A closer examination of neighborhood economic context : do neighborhood economic histories influence child health behaviors?

Child obesity is a critical health issue given that a third of U.S. children are overweight or obese and obese children are at increased risk of adverse health conditions in adulthood. Researchers have examined neighborhood economic context in relation to children’s obesity and obesity-rated health behaviors. Yet, few studies have examined neighborhood economic histories associated with child obesity-related behaviors or the effects of macroeconomic downturns on child obesity-related behaviors. This three article dissertation aims to advance current knowledge on the neighborhood-child obesity relationship in the U.S. by focusing on three areas. The first article reviews prior literature to summarize empirical findings on the effect of neighborhood economic context on child obesity and obesity-related behaviors. The review indicated several limitations in past literature: 1) using self- or parental reported indicators of health behaviors; 2) using a point in-time measure of neighborhood economic context; 3) using an index of neighborhood economic context without justification to include the particular economic measures; 4) lack of testing mediators or moderators, although conceptual frameworks often described potential mediators or moderators; and 5) lack of consideration of how macroeconomic context interacts with neighborhood contexts. The second article examines associations between neighborhood economic histories and child obesity-related behaviors. Findings showed that living in neighborhoods characterized by long-term moderate or high poverty, and poverty increase was associated with higher odds of physical activity among poor children, but was associated with lower odds of physical activity among non-poor children. Living in neighborhoods characterized by poverty decrease (presumably, gentrified neighborhoods) was associated with healthier dietary habits among non-poor children; however, it was not applicable to poor children. The third article investigates the impact of the Great Recession on food in the home environment through its association with neighborhood economic context. Findings reported that adverse neighborhood economic changes after the Great Recession were spatially concentrated in poor neighborhoods and that poor families living in neighborhoods most negatively affected by the Great Recession had higher odds of unhealthy home food environments. Research and policy implications regarding neighborhood-child obesity relationships are also discussed