(SDAR) Socioeconomic disparities in early origins of childhood obesity and body mass index trajectories

This is an application for R40 MCH SDAR Program (HRSA-18-072). This project will address MCHB Strategic Research Issue #II 'MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations' and Issue #IV 'Promoting the healthy development of MCH populations'. It contributes to understanding and reducing socioeconomic disparities in childhood obesity in the US from the early life. Childhood obesity is a major public health issue and 17.2% of US children were obese and 16.2% were overweight in 2013-2014.1 2 There are alarming widening socioeconomic disparities in childhood obesity in the US. Children from socioeconomically disadvantaged families (e.g. low parental education and/or low family income) have higher obesity rate than those from advantaged families: 25% among children with parental education =high school vs. 7% among those with parental college education. It remains unclear the developmental timings/ages when socioeconomic disparities in childhood obesity emerge and widen in the US or which early life determinants cause these disparities. Evidence supports developmental origins of obesity.3 4 Addressing socioeconomic disparities in obesity from early life period (prenatal infancy and early childhood) could inform intervention to reduce these disparities from the origins which has not achieved by existing interventions. In addition it is likely but not tested yet that food assistance programs (e.g. WIC and SNAP) and well-child care can protect low SES children from obesity through improving food security and correcting abnormal weight. The overall goal of our study is to understand when and why socioeconomic disparities in childhood obesity start in early life and how to reduce these disparities through food assistance policy and well-child care. Guided by a life course framework we will use existing secondary data from two US national longitudinal birth cohorts that tracked mother-child dyads from pregnancy to age 6 years (y): 1) the Early Childhood Longitudinal Study - Birth (ECLS-B 2001- 2007 N=10 700) 5 6 2) the Infant Feeding Practices Study II (IFPS II 2005-2007 N=3 033 newborns)7 and its Year Six Follow-Up (Y6FU 2012 N=1 542).8 In addition we will use growth data from the Early Childhood Longitudinal Study - Kindergarten (ECLS-K 1998-2007 N=22 666)9 to facilitate the analysis on risk of obesity and body mass index (BMI) trajectories by extending the age period to 14 y. The PI has access to all 3 datasets and has 5 publications on childhood obesity growth and diet using ECLS-B10-13 and IFPS II14 data since 2014. Our Specific Aims are: Aim 1) to examine socioeconomic disparities in risk of childhood obesity and BMI trajectories up to 14 y Aim 2) to explore modifiable root causes (e.g. maternal obesity and smoking infant feeding and sleep parenting food insecurity child diet and eating behaviors) of socioeconomic disparities in risk of childhood obesity through mediation analyses Aim 3) to test whether participation in food assistance programs (WIC and/or SNAP) and adherence to well- child care visits can modify socioeconomic disparities in risk of childhood obesity in the US.

Wen X, Mi B, Wang Y, Taveras EM, Bartashevskyy M?. Modifiable mediators for socioeconomic disparities in childhood obesity in the United States. International Journal of Obesity. Under review. 2020