Neighborhood deprivation and early childhood obesity: Characterizing longitudinal pathways & identifying multilevel mediators and moderators

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PROJECT SUMMARY/ABSTRACT Obese children are more likely to become obese adults who are at greater risk for heart disease and early death, and children from low-income families are at greater risk for developing obesity. Some work has linked neighborhood characteristics and obesity in children, but little is known about the longitudinal effects (and mechanisms) of neighborhood deprivation on the weight trajectories of low-income children. Moreover, few studies have incorporated neighborhood, family, and individual level factors to understand the complex and multilevel pathways leading to childhood obesity. Understanding these processes early in childhood is critical as the early emergence of obesity can set the trajectory for life long health risks. My long-term goal is to work as an independent researcher investigating multilevel influences on child health and development, with a focus on obesity, to inform preventive interventions and population health strategies. This K01 Mentored Research Scientist Development Award will fill critical training gaps in childhood obesity, neighborhood analysis, the intersection of self-regulation and health, and translational research. My dedicated and expert team of mentors at the NYU School of Medicine and Columbia University will oversee my training activities including structured mentorship meetings; mentor-guided instruction; participation in seminars and workshops; hands-on learning; and coursework. The complementary set of research studies will identify longitudinal associations of neighborhood deprivation with early childhood body mass index (BMI) trajectories and determine the ways in which children’s family and neighborhood social context and executive function skills moderate or mediate these associations in both rural and urban contexts. My primary hypothesis is that greater neighborhood deprivation will predict greater weight gain in early childhood and that children’s social context and executive function will shape this relation. To test this hypothesis, I will first identify longitudinal effects of neighborhood deprivation on children’s BMI trajectories in a rural low-income sample. Second, I will determine how social context factors at the neighborhood (e.g. safety, collective socialization, and geographic isolation) and family (e.g. income and education) levels moderate relations of neighborhood deprivation to BMI trajectories. Third, I will characterize the ways in which children’s executive function skills mediate and moderate relations of neighborhood deprivation to BMI trajectories. Finally, I will replicate these analyses in a high-poverty urban sample of children. This project takes an innovative, interdisciplinary approach and is the first to examine the complex ways in which neighborhood deprivation, social context, and executive function predict children’s BMI trajectories. Through these research and training experiences I will transition to an independent researcher and will be prepared to apply for an R01 to investigate multilevel mechanisms and moderators of childhood obesity and to experimentally test the hypothesis that improvements in executive function could buffer obesity risk in children from disadvantaged neighborhoods within the context of an ongoing large-scale effectiveness study.