Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Jamiur M. Robison

Abstract

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated that the presence of detracting neighborhood elements was strongly associated with food insecurity and perceived safety. Binary logistic regression analyses, controlling for sex, age, and race/ethnicity, showed a 23% (OR = 1.230; 95% CI, 1.151-1.315), 34.8% (OR = 1.348; 95% CI, 1.209-1.505), and 48.5% (OR = 1.485; 95% CI, 1.300-1.696) increase in odds of obesity in respondents who live in areas with one, two, and all three detracting elements, respectively. Controlling for the same variables and socioeconomic status, there was a 90.4% (OR = 1.904; 95% CI, 1.203-3.016) and 80.5% (OR = 1.805; 95 CI, 1.017-3.203) increase in odds of T2DM among those who resided in a neighborhood with two and all three detracting neighborhood elements, respectively. Predictors of T2DM were overweight/obese BMI, 12–17 years old, living with grandparents, food insecure, and living in a neighborhood with the presence of two detracting elements. Implications for positive social change include understanding the relationship between location, policy and health outcomes that can foster health equity and social justice.

Download

Included in

Epidemiology Commons

Share

 
COinS