Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the School District of Philadelphia, Pennsylvania, 2006-2013.
BACKGROUND
Recent analyses suggest that increases in rates of childhood obesity have plateaued nationally and may be decreasing among certain populations and communities, including Philadelphia, Pennsylvania. We examined 7 years of data, including 3 years not previously reported, to assess recent trends in major demographic groups.


METHODS
We analyzed nurse-measured data from the School District of Philadelphia for school years 2006-07 through 2012-13 to assess trends in obesity (body mass index [BMI] ≥95th percentile) and severe obesity (BMI ≥120% of the 95th percentile) among all children aged 5 to 18 years for whom measurements were recorded.


RESULTS
Over 7 school years, the prevalence of childhood obesity declined from 21.7% to 20.3% (P = .01); the prevalence of severe obesity declined from 8.5% to 7.3% (P < .001). Declines were larger among boys than among girls and among African Americans and Asians than among non-Hispanic whites and Hispanics. Over the final 3 years of study, the prevalence of obesity continued to decrease significantly among boys (including African Americans and Asians) but increased significantly among Hispanic girls and girls in grades kindergarten through 5. At the end of the study period, Hispanics had the highest prevalence of obesity among boys (25.9%) and girls (23.0%). The prevalence of severe obesity continued to trend downward in boys and decrease significantly among girls (including African American girls) but remained highest among Hispanic boys (10.1%) and African American girls (8.3%).


CONCLUSIONS
The prevalence of obesity and severe obesity continued to decline among children in Philadelphia, but in some groups initial reductions were reversed in the later period. Further monitoring, community engagement, and targeted interventions are needed to address childhood obesity in urban communities.
Philadelphia Department of Public Health, 500 S Broad St, Philadelphia, PA 19146. Email: Jessica.Robbins@phila.gov.
Jessica M
JM
Robbins
Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
Giridhar
G
Mallya
Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
Amanda
A
Wagner
Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
James W
JW
Buehler
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000517:prevention & control; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D012574:Schools / Q000706:statistics & numerical data / Q000639:trends*; D012737:Sex Factors; D013334:Students / Q000706:statistics & numerical data*