Author(s): Van Cleave J, Gortmaker SL, Perrin JM
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Abstract CONTEXT: Rates of obesity and other childhood chronic conditions have increased over recent decades. Patterns of how conditions change over time have not been widely examined. OBJECTIVE: To evaluate change in prevalence of obesity and other chronic conditions in US children, including incidence, remission, and prevalence. DESIGN, SETTING, AND PARTICIPANTS: Prospective study using the National Longitudinal Survey of Youth-Child Cohort (1988-2006) of 3 nationally representative cohorts of children. Children were aged 2 through 8 years at the beginning of each study period, and cohorts were followed up for 6 years, from 1988 to 1994 (cohort 1, n = 2337), 1994 to 2000 (cohort 2, n = 1759), and 2000 to 2006 (n = 905). MAIN OUTCOME MEASURES: Parent report of a child having a health condition that limited activities or schooling or required medicine, special equipment, or specialized health services and that lasted at least 12 months. Obesity was defined as a body mass index at or above the 95th percentile for age. Chronic conditions were grouped into 4 categories: obesity, asthma, other physical conditions, and behavior/learning problems. RESULTS: The end-study prevalence of any chronic health condition was 12.8\% (95\% confidence interval [CI], 11.2\%-14.5\%) for cohort 1 in 1994, 25.1\% (95\% CI, 22.7\%-27.6\%) for cohort 2 in 2000, and 26.6\% (95\% CI, 23.5\%-29.9\%) for cohort 3 in 2006. There was substantial turnover in chronic conditions: 7.4\% (95\% CI, 6.5\%-8.3\%) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end, 9.3\% (95\% CI, 8.3\%-10.3\%) reported conditions at the beginning that resolved within 6 years, and 13.4\% (95\% CI, 12.3\%-14.6\%) had new conditions that arose during the 6-year study period. The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 (51.5\%; 95\% CI, 47.3\%-55.0\%), and there were higher rates among male (adjusted odds ratio [AOR], 1.24; 95\% CI, 1.07-1.42), Hispanic (AOR, 1.36; 95\% CI, 1.11-1.67), and black (AOR, 1.60; 95\% CI, 1.35-1.90) youth. CONCLUSIONS: Prevalence of chronic conditions among children and youth increased from 1988 to 2006. However, presence of these conditions was dynamic over each 6-year cohort.
This article was published in JAMA
and referenced in International Journal of Physical Medicine & Rehabilitation