title: Educational outcomes associated with childhood obesity in the United States: cross-sectional results from the 2011-2012 National Survey of Children's Health.
abstract: BACKGROUND
  Past research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. However, there is emerging evidence that childhood obesity may have more immediate effects on school-related outcomes. We examine a range of educational attainment indicators to examine the possible pathway between obesity status and academic performance, while investigating the proximal effects of childhood obesity on health and utilization of health services, and whether these variables attenuate the relationship between obesity status and educational outcomes.
  
  
  METHODS
  Data for the current study come from the 2011-2012 National Survey of Children’s Health, which details the impacts of childhood obesity on a range of outcomes among a nationally representative sample of children and adolescents aged 10-17 years (N=45,255). Educational outcomes (school absences, school problems, repeating a grade and school engagement) were modeled by logistic regression as a function of BMI, overall health status, health care utilization, and a range of sociodemographic variables.
  
  
  RESULTS
  BMI status was significantly associated with all educational outcomes (p<0.001 for all), overall health status (p<0.001), and health care utilization (p=0.016). Prior to adjustment for covariates, obese children were significantly more likely to have school absences and school problems, to repeat a grade, and to have lower school engagement than non-overweight children. After adjustment for sociodemographic and health/healthcare variables, these outcomes remained significant for all but repeating a grade. The odds of having school problems, repeating a grade, and low school engagement that were associated with obesity were attenuated by the addition of sociodemographic variables into the model, while the addition of health and health care variables in the model decreased the odds of school absences.
  
  
  CONCLUSIONS
  This study provides evidence that increased weight status in children is associated with poorer educational outcomes. While recognizing that these are cross-sectional data, we suggest that 1) health-related and sociodemographic factors should be a focus point of intervention, and 2) a socio-structural approach including Coordinated School Health intervention is crucial to reducing childhood obesity and improving educational outcomes in this population.
authors.forename: Felicia R
authors.initials: FR
authors.lastname: Carey
authors.forename: Gopal K
authors.initials: GK
authors.lastname: Singh
authors.forename: H Shelton
authors.initials: HS
authors.lastname: Brown
authors.forename: Anna V
authors.initials: AV
authors.lastname: Wilkinson
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D000067576:Child Health; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000150:complications*; D012574:Schools; D011795:Surveys and Questionnaires; D014481:United States