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Paediatrics

Pediatric obesity during COVID-19: the role of neighborhood social vulnerability and collective efficacy

International Journal of Obesity volume 48, pages 550–556 (2024)Cite this article

Subjects

Abstract

Introduction

Childhood obesity increased in the first year of COVID-19 with significant disparities across race, ethnicity, and socioeconomic status. Social distancing led to fewer physical activity opportunities but increased screen time and high-calorie food consumption, all co-determined by neighborhood environments. This study aimed to test the moderation effects of neighborhood socioeconomic and built environments on obesity change during COVID-19.

Methods

Using electronic health records from a large pediatric primary care network in 2018–2022, we cross-sectionally examined 163,042 well visits of 2–17-year-olds living in Philadelphia County in order to examine (1) the pandemic’s effect on obesity prevalence and (2) moderation by census-tract-level neighborhood socioeconomic disadvantage, crime, food and physical activity-related environments using interrupted-time-series analysis, Poisson regression, and logistic regression.

Results

Weekly obesity prevalence increased by 4.9 percent points (pp) during the pandemic (January 2021–August 2022) compared to pre-pandemic (March 2018–March 2020) levels. This increase was pronounced across all age groups, racially/ethnically minoritized groups, and insurance types (ranging from 2.0 to 6.4 pp) except the Non-Hispanic-white group. The increase in obesity among children racially/ethnically minoritized groups was significantly larger in the neighborhoods with high social vulnerability (3.3 pp difference between high and low groups), and low collective efficacy (2.0 pp difference between high and low groups) after adjusting for age, sex, and insurance type.

Conclusions

Racially/ethnically minoritized children experienced larger obesity increases during the pandemic, especially those in socioeconomically disadvantaged neighborhoods. However, the buffering effect of community collective efficacy on the disparities underscores the importance of environments in pediatric health.

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Fig. 1: Time series line plot of obesity prevalence.
Fig. 2: Obesity increase (percent point) during COVID-19 among racially/ethnically minoritized children by neighborhood social vulnerability and collective efficacy in multivariate model.

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Data availability

The data analyzed during this study are held securely by the CHOP Arcus team. Due to privacy concerns and regulatory restrictions, the data cannot be made available publicly. Interested researchers may contact the CHOP Arcus team to discuss the feasibility of accessing the study data.

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Acknowledgements

We would like to thank Rachel Sanderlin and Vivian Shoukrun for their assistance in editing.

Funding

This project was supported by the National Heart, Lung and Blood Institute (K01HL155860) and Clinical Futures, a Research Center of Emphasis at Children’s Hospital of Philadelphia. The research presented in this paper is that of the authors and does not reflect the official policy of the NHLBI and CHOP. No financial disclosures were reported by the authors of this paper.

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Authors and Affiliations

  1. Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Jungwon Min & Vicky Tam

  2. Clinical Futures and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Stephanie Mayne

  3. Department of Pediatrics and Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Stephanie Mayne

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  1. Jungwon Min
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Contributions

JM conceptualized and designed the study, extracted and analyzed data, interpreted results, drafted the initial manuscript, and critically reviewed and revised the manuscript. VT contributed to the study design, extracted and analyzed data, and critically reviewed and revised the manuscript. SM contributed to the study design, critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Jungwon Min.

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Min, J., Tam, V. & Mayne, S. Pediatric obesity during COVID-19: the role of neighborhood social vulnerability and collective efficacy. Int J Obes 48, 550–556 (2024). https://doi.org/10.1038/s41366-023-01448-5

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