{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:18:26Z","timestamp":1791656306621,"version":"4.3.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Childhood Obesity"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Research is needed to explore inequities in physical activity (PA) and access to healthy eating resources for children on a national scale. This study examined disparities in childhood obesogenic environments across all United States (US) counties by income and race\/ethnicity and their interaction with county rurality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data for four PA variables (exercise opportunities, school proximity, walkability, crime) and six nutrition variables (grocery stores, farmers markets, fast-food restaurants, full-service restaurants, convenience stores, and births at baby-friendly hospitals) were collected for all US counties (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3142) to comprise the Childhood Obesogenic Environment Index (COEI). Variables were ranked and allocated a percentile for each county, and a total obesogenic environment score was created by averaging variable percentiles. Analysis of variance was used to assess differences by tertiles of county-level median household income (low\/intermediate\/high) and percentage of non-Hispanic (NH) White residents (low\/intermediate\/high). Interaction tests were used to assess effect modification by rurality, and stratified results were presented for all significant interactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were significant differences in COEI values according to tertiles of median household income (F = 260.9,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Low-income counties (M = 54.3, SD = 8.3) had worse obesogenic environments than intermediate (M = 49.9, SD = 7.9) or high (M = 45.9, SD = 8.8) income counties. There was also a significant interaction between rurality and median household income (F = 13.9,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Similarly, there were significant differences in COEI values according to tertiles of race\/ethnicity (F = 34.5,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001), with low percentage NH White counties (M = 51.8, SD = 9.8) having worse obesogenic environment scores than intermediate (M = 48.7, SD = 8.4) or high (M = 49.5, SD = 8.5) NH White counties. There was also a significant interaction between rurality and race\/ethnicity (F = 13.9,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Low-income counties and those with more racial\/ethnic minority residents, especially in rural areas, had less supportive PA and healthy eating environments for youth. Targeted policy and environmental approaches that aimed to address concerns specific to underserved communities are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/chi.2024.0217","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T12:53:21Z","timestamp":1720011201000},"page":"653-657","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Disparities in Obesogenic Environments by Income, Race\/Ethnicity, and Rurality Across All US Counties"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8724-8241","authenticated-orcid":false,"given":"Andrew T.","family":"Kaczynski","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA."},{"name":"Prevention Research Center, University of South Carolina, Columbia, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn E.","family":"Wende","sequence":"additional","affiliation":[{"name":"Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caylin A.","family":"Eichelberger","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Hesam Shariati","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12334"},{"key":"e_1_3_5_3_2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.puhe.2023.07.017","article-title":"Geographic variation and trends in prevalence of obesity among US adolescents, 2016\u20132021","volume":"223","author":"Liu J","year":"2023","unstructured":"Liu J, , Lavie CJ, , Park YMM, et al. 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