The Association Between Food Environments and Preschool-Aged Children Obesity Rate: A County-Level Cross- Sectional Study in the United State

Background: Childhood obesity is becoming a serious health problem in the World. Obese children have a 70% chance of being overweight or obese as adults, and have higher risks for many diseases, such as heart disease, type 2 diabetes, stroke, and several types of cancers. Evidence indicates that rural urban differences in terms of food availability and food accessibility may be a major contributor to these geographic health disparities in childhood obesity.;Methods: In this cross-sectional county-level study, I analyzed data from Food Environment Atlas Data Documentation. Multi-linear regression models estimate associations between food availability and food access (percentage of children who have low access, per capita grocery stores, supercenters, convenience stores, specialized food stores, fast-food restaurants, and full-service restaurants) in both urban and rural areas in the United States, and low-income preschool childhood obesity rate during the period 2006 to 2008 and the period 2009 to 2011. Controls include race and poverty rate.;Results: In period of 2006-08, lower preschool-aged children obesity rates were associated with more per capita full-service restaurants in both rural and urban counties. Higher preschool-aged children obesity rates were associated with more grocery stores, convenience stores per capita in urban counties. In the period 2009-11, lower preschool-aged children obesity rates were associated with more per capita full-service restaurants in both rural and urban counties. Higher preschool-aged children obesity rates were associated with more grocery stores per capita in urban counties. However, fast-food restaurants in rural areas are unexpected negatively associated with the preschool-aged children obesity, but not statistically significant.;Conclusion: There is a strong need for public health campaigns to increase awareness of the negative health effects of children obesity and increase engagement of healthy behavior, especially among preschool-aged children. Future perspective studies are needed for the confirmation of study results and exploration of the potential disparities in children health.