Obesity Disparities in California Vary by School Ethnic Segregation and School Neighbourhood Income.

objectiveThis study examines how ethnic disparities in childhood obesity differ across combinations of school ethnic composition and school neighbourhood income in California, to identify the contexts in which disparities are greatest. Prior studies have been unable to study this due to the high correlation between segregation and income.

methodsThis observational study focuses on overweight/obesity data objectively measured among California public school children in 2018/2019 and school neighbourhood data from the American Community Survey, using a 'within versus between' differences analysis.

resultsBlack and Latino children had higher overweight/obesity prevalence than White children, but disparities varied across schools. Disparities were smallest in integrated low-income schools: the Black versus White (B/W) and the Latino versus White (L/W) disparities were 3% and 10%, respectively. In integrated high-income schools, these disparities were 8% and 13%, respectively. Disparities between segregated low-income schools and segregated high-income schools were 11% (B/W) and 14% (L/W), and 22% (B/W) and 26% (L/W). The largest disparity was between minority children in minority-segregated low-income schools compared to White children in White-segregated high-income schools (B/W disparity 23% and L/W 28%).

conclusionsPlace-based interventions to reduce childhood obesity should prioritize low-income, ethnically segregated schools, where the largest disparities were observed.