PediatricsORIGINAL ARTICLE

Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children’s Health

Kelsi Batioja, BS; Covenant Elenwo, MPH; Amy Hendrix-Dicken, MA; Lamiaa Ali, MD; Marianna S. Wetherill, PhD; and Micah Hartwell, PhD
Notes and Affiliations
Notes and Affiliations

Received: October 20, 2023

Accepted: December 4, 2023

Published: January 9, 2024

  • Kelsi Batioja, BS, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Covenant Elenwo, MPH, 

    Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA

  • Amy Hendrix-Dicken, MA, 

    Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA

  • Lamiaa Ali, MD, 

    Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA

  • Marianna S. Wetherill, PhD, 

    College of Public Health – Schusterman Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA

  • Micah Hartwell, PhD, 

    Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

Abstract

Context: Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity.

Objectives: Our primary objective was to utilize the National Survey of Children’s Health (NSCH) 2021 data to determine the current associations between childhood obesity and SDOH. Secondarily, we estimated the prevalence of select SDOH among children with obesity.

Methods: We conducted a cross-sectional analysis of 2021 NSCH to extract data related to the SDOH domains. We extracted sociodemographic variables to utilize as controls and constructed logistic regression models to determine associations, via odds ratios, between SDOH and childhood obesity.

Results: Within the binary regression models, children with obesity (≥95th percentile) were more likely than children without obesity to experience SDOH in all domains. After controlling for sociodemographic variables, children with obesity were significantly more likely to experience food insecurity when compared to children without obesity (adjusted odds ratio [AOR]=1.39; 95 % confidence interval [CI]: 1.13–1.17).

Conclusions: In line with the current American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG), improving policies for nutrition programs and addressing the lack of access to nutritious foods may alleviate some food insecurity. Ensuring that children have access to sufficient nutritious foods is critical in addressing childhood obesity and thus decreasing risk of chronic disease.

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