A Multilevel Approach to Estimating Small Area Childhood Obesity Prevalence at the Census Block-Group Level

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Zhang, Xingyou ; Onufrak, Stephen ; Holt, James B. ; Croft, Janet B.
• Description:
  Introduction
  
  Traditional survey methods for obtaining nationwide small-area estimates (SAEs) of childhood obesity are costly. This study applied a geocoded national health survey in a multilevel modeling framework to estimate prevalence of childhood obesity at the census block-group level.
  
  Methods
  
  We constructed a multilevel logistic regression model to evaluate the influence of individual demographic characteristics, zip code, county, and state on the childhood obesity measures from the 2007 National Survey of Children’s Health. The obesity risk for a child in each census block group was then estimated on the basis of this multilevel model. We compared direct survey and model-based SAEs to evaluate the model specification.
  
  Results
  
  Multilevel models in this study explained about 60% of state-level variances associated with childhood obesity, 82.8% to 86.5% of county-level, and 93.1% of zip code-level. The 95% confidence intervals of block- group level SAEs have a wide range (0.795-20.0), a low median of 2.02, and a mean of 2.12. The model-based SAEs of childhood obesity prevalence ranged from 2.3% to 54.7% with a median of 16.0% at the block-group level.
  
  Conclusion
  
  The geographic variances among census block groups, counties, and states demonstrate that locale may be as significant as individual characteristics such as race/ethnicity in the development of the childhood obesity epidemic. Our estimates provide data to identify priority areas for local health programs and to establish feasible local intervention goals. Model-based SAEs of population health outcomes could be a tool of public health assessment and surveillance.
  
  
• Subjects:
  Female Humans Original Research Pregnancy Smoking Cessation
• Source:
  Prev Chronic Dis. 10.
• ISSN:
  1545-1151
• Document Type:
  Journal Article
• Volume:
  10
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:6a5895c7e7b8ab5cf04aded3571bfc14f8fa2b80c91685776d5b331c43f1cab34e50a76d19ab9495f704347268871f9d4bb9ddd72a6fec494eccd6d2a73fb031
• Download URL:
  https://stacks.cdc.gov/view/cdc/13577/cdc_13577_DS1.pdf
• File Type:
  [PDF - 343.54 KB ]