Objectives: Conflicting findings on associations between food and physical activity (PA) environments and children's weight status demand attention in order to inform effective interventions. We assess relationships between the food and PA environments in inner-city neighborhoods and children's weight status and address sources of conflicting results of prior research.

Methods: Weight status of children ages 3-18 was assessed using parent-measured heights and weights. Data were collected from 702 children living in four low-income cities in New Jersey between 2009 and 2010. Proximity of a child's residence to a variety of food and PA outlets was measured in multiple ways using geo-coded data. Multivariate analyses assessed the association between measures of proximity and weight status.

Results: Significant associations were observed between children's weight status and proximity to convenience stores in the 1/4 mile radius (OR = 1.9) and with presence of a large park in the 1/2 mile radius (OR = 0.41). No associations were observed for other types of food and PA outlets.

Conclusions: Specific aspects of the food and PA environments are predictors of overweight and obese status among children, but the relationships and their detection are dependent upon aspects of the geospatial landscape of each community.

School food and physical activity (PA) environments can influence children’s dietary and physical activity behaviors. However, evidence on whether school environment is associated with students’ weight status is less definitive. In this study, we examined the association between students’ body mass index (BMI) and measures of school food and PA environments. We calculated BMI from nurse-measured data collected on 19,188 6–19-year-old students from 90 public schools in four low-income cities in New Jersey in 2015–2016. Based on a questionnaire administered to school nurses, we constructed 6 food and 3 PA indices capturing the healthfulness of key dimensions in the school food and PA environment domains. Multilevel linear models, stratified by school level (elementary and secondary), examined the association between BMI z-scores and indices of the school environment. The food and PA domains were modeled separately and then combined. Joint significance of indices within each domain was tested. Analyses were conducted in 2019–2020. In the combined model for elementary schools, indices in both the food and PA domains were jointly significant (p = 0.005 and p < 0.001, respectively). With regard to specific indices in the model, students’ BMI z-score was 0.03 units lower for each additional outdoor PA facility (95% CI [−0.06, −0.00]; p = 0.036). Similarly, for secondary schools, both the food and PA domains were jointly significant (p = 0.004 and p = 0.020, respectively). Each additional unhealthy item in vending machines was associated with a 0.12 unit increase in BMI z-score (95% CI [+0.00, 0.23]; p = 0.042). Overall, healthier food and PA environments were associated with lower student BMI.

The tables and graphs in this chartbook were created using data collected by Camden Public Schools for the school year 2008-2009. Rutgers Center for State Health Policy obtained de-identified data from the schools and computed a BMI score and a BMI percentile (BMIPCT) for each child. Weight status is defined using the following BMIPCT categories.

BMIPCT

BMIPCT < 85

BMIPCT ~ 85

BMIPCT ~ 95

BMIPCT ~ 97

Weight Status

Not Overweight or Obese

Overweight and Obese

Obese

Very Obese

BMIPCT categories are presented at the city level and in sub-group analysis by age, gender, and race. Aggregate data are also presented at the school level, with notation, where representativeness of the data was a concern.

Tables and graphs on pages 5, 7, 9, and 11 show comparisons with national estimates (National Health and Nutrition Examination Survey, 2007-2008). The national data are representative of all 2-19 year old children in the US.

Each graph and table is accompanied by brief summary statements. Readers are encouraged to review the actual data presented in tables and graphs as there is much more detail.

The New Jersey Childhood Obesity Study, funded by the Robert Wood Johnson Foundation, aims to provide vital information for planning, implementing and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland.

These five communities are being supported by RWJF's New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity.

Effective interventions for addressing childhood obesity require community-specific information on who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community.

Using a comprehensive research study, the Center for State Health Policy at Rutgers University is working collaboratively with the State Program Office for New Jersey Partnership for Healthy I<ids and the five communities to address these information needs. The main components of the study include:

• A household survey of 1700 families with 3 -18 year old children

• De-identified heights and weights data from public school districts

• Assessment of the food and physical activity environments using objective data

Data books and maps based on the results of the study are being shared with the community coalitions in the five communities to help them plan their interventions.

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity. Effective interventions for addressing childhood obesity require community-specific information on

who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community. Based on comprehensive research, a series of reports are being prepared for each community to assist in planning effective interventions.

The main components of the study were:

• A household telephone survey of 1700 families with 3–18 year old children,

• De-identified heights and weights measured at public schools,

• Assessment of the food and physical activity environments using objective data.

This report presents the results from the household survey. Reports based on school body mass index (BMI) data and food and physical activity environment data are available at www.cshp.rutgers.edu/childhoodobesity.htm.

The New Jersey Childhood Obesity Study was designed to provide vital information for planning, implementing, and evaluating interventions aimed at preventing childhood obesity in five New Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by the Robert Wood Johnson Foundation’s New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity. Effective interventions for addressing childhood obesity require community-specific information on

who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community. Based on comprehensive research, a series of reports are being prepared for each community to assist in planning effective interventions.

The main components of the study were:

• A household telephone survey of 1700 families with 3–18 year old children,

• De-identified heights and weights measured at public schools,

• Assessment of the food and physical activity environments using objective data.

This report presents the results from the household survey. Reports based on school body mass index (BMI) data and food and physical activity environment data are available at www.cshp.rutgers.edu/childhoodobesity.htm.