Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

(SDAS) Co-Morbid Physical And Mental Health Care Needs For Children And Youth At Risk For Obesity

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Project Number: R40MC26825
Grantee: Wellesley College
Department/Center: Wellesley Centers for Women
Project Date: 04/01/2014

Final Report


Principal Investigator

Michelle V Porche, Ed.D
Associate Director, Senior Research Scientist
106 Central Street
Wellesley Hills, MA  02481
Phone: (781) 283-2498


  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)


For this proposed R40 Maternal and Child Health Secondary Data Analysis Studies (MCH SDAS) Program study, secondary data analysis of the 2012 National Survey of Children’s Health (NSCH) will be used to investigate prevalence of co-morbid chronic physical and mental health care needs that put youth at risk for overweight and obesity, and for poor academic performance in school, as mediated by physical activity and moderated by child, family, and neighborhood characteristics. Models are based on Goldhagen’s (2007) Health Equity model that integrates principles and practice of social justice, social capital, human rights and health-equity ethics. It is an emerging model for health that provides a blueprint for restructuring our approach to health and wellness that is relevant to the prevention and treatment of obesity. The health problem of obesity has been approached with a classical biomedical model in which obesity is conceptualized as a result of food choice and genetics. However, the socio-economic, political, environmental and cultural and social determinants of obesity have often been overlooked. As such, a relevant and effective response to obesity (especially for children and adolescents with disabilities) should be a health equity model that includes the community and culture. The NSCH 2012 will be used to model these associations for a subset of the sample that have data on bodymass index (BMI): children and youth ages 10 to 17 years old (n = 43,864). Over 16% of the sample children are identified with complex chronic health care needs. Of these, 18% are identified as overweight and 21% are identified as obese. Over a third of children with special health care needs have emotional, behavioral or developmental issues, and those children are at greater risk for obesity (39% vs. 33%). Analyses will allow comparisons on obesity risk and school outcomes for children with co-morbid special health care needs and those without, and will explore ethnic and racial disparities. The aims of this proposal are: (1) To model the prevalence and types of co-morbid chronic physical and mental health care needs for a national sample of children ages 10-17 in order to assess the association with risk of (1) obesity, and (2) poor academic performance, as mediated by physical activity and moderated by child and family, and neighborhood characteristics; and (2) To test the association of special health care needs to obesity and school outcomes by race and ethnicity using both within and between ethnic racial group analyses including culturally specific factors (e.g., language spoken in the home). Findings will add to a growing understanding of the relative risk of various co-morbid conditions and the mechanisms that may exacerbate or limit the impact of these childhood conditions on subsequent obesity and academic outcomes.


Listed is descending order by year published.

Porche MV, Costello DM, Rosen-Reynoso M. Adverse family experiences, child mental health, and educational outcomes for a national sample of students. School Mental Health. 2015;8(1):44-60 (Epub ahead of print]


Access to Health Care, Chronic Illness, Health Disparities, Mental Health & Wellbeing, Neighborhood, Obesity & Weight, School Outcomes & Services, Special Health Care Needs

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