Household Income Moderates Longitudinal Relations Between Neighborhood Child Opportunity Index and BMI Growth

Background: To examine longitudinal associations of early neighborhood Child Opportunity Index 2.0 (COI) with children's BMI trajectories and identify whether household economic resources moderate relations of COI in infancy/toddlerhood and the preschool years to longitudinal BMI growth between 2 and 12 years. Methods: Family data (n = 1091) were drawn from the Family Life Project, a longitudinal study of families residing in rural high-poverty areas. Neighborhood COI was obtained for each developmental period: infancy/toddlerhood (2-15 months) and the preschool years (2-5 years). BMIs were created from anthropometrics collected at six time points. Results: Higher neighborhood COIs during the infancy/toddlerhood (β = -0.0130, p < 0.01) and preschool years (β = -0.0093, p < 0.05) were associated with lower BMI at 5 years of age; although the latter became nonsignificant after adjusting for infancy/toddlerhood COI. Both household income and time spent in poverty moderated associations of infancy/toddlerhood exposure to neighborhood COI with BMI change. Among children residing in not poor households, higher neighborhood level child opportunity was associated with a slower increase in BMI from 2 to 12 years (β = -0.0369, p < 0.05), and a lower BMI at 12 years (β = -0.0395, p < 0.05). Conclusions: Neighborhood COI during the infant and toddler years is longitudinally associated with child growth, and long-term associations are evident among children residing in not poor households. Future work is needed to better understand how family and neighborhood-level resources interact to influence obesity risk, particularly for those at high risk.