Declining Trends and Widening Disparities in Overweight and Obesity Prevalence Among Massachusetts Public School Districts, 2009-2014.
OBJECTIVE
We evaluated the overall and sociodemographic disparities in trends in prevalence of childhood overweight and obesity in Massachusetts public school districts between 2009 and 2014.


METHODS
In 2009, Massachusetts mandated annual screening of body mass index for students in grades 1, 4, 7, and 10. This was part of the statewide Mass in Motion prevention programs. We assessed trends in the prevalence of overweight and obesity between 2009 and 2014 by district, gender, grade, and district income.


RESULTS
From 2009 to 2014, prevalence decreased 3.0 percentage points (from 34.3% to 31.3%) statewide. The 2014 district-level rates ranged from 13.9% to 54.5% (median = 31.2%). When stratified by grade, the decreasing trends were significant only for grades 1 and 4. Although rates of districts with a median household income greater than $37, 000 improved notably, rates of the poorest remain unchanged and were approximately 40%.


CONCLUSIONS
Although overall prevalence began to decrease, the geographic and socioeconomic disparities in childhood obesity are widening and remain a public health challenge in Massachusetts. Special efforts should be made to address the needs of socioeconomically disadvantaged districts and to narrow the disparities in childhood obesity.
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
Wenjun
W
Li
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
James H
JH
Buszkiewicz
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
Robert B
RB
Leibowitz
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
Mary Ann
MA
Gapinski
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
Laura J
LJ
Nasuti
Wenjun Li is with the Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester. James H. Buszkiewicz, Robert B. Leibowitz, Mary Ann Gapinski, Laura J. Nasuti, and Thomas G. Land are with the Massachusetts Department of Public Health, Boston.
Thomas G
TG
Land
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence