Cited by 460Obesity, Physical Activity, DietObesity and Health PracticesPhysical Activity and Health

The DOI matches its Crossref record; 31 of the 33 references it cites were found in a registry or an index; none of the 34 sources its claims cite is checked for support yet.

Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016

Open access

Abstract

Importance: Differences in childhood obesity by demographics and urbanization have been reported. Objective: To present data on obesity and severe obesity among US youth by demographics and urbanization and to investigate trends by urbanization. Design, Setting, and Participants: Measured weight and height among youth aged 2 to 19 years in the 2001-2016 National Health and Nutrition Examination Surveys, which are serial, cross-sectional, nationally representative surveys of the civilian, noninstitutionalized population. Exposures: Sex, age, race and Hispanic origin, education of household head, and urbanization, as assessed by metropolitan statistical areas (MSAs; large: ≥ 1 million population). Main Outcomes and Measures: Prevalence of obesity (body mass index [BMI] ≥95th percentile of US Centers for Disease Control and Prevention [CDC] growth charts) and severe obesity (BMI ≥120% of 95th percentile) by subgroups in 2013-2016 and trends by urbanization between 2001-2004 and 2013-2016. Results: Complete data on weight, height, and urbanization were available for 6863 children and adolescents (mean age, 11 years; female, 49%). In 2013-2016, the prevalence among youth aged 2 to 19 years was 17.8% (95% CI, 16.1%-19.6%) for obesity and 5.8% (95% CI, 4.8%-6.9%) for severe obesity. Prevalence of obesity in large MSAs (17.1% [95% CI, 14.9%-19.5%]), medium or small MSAs (17.2% [95% CI, 14.5%-20.2%]) and non-MSAs (21.7% [95% CI, 16.1%-28.1%]) were not significantly different from each other (range of pairwise comparisons P = .09-.96). Severe obesity was significantly higher in non-MSAs (9.4% [95% CI, 5.7%-14.4%]) compared with large MSAs (5.1% [95% CI, 4.1%-6.2%]; P = .02). In adjusted analyses, obesity and severe obesity significantly increased with greater age and lower education of household head, and severe obesity increased with lower level of urbanization. Compared with non-Hispanic white youth, obesity and severe obesity prevalence were significantly higher among non-Hispanic black and Hispanic youth. Severe obesity, but not obesity, was significantly lower among non-Hispanic Asian youth than among non-Hispanic white youth. There were no significant linear or quadratic trends in obesity or severe obesity prevalence from 2001-2004 to 2013-2016 for any urbanization category (P range = .07-.83). Conclusions and Relevance: In 2013-2016, there were differences in the prevalence of obesity and severe obesity by age, race and Hispanic origin, and household education, and severe obesity was inversely associated with urbanization. Demographics were not related to the urbanization findings.

Overview

Integrity signals

Registry

Crossref · 10.1001/jama.2018.5158

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

Show all 39 claims

  • The quote only partly states this claim. 1
  • It may state two separate claims as one. 14
  • Probably not a substantial claim. 29
36 of 36
  • The paper relies on this without support.

    The youth excluded from analysis due to missing weight, height, or pregnancy did not differ systematically from included youth in ways that would bias obesity prevalence estimates.

    “In 2013–2016, 152 youth aged 2 to 19 years were missing weight, height, or both and 9 were pregnant and were excluded from the analysis (unweighted percentage, 161 of 7024 participants [2.3%]) leaving a total sample size of 6863.”
  • The paper relies on this without support.

    The changes in NCHS urbanization classification schemes across 2001-2016 did not affect the comparability of urbanization categories over time.

    “Level of urbanization was categorized based on 1990 (for NHANES 2001–2004), 2006 (for NHANES 2005–2012), and 2013 (for NHANES 2013–2016) NCHS classification schemes for counties.”
  • The paper relies on this without support.

    The 99.9% agreement between county of residence and county of examination location observed for 2007-2014 applies to all survey cycles.

    “Unweighted agreement between urbanization level categories based on county of residence and county location of examination was 99.9% for NHANES 2007–2014 participants.”
  • The paper relies on this without support.

    The self-reported race and Hispanic origin and education of household head are accurate enough for the analyses.

    “Race and Hispanic origin was reported by participants or proxy respondents (such as parents) and was categorized as non-Hispanic white, non-Hispanic black, non-Hispanic Asian, Hispanic, and other (including multiple races).”
  • The paper relies on this without support.

    The NHANES sample weights adequately adjust for nonresponse and noncoverage.

    “Examination sample weights were used in all analyses and adjusted for the differential probabilities of selection, noncoverage, and nonresponse.”
5 of 5

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Noncore counties are described as metropolitan but grouped as non-MSA

    Minor

    The methods describe noncore counties as metropolitan counties, then place noncore counties in the non-MSA category.

1 of 1

Citations

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Show all 33 references

2 of the 33 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Ingram, 2012, NCHS urban-rural classification scheme for counties., Vital Health Stat 2, 1
  2. Korn, 1998, Confidence intervals for proportions with small expected number of positive counts estimated from survey data., Surv Methodol, 24
  3. Cochran, 1977, Sampling techniques

Cited by

Sorted by citations

Items 101–200 of 460

Metadata

Authors
Ogden, C. L., Fryar, C. D., Hales, C. M., Carroll, M. D., Aoki, Y., & Freedman, D. S.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Ogden, Cynthia L.
Venue
JAMA
Published
2018-06-19
Volume
319
Issue
23
Pages
2410
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2809044706
Cited by
459
References
33
Citations by year
2026: 14 · 2025: 35 · 2024: 55 · 2023: 57 · 2022: 65 · 2021: 85 · 2020: 78 · 2019: 58 · 2018: 11
FWCI
55.19
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords
childhood obesity, adolescent obesity, morbid obesity, urbanization, metropolitan statistical areas, obesity prevalence, demographic disparities, racial and ethnic disparities, Hispanic origin, household income, educational attainment, sex differences, obesity trends, body mass index, children and adolescents, United States, NHANES
MeSH terms
Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Educational Status, Female, Hispanic or Latino, Humans, Male, Nutrition Surveys, Obesity, Morbid, Population, Risk Factors, United States, Body Mass Index, Prevalence, Age Distribution, Sex Distribution, Young Adult, Pediatric Obesity

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