title: The Relationship between Childhood Obesity, Low Socioeconomic Status, and Race/Ethnicity: Lessons from Massachusetts.
abstract: BACKGROUND
  Previous studies have shown race/ethnicity, particularly African American and/or Hispanic status, to be a predictor of overweight/obese status in children. However, these studies have failed to adjust for low socioeconomic status (SES). This study assessed whether race/ethnicity remained an independent predictor of childhood obesity when accounting for variations in SES (low-income) among communities in Massachusetts.
  
  
  METHODS
  This study was based on 2009 summarized data from 68 Massachusetts school districts with 111,799 students in grades 1, 4, 7, and 10. We studied the relationship between the rate of overweight/obese students (mean = 0.32; range = 0.10-0.46), the rate of African American and Hispanic students (mean = 0.17; range = 0.00-0.90), and the rate of low-income students (mean = 0.27; range = 0.02-0.87) in two and three dimensions. The main effect of the race/ethnicity rate, the low-income rate, and their interaction on the overweight and obese rate was investigated by multiple regression modeling.
  
  
  RESULTS
  Low-income was highly associated with overweight/obese status (p < 0.0001), whereas the effect of race/ethnicity (p = 0.27) and its interaction (p = 0.23) with low-income were not statistically significant. For every 1% increase in low-income, there was a 1.17% increase in overweight/obese status. This pattern was observed across all African American and Hispanic rates in the communities studied.
  
  
  CONCLUSIONS
  Overweight/obese status was highly prevalent among Massachusetts students, varying from 10% to 46% across communities. Although there were higher rates of overweight/obese status among African American and Hispanic students, the relationship disappeared when controlling for family income. Our findings suggest low SES plays a more significant role in the nation's childhood obesity epidemic than race/ethnicity.
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Robert
authors.initials: R
authors.lastname: Rogers
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Taylor F
authors.initials: TF
authors.lastname: Eagle
authors.affiliation: 2 Massachusetts Department of Public Health , Boston, MA.
authors.forename: Anne
authors.initials: A
authors.lastname: Sheetz
authors.affiliation: 2 Massachusetts Department of Public Health , Boston, MA.
authors.forename: Alan
authors.initials: A
authors.lastname: Woodward
authors.affiliation: 2 Massachusetts Department of Public Health , Boston, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Leibowitz
authors.affiliation: 3 University of Michigan School of Nursing , Ann Arbor, MI.
authors.forename: MinKyoung
authors.initials: M
authors.lastname: Song
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sylvester
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Nicole
authors.initials: N
authors.lastname: Corriveau
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Eva
authors.initials: E
authors.lastname: Kline-Rogers
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Qingmei
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.|4 Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.affiliation: 1 Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System , Ann Arbor, MI.|4 Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Eagle
mesh_terms: D000293:Adolescent; D001741:Black or African American; D015992:Body Mass Index; D002648:Child; D005006:Ethnicity; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D008404:Massachusetts / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D011203:Poverty / Q000706:statistics & numerical data; D012923:Social Class