Preventing Chronic Disease | Neighborhood Disparities in Prevalence of Childhood Obesity Among Low-Income Children Before and After Implementation of New York City Child Care Regulations - CDC

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Preventing Chronic Disease | Neighborhood Disparities in Prevalence of Childhood Obesity Among Low-Income Children Before and After Implementation of New York City Child Care Regulations - CDC

Neighborhood Disparities in Prevalence of Childhood Obesity Among Low-Income Children Before and After Implementation of New York City Child Care Regulations

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• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Jackson P. Sekhobo, PhD, MPA; Lynn S. Edmunds, DrPH, MS, RD; Karen Dalenius, MPH, RD; Jan Jernigan, PhD; Christopher F. Davis, PhD, MPH, CPH; Mark Giddings, BS; Catherine Lesesne, PhD, MPH; Laura Kettel Khan, PhD, MIM

Suggested citation for this article: Sekhobo JP, Edmunds LS, Dalenius K, Jernigan J, Davis CF, Giddings M, et al. Neighborhood Disparities in Prevalence of Childhood Obesity Among Low-Income Children Before and After Implementation of New York City Child Care Regulations. Prev Chronic Dis 2014;11:140152. DOI: http://dx.doi.org/10.5888/pcd11.140152.

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Abstract

Introduction
New York City Article 47 regulations, implemented in 2007, require licensed child care centers to improve the nutrition, physical activity, and television-viewing behaviors of enrolled children. To supplement an evaluation of the Article 47 regulations, we conducted an exploratory ecologic study to examine changes in childhood obesity prevalence among low-income preschool children enrolled in the Nutrition Program for Women, Infants, and Children (WIC) in New York City neighborhoods with or without a district public health office. We conducted the study 3 years before (from 2004 through 2006) and after (from 2008 through 2010) the implementation of the regulations in 2007.

Methods
We used an ecologic, time-trend analysis to compare 3-year cumulative obesity prevalence among WIC-enrolled preschool children during 2004 to 2006 and 2008 to 2010. Outcome data were obtained from the New York State component of the Centers for Disease Control and Prevention’s Pediatric Nutrition Surveillance System.

Results
Early childhood obesity prevalence declined in all study neighborhoods from 2004–2006 to 2008–2010. The greatest decline occurred in Manhattan high-risk neighborhoods where obesity prevalence decreased from 18.6% in 2004–2006 to 15.3% in 2008–2010. The results showed a narrowing of the gap in obesity prevalence between high-risk and low-risk neighborhoods in Manhattan and the Bronx, but not in Brooklyn.

Conclusion
The reductions in early childhood obesity prevalence in some high-risk and low-risk neighborhoods in New York City suggest that progress was made in reducing health disparities during the years just before and after implementation of the 2007 regulations. Future research should consider the built environment and markers of differential exposure to known interventions and policies related to childhood obesity prevention.

Acknowledgments

The evaluation of the New York City Department of Health and Mental Hygiene’s regulations for beverages, physical activity, and screen time for children aged 3 years or older in licensed, group child care centers was funded by grant no. 65425 from the Robert Wood Johnson Foundation (RWJF) to the CDC Foundation. Technical assistance was provided by CDC’s National Center for Chronic Disease Prevention and Health Promotion’s Division of Nutrition, Physical Activity, and Obesity. ICF International was the lead contractor for the study in conjunction with the New York City Department of Health and Mental Hygiene (DHMH). Beth Dixon was a consultant on the project. We thank Laura Leviton, RWJF; Tamara Dumanovsky, New York City DHMH; and Julia Ruben and David Cotton, ICF International for their support and contributions to the study. The findings and conclusions of this paper are those of the authors and do not necessarily reflect the official views of CDC.

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Author Information

Corresponding Author: Jackson P. Sekhobo, Division of Nutrition, New York State Department of Health, 150 Broadway, Menands, NY 12204. Telephone: 518-402-7109. E-mail: Jackson.Sekhobo@health.ny.gov

Author Affiliations: Lynn S. Edmunds, Mark Giddings, New York State Department of Health, Albany, New York; Karen Dalenius, Jan Jernigan, Laura Kettel Khan, Centers for Disease Control and Prevention, Atlanta, Georgia; Christopher F. Davis, University at Albany School of Public Health, Albany, New York; Catherine Lesesne, ICF International, Atlanta, Georgia.

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