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Pie graph: CSHCN who were overweight Pie graph: Non-CSHCN who were overweight Bar graph: percent of obese children by complexity of condition Bar graph: Overweight and obese by age and CSHCN status Bar graph: Overweight and obese by poverty status and CSHCN status

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Overweight and Obesity

Maintaining a healthy body weight is as important for children as for adults, as overweight children are at risk for development of Type 2 diabetes, heart problems, high blood pressure and other health concerns that can continue throughout their lives. Establishing and maintaining a healthy body weight is an important precursor to long-term adolescent and adult health.

Because children are growing, their weight constantly increases. As a result, overweight and obesity in children are defined relative to the population of children of the same age and sex, rather than against an absolute standard. Those at or above the 85th percentile in body-mass index (BMI) for their age and sex are considered to be overweight, and those at or above the 95th percentile are classified as obese. The NSCH measures children's BMI using a parent's report of the child's height and weight. These reports are considered to be most accurate for children aged 10-17, so this analysis is limited to that age group. Obesity can be both a cause and a consequence of special health care needs; that is, overweight and obesity can lead to health problems, but functional limitations, diet changes, and medications related to health problems can also lead to overweight and obesity.

Children aged 10-17 with special health care needs are more likely to be overweight or obese than other children of the same age: 36.3 percent of CSHCN were classified as overweight or obese based on parent-reported height and weight, compared to 30.2 percent of children without special health care needs. This difference was significant even after statistical adjustment for other socio-demographic differences between CSHCN and non-CSHCN. Children with more complex service needs—those who require more than prescription medications to manage their conditions—are the most likely to be overweight or obese (38.5 percent). Across States, the percentage of CSHCN aged 10-17 identified as overweight or obese ranged from 18.1 percent to 54.4 percent.

Rates of overweight and obesity are highest among CSHCN in low-income households and in racial and ethnic minority groups, likely due to less opportunity to access healthy foods and regular exercise. Among CSHCN with household incomes below the Federal poverty level (FPL), nearly half (48.4 percent) are overweight or obese, compared to 26.9 percent of CSHCN with household incomes of 400 percent or more of FPL. Among households with higher incomes, CSHCN are more likely to be overweight or obese than non-CSHCN.

Rates of overweight and obesity also vary by racial/ethnic group: nearly 45 percent of Black children and Hispanic children in English-speaking households were overweight or obese, compared to 31.9 percent of White children and 34.7 percent of Hispanic children in Spanish-speaking households.

While the percentage of children who are overweight or obese remained stable between 2003 and 2007, the rate of obesity increased from 14.8 percent to 16.4 percent. Among CSHCN, the rates of both overweight/obesity and obesity alone did not change significantly over this period, although in both periods CSHCN were at higher risk than non-CSHCN for overweight or obesity.