, 2008, Grow et al., 2010, Sallis and Glanz, 2006), which is crucial for establishing a direct association between neighborhood context and young children’s activities. Our paper fills this gap by using data from a large, birth cohort study of urban children to address two questions: (1) are the activity patterns (outdoor play and television watching) of five-year-old children associated with their weight status, and (2) are children’s residential contexts, as assessed by both subjective and objective measures, associated with their activity patterns?

Section snippets

Children’s physical and sedentary activities and obesity

It is clear from experimental intervention studies that regular exercise is beneficial for older children’s weight status (Goran, Reynolds, & Lindquist, 1999). Moreover, children who spend more time engaged in sedentary activities like watching television or playing video games are more likely to be overweight (Escobar-Chaves and Anderson, 2008, Gable et al., 2007), although at least one study did not find a link between three-year-olds’ television viewing and body mass index (BMI) (Burdette &

Residential context and children’s physical activity

Recent scholarly attention in the U.S. has focused on neighborhood environments as determinants of adults’ weight status and physical activity. Generally, individuals in more disadvantaged neighborhoods have lower levels of physical activity and higher rates of obesity, controlling for individual-level SES (Boardman et al., 2005, Fisher et al., 2004, Humpel et al., 2002). These links may be due to safety concerns (crime; poorly lighted streets), the built environment (lack of parks,

Data

The Fragile Families and Child Wellbeing Study (FFCWS) follows a birth cohort of urban parents and their children (N = 4898), and when weighted it is representative of all births in large U.S. cities in 1998–1999. The study oversampled unmarried mothers, who make up about three-quarters of the sample, with the remaining one-quarter of mothers married at the time of the child’s birth. Follow-up interviews were conducted when the child was one, three, and five years old. Data for this paper are

Results

Table 1 presents descriptive statistics for the sample, consisting of the mean and standard deviation for each variable. The mean BMI percentile in the sample was 66.2, and in categorical terms (not shown) approximately 19% of the sample was overweight (between the 85th and 95th percentiles), and 16% were obese (≥95th percentile). On average, children played outside about 2 h per day, and watched more than two and a half hours of television per day. Mothers took their children to the playground

Discussion

Our analysis, one of the first to incorporate objective and subjective neighborhood characteristics when examining young children’s physical and sedentary activities, revealed some surprising findings. Despite most recent research documenting a negative association between SES and the likelihood of overweight for children (e.g. Danielzik, Czerwinski-Mast, Langnase, Dilba, & Muller, 2004), we found a nonlinear effect – the poorest and wealthiest children in our sample had the lowest BMIs, while

Acknowledgements

Preparation of this article was funded by the Robert Wood Johnson Foundation through its national program Active Living Research (ALR). The authors thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) through grants R01HD36916, R01HD39135, and R01HD40421, as well as a consortium of private foundations for their support of the Fragile Families and Child Wellbeing Study.

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