{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:34:56Z","timestamp":1793136896325,"version":"4.5.0"},"reference-count":57,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Physical and social neighborhood attributes may have implications for children\u2019s growth and development patterns. The extent to which these attributes are associated with body mass index (BMI) trajectories and obesity risk from childhood to adolescence remains understudied.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine associations of neighborhood-level measures of opportunity and social vulnerability with trajectories of BMI and obesity risk from birth to adolescence.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used data from 54 cohorts (20\u202f677 children) participating in the Environmental Influences on Child Health Outcomes (ECHO) program from January 1, 1995, to January 1, 2022. Participant inclusion required at least 1 geocoded residential address and anthropometric measure (taken at the same time or after the address date) from birth through adolescence. Data were analyzed from February 1 to June 30, 2022.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Census tract\u2013level Child Opportunity Index (COI) and Social Vulnerability Index (SVI) linked to geocoded residential addresses at birth and in infancy (age range, 0.5-1.5 years), early childhood (age range, 2.0-4.8 years), and mid-childhood (age range, 5.0-9.8 years).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n BMI (calculated as weight in kilograms divided by length [if aged &amp;lt;2 years] or height in meters squared) and obesity (age- and sex-specific BMI \u226595th percentile). Based on nationwide distributions of the COI and SVI, Census tract rankings were grouped into 5 categories: very low (&amp;lt;20th percentile), low (20th percentile to &amp;lt;40th percentile), moderate (40th percentile to &amp;lt;60th percentile), high (60th percentile to &amp;lt;80th percentile), or very high (\u226580th percentile) opportunity (COI) or vulnerability (SVI).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 20\u202f677 children, 10 747 (52.0%) were male; 12 463 of 20 105 (62.0%) were White, and 16 036 of 20 333 (78.9%) were non-Hispanic. (Some data for race and ethnicity were missing.) Overall, 29.9% of children in the ECHO program resided in areas with the most advantageous characteristics. For example, at birth, 26.7% of children lived in areas with very high COI, and 25.3% lived in areas with very low SVI; in mid-childhood, 30.6% lived in areas with very high COI and 28.4% lived in areas with very low SVI. Linear mixed-effects models revealed that at every life stage, children who resided in areas with higher COI (vs very low COI) had lower mean BMI trajectories and lower risk of obesity from childhood to adolescence, independent of family sociodemographic and prenatal characteristics. For example, among children with obesity at age 10 years, the risk ratio was 0.21 (95% CI, 0.12-0.34) for very high COI at birth, 0.31 (95% CI, 0.20-0.51) for high COI at birth, 0.46 (95% CI, 0.28-0.74) for moderate COI at birth, and 0.53 (95% CI, 0.32-0.86) for low COI at birth. Similar patterns of findings were observed for children who resided in areas with lower SVI (vs very high SVI). For example, among children with obesity at age 10 years, the risk ratio was 0.17 (95% CI, 0.10-0.30) for very low SVI at birth, 0.20 (95% CI, 0.11-0.35) for low SVI at birth, 0.42 (95% CI, 0.24-0.75) for moderate SVI at birth, and 0.43 (95% CI, 0.24-0.76) for high SVI at birth. For both indices, effect estimates for mean BMI difference and obesity risk were larger at an older age of outcome measurement. In addition, exposure to COI or SVI at birth was associated with the most substantial difference in subsequent mean BMI and risk of obesity compared with exposure at later life stages.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, residing in higher-opportunity and lower-vulnerability neighborhoods in early life, especially at birth, was associated with a lower mean BMI trajectory and a lower risk of obesity from childhood to adolescence. Future research should clarify whether initiatives or policies that alter specific components of neighborhood environment would be beneficial in preventing excess weight in children.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.47957","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T11:33:45Z","timestamp":1671708825000},"page":"e2247957","source":"Crossref","is-referenced-by-count":119,"title":["Associations of Neighborhood Opportunity and Social Vulnerability With Trajectories of Childhood Body Mass Index and Obesity Among US Children"],"prefix":"10.1001","volume":"5","author":[{"given":"Izzuddin M.","family":"Aris","sequence":"first","affiliation":[{"name":"Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Perng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora"},{"name":"Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Dabelea","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora"},{"name":"Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora"},{"name":"Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"Padula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Alshawabkeh","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen M.","family":"V\u00e9lez-Vega","sequence":"additional","affiliation":[{"name":"UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy L.","family":"Aschner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey"},{"name":"Department of Pediatrics, Albert Einstein College of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Carlos A.","family":"Camargo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Emergency Medicine, Massachusetts General Hospital, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara J.","family":"Sussman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne L.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Avera Research Institute, Sioux Falls, South Dakota"},{"name":"Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assiamira","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeyi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L. 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