Ethnic and Gender Differences in Pediatric Obesity

Although obesity is on the rise among all demographic groups, prevalence rates differ across gender and ethnic groups. Results from the National Health and Nutrition Examination Survey (NHANES) indicate that non-Hispanic black female children and adolescents had the highest overweight rates and were significantly more likely to be overweight than non-Hispanic white female children and Mexican American female children (Ogden et al., 2006). This trend continues into adulthood, when non-Hispanic black women are more likely than any other subgroup to be obese. Among males, Mexican American children and adolescents had significantly higher overweight rates than non-Hispanic white and non-Hispanic black children and adolescents.

Consequences of Pediatric Obesity

The consequences of pediatric obesity are numerous, and their severity has been realized only in recent years. Serious consequences can be seen in childhood and into adulthood, including increased risk for a variety of physical and psychosocial difficulties.

Studies have found that obese and overweight children are at elevated risk for type 2 diabetes, sleep apnea, arthritis, gallstones, and some types of cancer (Ravussin & Swinburn, 1992; Thompson, Edelsburg, Kinsey, & Oster, 1998; Wang & Dietz, 2002). Psychosocial costs include increased risk for negative self-concepts, lower popularity, peer victimization, and lower overall quality of life (Davison & Birch, 2001; Erickson, Robinson, Haydel, & Killen, 2000; Storch, et al., 2007; Thompson & Tantleff-Dunn, 1998; Whitaker, Wright, Pepe, Seidel, & Dietz, 1997).

Overweight children are also at risk for obesity into adulthood, which in turn is associated with a number of medical and mental health risks (Freedman et al., 2001). Beyond individual consequences, the costs of the increasing prevalence of obesity to the national health care system promise to be substantial.

In light of the myriad of direct and indirect consequences of pediatric obesity for the individual and the nation, public attention and rhetoric on the subject have escalated recently. The discussion has focused on a number of important topics, including policy issues, prevention efforts, and intervention strategies. Each of these will be explored in greater detail throughout the book, but we offer an overview here as a way of framing some of the most important issues.

Pediatric obesity has increased two- to threefold in the past thirty years in the United States and continues to rise. As one of the most frequent pediatric chronic conditions, it is important to define populations of children at higher risk for obesity to direct limited resources for treatment, prevention, and research. Individual risk factors such as parental overweight or television viewing have been well described but are not particularly useful to direct resources to the most vulnerable children. Nationally representative surveys show that Mexican American and non-Hispanic black children are at higher risk for obesity than are non-Hispanic white children. Data on the prevalence of overweight in Asian American and non-Mexican American Latino children, particularly children from Puerto Rico, are scarce. Among non-Hispanic white adolescents, overweight is more frequent with lower socioeconomic status, whereas in non-Hispanic black and Mexican American adolescents this association is less clear or may be in the opposite direction. Although the associations of ethnicity, race, and socioeconomic factors with pediatric overweight are relatively well defined, other important social health determinants are less well understood. For example, it is unclear if children living in medically underserved areas and using community health centers are at increasing risk for overweight or if urban, suburban, or rural US areas have the highest prevalence of pediatric overweight. These are important questions to answer to adequately plan public health and research efforts and train health professionals.