Trends in Obesity and Among Students in Philadelphia

Trends in Obesity and Among Students in Philadelphia

Abstract and Introduction

Abstract

Introduction Recent analyses suggest that increases in rates of childhood obesity have plateaued nationally and may be decreasing among certain populations and communities, including Philadelphia, Pennsylvania. We examined 7 years of data, including 3 years not previously reported, to assess recent trends in major demographic groups.

Methods We analyzed nurse-measured data from the School District of Philadelphia for school years 2006–07 through 2012–13 to assess trends in obesity (body mass index [BMI] ≥95th percentile) and severe obesity (BMI ≥120% of the 95th percentile) among all children aged 5 to 18 years for whom measurements were recorded.

Results Over 7 school years, the prevalence of childhood obesity declined from 21.7% to 20.3% (P = .01); the prevalence of severe obesity declined from 8.5% to 7.3% (P < .001). Declines were larger among boys than among girls and among African Americans and Asians than among non-Hispanic whites and Hispanics. Over the final 3 years of study, the prevalence of obesity continued to decrease significantly among boys (including African Americans and Asians) but increased significantly among Hispanic girls and girls in grades kindergarten through 5. At the end of the study period, Hispanics had the highest prevalence of obesity among boys (25.9%) and girls (23.0%). The prevalence of severe obesity continued to trend downward in boys and decrease significantly among girls (including African American girls) but remained highest among Hispanic boys (10.1%) and African American girls (8.3%).

Conclusion The prevalence of obesity and severe obesity continued to decline among children in Philadelphia, but in some groups initial reductions were reversed in the later period. Further monitoring, community engagement, and targeted interventions are needed to address childhood obesity in urban communities.

Introduction

Since the 1970s, the prevalence of childhood obesity in the United States has more than tripled, raising concerns for the health of children and the health of the US population. Children with obesity are at increased risk for type 2 diabetes, cardiovascular disease, sleep apnea, orthopedic problems, and psychosocial distress. In 2012, 16.9% of children aged 2 to 19 years were obese. African American and Hispanic children had the highest obesity prevalence.

However, recent data suggest that the prevalence of childhood obesity is plateauing and may be decreasing among certain populations and in particular communities. Most notably, the prevalence of obesity declined nationally by 40% among children aged 2 to 5 between National Health and Nutrition Examination Survey (NHANES) 2003–04 and NHANES 2011–12. In that same period (2003–2012), reductions in obesity prevalence among school-aged children ranged from 1% to 13% in California; Mississippi; New Mexico; West Virginia; Kearney, Nebraska; New York City; and Philadelphia. Local and state declines were seen over a period of 6 or fewer years, so long-term trends are unclear. Moreover, there were generally larger reductions in obesity prevalence among white children than among racial/ethnic minority children, exacerbating existing disparities.

In the context of these reports, we updated an earlier study of obesity among Philadelphia public school children from school year 2006–07 through school year 2009–10. That earlier analysis found a 4.8% decline in the prevalence of obesity, with larger declines for African American boys and Hispanic girls. Our objective was to examine obesity trends among children in different grade categories (kindergarten [K]–5, 6–8, and 9–12) and by sex and racial/ethnic groups. We examined 3 additional years of height and weight data from the School District of Philadelphia and assessed trends both in the period since the earlier study and over the 7-year period from school years 2006–07 through 2012–13.