Childhood obesity and schools: evidence from the national survey of children's health.
BACKGROUND
The international prevalence of childhood obesity and obesity-related diseases has received increasing attention. Applying data from the Centers for Disease Control and Prevention, we explore relationships between childhood obesity and school type, National School Lunch Program (NSLP) and School Breakfast Program (SBP) eligibility, membership in sports clubs and other sociodemographic, and household factors.


METHODS
Nonlinear regression models with interaction terms were developed to investigate the effects of school type, physical activity, and NSLP/SBP, etc, on children's body mass index (BMI). Probit models then examine the probability of a child being overweight.


RESULTS
Though clinically small, statistically significant effects on BMI were found for children from households eligible for the NSLP/SBP, attending public schools. They have a mean BMI value 0.401 higher than counterparts attending private schools (p < .05). If the child both attends public school and is eligible for the NSLP/SBP, then his or her BMI is 0.725 higher (p < .001). Children taking part in the NSLP or SBP have a 4.5% higher probability of being overweight (p < .001).


CONCLUSIONS
Regardless of household socioeconomic status, children attending public schools have higher BMI than those attending private schools. Eligibility for free or reduced-cost lunch or breakfast programs at public schools is positively correlated with children's BMI. Children attending public schools are more likely to be overweight. In lower socioeconomic status households, school type does not have a significant effect on the probability of being overweight. Policy recommendations for factors to address childhood obesity are discussed.
Li
Ji
J
Department of Agricultural, Environmental and Development Economics, The Ohio State University, 103 Ag Admin, 2120 Fyffe Road, Columbus, OH 43210, USA. li700@buckeyemail.osu.edu
Hooker
Neal H
NH
D015992:Body Mass Index; D002648:Child; D005247:Feeding Behavior; D005260:Female; D005522:Food Services / Q000191:economics / Q000592:standards; D006293:Health Promotion; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D050177:Overweight; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012574:Schools / Q000145:classification* / Q000706:statistics & numerical data; D012923:Social Class; D014481:United States / Q000453:epidemiology