title: Social determinants of disparities in weight among US children and adolescents.
abstract: OBJECTIVE
  To explore whether contextual variables attenuate disparities in weight among 18,639 US children and adolescents aged 2 to 18 years participating in the National Health and Nutrition Examination Survey, 2001 to 2010.
  
  
  METHODS
  Disparities were assessed using the Symmetrized Rényi Index, a new measure that summarizes disparities in the severity of a disease, as well as the prevalence, across multiple population groups. Propensity score subclassification was used to ensure covariate balance between racial and ethnic subgroups and account for individual-level and contextual covariates.
  
  
  RESULTS
  Before propensity score subclassification, significant disparities were evident in the prevalence of overweight and/or obesity and the degree of excess weight among overweight/obese children and adolescents. After propensity score subclassification, racial/ethnic disparities in the prevalence and severity of excess weight were completely attenuated within matched groups, indicating that racial and ethnic differences were explained by social determinants such as neighborhood socioeconomic and demographic factors.
  
  
  CONCLUSIONS
  The limited overlap in covariate distributions between various racial/ethnic subgroups warrants further attention in disparities research. The attenuation of disparities within matched groups suggests that social determinants such as neighborhood socioeconomic factors may engender disparities in weight among US children and adolescents.
authors.affiliation: Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD. Electronic address: lrossen@cdc.gov.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Rossen
authors.affiliation: Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
authors.forename: Makram
authors.initials: M
authors.lastname: Talih
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D017028:Caregivers / Q000193:education; D002648:Child; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D055361:Multilevel Analysis; D009749:Nutrition Surveys; D063766:Pediatric Obesity / Q000191:economics / Q000208:ethnology*; D015995:Prevalence; D057216:Propensity Score; D012111:Residence Characteristics; D012720:Severity of Illness Index; D012923:Social Class; D064890:Social Determinants of Health; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: Epidemiologic methods; Health status disparities; Multilevel analysis; Obesity; Propensity score; Residence characteristics; Social determinants of health