title: Understanding childhood obesity in America: linkages between household income, community resources, and children's behaviors.
abstract: BACKGROUND
  Understanding childhood obesity's root causes is critical to the creation of strategies to improve our children's health. We sought to define the association between childhood obesity and household income and how household income and childhood behaviors promote childhood obesity.
  
  
  METHODS
  We assessed body mass index in 109,634 Massachusetts children, identifying the percentage of children who were overweight/obese versus the percentage of children in each community residing in low-income homes. We compared activity patterns and diet in 999 sixth graders residing in 4 Michigan communities with varying annual household income.
  
  
  RESULTS
  In Massachusetts, percentage of overweight/obese by community varied from 9.6% to 42.8%. As household income dropped, percentage of overweight/obese children rose. In Michigan sixth graders, as household income goes down, frequency of fried food consumption per day doubles from 0.23 to 0.54 (P < .002), and daily TV/video time triples from 0.55 to 2.00 hours (P < .001), whereas vegetable consumption and moderate/vigorous exercise go down.
  
  
  CONCLUSIONS
  The prevalence of overweight/obese children rises in communities with lower household income. Children residing in lower income communities exhibit poorer dietary and physical activity behaviors, which affect obesity.
authors.affiliation: Cardiovascular Center, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5852, USA.
authors.forename: Taylor F
authors.initials: TF
authors.lastname: Eagle
authors.forename: Anne
authors.initials: A
authors.lastname: Sheetz
authors.forename: Roopa
authors.initials: R
authors.lastname: Gurm
authors.forename: Alan C
authors.initials: AC
authors.lastname: Woodward
authors.forename: Eva
authors.initials: E
authors.lastname: Kline-Rogers
authors.forename: Robert
authors.initials: R
authors.lastname: Leibowitz
authors.forename: Jean
authors.initials: J
authors.lastname: Durussel-Weston
authors.forename: LaVaughn
authors.initials: L
authors.lastname: Palma-Davis
authors.forename: Susan
authors.initials: S
authors.lastname: Aaronson
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Fitzgerald
authors.forename: Lindsey R
authors.initials: LR
authors.lastname: Mitchell
authors.forename: Bruce
authors.initials: B
authors.lastname: Rogers
authors.forename: Patricia
authors.initials: P
authors.lastname: Bruenger
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Skala
authors.forename: Caren
authors.initials: C
authors.lastname: Goldberg
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.forename: Steven R
authors.initials: SR
authors.lastname: Erickson
authors.forename: Kim A
authors.initials: KA
authors.lastname: Eagle
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005191:Family Characteristics; D054624:Health Status Disparities; D006801:Humans; D007182:Income; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D008404:Massachusetts / Q000453:epidemiology; D008824:Michigan / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics; D018570:Risk Assessment; D012572:School Health Services; D012959:Socioeconomic Factors