Childhood Obesity: A Case Study

Socioeconomic Factors: Rarely is childhood obesity caused by a medical condition. A child’s environment is very complex and includes family, peers, school, community/neighborhoods, and society at large, as filtered through media, advertising, and prevailing social norms. Socioeconomic status is an important determinant of standard of living and health status, as it influences the incidence and prevalence of various health conditions such as childhood obesity. Several ways of measuring socioeconomic status have been proposed, and most of them include some quantification of family income, parental education, neighborhoods, and healthy food accessibility.

Poverty has a major impact on a child’s health. Low-income families cannot always gain access to good housing, education, and many other things that are basic life necessities. As a result, they are often forced to settle in a neighborhood characterized by social exclusion that has limited infrastructure for a healthy environment. These neighborhoods frequently lack full-service grocery stores and farmers’ markets where residents can buy a variety of healthy and high-quality fruits, vegetables, whole grains, and low-fat dairy products.4 The
residents of these neighborhoods usually have limited transportation, and therefore they usually shop at small neighborhood convenience and corner stores, where fresh produce and low-fat items are limited, if available at all. Several literature reviews have examined neighborhood disparities in food access and have found that neighborhood residents with better access to supermarkets and limited access to convenience stores tend to have healthier diets and reduced risk of childhood obesity.4

In 2009, the U.S.
Department of Agriculture conducted a 1-year study to assess the magnitude of areas with limited access to affordable and nutritious food. The study found that 23.5 million people live in low-income neighborhoods that are more than 1 mile away from a supermarket or large grocery store. Also, the study found that these poor neighborhoods had half as many supermarkets as wealthy neighborhoods have. Furthermore, the study revealed that eight percent of residents in low income areas are African American compared to 31 percent of whites.5 In West Louisville, Kentucky, where the low-income African American neighborhoods are located, there is only one supermarket for every 25,000 residents, compared to the county average of one supermarket for every 12,500
residents.6

In contrast to full-service grocery stores and farmers’ markets, low-income communities and neighborhoods have access to ample choices of fast food restaurants. “Fast food restaurants in African American’s neighborhoods have significantly higher odds of using kids' meal toy displays to market their products to children compared to restaurants in white neighborhoods,” said Punam Ohri-Vachaspati.7 This association creates a higher risk for African American children to consume unhealthy diets, including fast food, and to have a higher potential of obesity.

The Daily Beast published a report ranking the top cities in terms of the number of chain restaurants. The report included a total of 40 towns that have populations over 200,000. In the list, which ranked the top 40 towns by the number of fast food chain restaurants to the population, Louisville, Kentucky was ranked second (behind Orlando). In The Consumerist’s top 10 cities with the highest fast food saturation list, Louisville was found to have 377 fast food restaurants, which means 147.1 fast food restaurants per 100,000.8 Most of these restaurants are distributed in downtown and West Louisville Metro, where the African American communities and neighborhoods are located