ArticleJAMA2014
Association between casino opening or expansion and risk of childhood overweight and obesity.
Article in JAMA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Sex and body size disparities under MELD 3.0: Evaluation of persisting gaps in liver transplant access.Hepatology (Baltimore, Md.) · 2026Article
- Poverty and Childhood Obesity: Current Evidence and Methodologies for Future Research.Current obesity reports · 2025Review
- What is the causal effect of income gains on youth obesity? Leveraging the economic boom created by the Marcellus Shale development.Social science & medicine (1982) · 2021Article
- Using Electronic Medical Record Data to Better Understand Obesity in Hispanic Neighborhoods in El Paso, Texas.International journal of environmental research and public health · 2020Article
- Menstrual health and hygiene among Indigenous Australian girls and women: barriers and opportunities.BMC women's health · 2019Article
- Low-income workers' perceptions of wages, food acquisition, and well-being.Translational behavioral medicine · 2019Article
- Casino Ownership and Health-Related Community Resources Among Native American Tribes in California.Preventing chronic disease · 2019Article
- The Role of Children's Health in the Intergenerational Transmission of Economic Status.Child development perspectives · 2017Article
- Association between Native American-owned casinos and the prevalence of large-for-gestational-age births.International journal of epidemiology · 2017Article
- The development of scientific evidence for health policies for obesity: why and how?International journal of obesity (2005) · 2017Review
- Impacts of casinos on key pathways to health: qualitative findings from American Indian gaming communities in California.BMC public health · 2016Article
- Gains in income during early childhood are associated with decreases in BMI z scores among children in the United States.The American journal of clinical nutrition · 2015Article
Corrections and comments
- Commented on by
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
importanceEconomic resources have been inversely associated with risk of childhood overweight/obesity. Few studies have evaluated whether this association is a direct effect of economic resources or is attributable to unmeasured confounding or reverse causation. American Indian-owned casinos have resulted in increased economic resources for some tribes and provide an opportunity to test whether these resources are associated with overweight/obesity.
objectiveTo assess whether openings or expansions of American Indian-owned casinos were associated with childhood overweight/obesity risk. DESIGN, SETTING, AND
participantsWe used repeated cross-sectional anthropometric measurements from fitness testing of American Indian children (aged 7-18 years) from 117 school districts that encompassed tribal lands in California between 2001 and 2012. Children in school districts encompassing American Indian tribal lands that either gained or expanded a casino were compared with children in districts with tribal lands that did not gain or expand a casino. MAIN OUTCOMES AND MEASURES: Per capita annual income, median annual household income, percentage of population in poverty, total population, child overweight/obesity (body mass index [BMI] ≥85th age- and sex-specific percentile) and BMI z score.
resultsOf the 117 school districts, 57 gained or expanded a casino, 24 had a preexisting casino but did not expand, and 36 never had a casino. The mean slots per capita was 7 (SD, 12) and the median was 3 (interquartile range [IQR], 0.3-8). Among districts where a casino opened or expanded, the mean change in slots per capita was 13 (SD, 19) and the median was 3 (IQR, 1-11). Forty-eight percent of the anthropometric measurements were classified as overweight/obese (11,048/22,863). Every casino slot machine per capita gained was associated with an increase in per capita annual income (β = $541; 95% CI, $245-$836) and a decrease in percentage in poverty (β = -0.6%; 95% CI, -1.1% to -0.20%) among American Indians living on tribal lands. Among American Indian children, every slot machine per capita gained was associated with a decreased probability of overweight/obesity by 0.19 percentage points (95% CI, -0.26 to -0.11 percentage points) and a decrease in BMI z score (β = -0.003; 95% CI, -0.005 to -0.0002). CONCLUSIONS AND RELEVANCE: In this study, opening or expanding a casino was associated with increased economic resources and decreased risk of childhood overweight/obesity. Given the limitations of an ecological study, further research is needed to better understand the mechanisms behind this association.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.