Examining the Link Between Poverty and Obesity

F. Bruder Stapleton, MD

Increased income from casinos was associated with decreased risk for overweight or obesity in American Indian children.

Poverty is a social determinant of childhood obesity. Investigators assessed whether increased income from new American Indian casinos reduced the risk for obesity in children aged 7 to 18 years in 117 school districts in California between 2001 and 2012. They evaluated economic and obesity measures in 57 districts before and after they opened or expanded casinos, 24 districts with casinos that did not expand, and 36 districts without casinos.

Among the 57 districts with new or expanded casinos, the mean increase in slot machines was 13 per capita. Overall, each slot machine per capita gained was associated with an increase in average per capita annual income of $541 and a 0.6% decrease in the percentage of American Indians living in poverty on tribal land. Among American Indian children, each additional slot was associated with a decrease in body-mass index z-score of 0.003 and a decrease in the probability of overweight or obesity of 0.19 percentage points. No spillover effects were observed among white children in these districts.

Citation(s):

Jones-Smith JC et al. Association between casino opening or expansion and risk of childhood overweight and obesity. JAMA 2014 Mar 5; 311:929.

Halfon N.Socioeconomic influences on child health: Building new ladders of social opportunity. JAMA 2014 Mar 5; 311:915.