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Trends in Obesity and Among Students in Philadelphia

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Trends in Obesity and Among Students in Philadelphia

Results


The number of enrolled K to 12 students in the School District of Philadelphia declined each year, from a high of 186,176 in the 2006–07 school year to 147,818 in the 2012–13 school year (Table 1); the number of students with valid height and weight measurements varied by school year, with a high of 122,448 in 2009–10 and a low of 88,798 in 2012–13 (Table 2). The proportion of students whose BMI status could be assessed reached a high of 73% in 2010–11 before declining to 60% in 2012–13.

The majority of enrolled students and the majority with BMI assessments were African American, but the proportion of African American students declined over the 7 years. The percentage of students who were Hispanic, non-Hispanic white, or Asian rose slightly (Table 1 and Table 2).

Obesity


Over the full 7-year study period from 2006–07 through 2012–13, the prevalence of obesity among all children decreased from 21.7% to 20.3%, a relative decline of 6.3% (P = .01). Relative obesity reductions were larger in the first 4 years (4.6%) than in the last 3 years (1.8%).

Among boys, the prevalence of obesity declined from 21.9% to 20.1% over the 7-year period, a relative decline of 8.1% (P < .001, Table 3). The largest percentage declines were seen in grades K to 5 (8.8%) and among African Americans (11.3%) and Asians (18.8%). Every racial/ethnic group had a lower prevalence of obesity in 2009–10 than in 2006–07, but only African American and Asian boys had a significantly lower prevalence in 2012–13 than in 2009–10. Hispanic boys experienced the smallest decline from 2006–07 through 2012–13 (1.7%), which was nonsignificant; they also had the highest obesity prevalence throughout the 7-year period.

Among girls, the prevalence of obesity trended downward, from 21.4% to 20.5% over the 7-year period, a relative decline of 4.3% (P = .75, Table 3). The decline was larger in the first 4 years (3.3%) than in the final 3 years (1.0%). None of the subgroups experienced significant reductions in obesity over the 7-year period. Overall, the largest reductions were seen in grades 6 to 8 (6.1%) and among African Americans (3.8%) and Asians (7.1%). There was a small but statistically significant increase (from 19.2% to 19.5%) among girls in grades K to 5. Among Hispanic girls, the prevalence of obesity initially declined from 22.7% to 20.9% from 2006–07 through 2009–10 but then increased significantly to 23.0% by school year 2012–13, representing the highest prevalence among girls in all racial/ethnic groups.

The prevalence of obesity was higher among boys than girls in 2006–07 (21.9% vs 21.4%) but was equal or higher among girls than boys in each subsequent school year.

Severe Obesity


The prevalence of severe obesity declined significantly for all children (8.5% to 7.3%, a relative decline of 13.9%), for boys (8.9% to 7.5%) and for girls (8.1% to 7.2%) over the 7-year period (Table 4); declines among girls continued over the last 3 years. The highest prevalence was in grades 6 to 8 for both boys and girls. The patterns by race/ethnicity were similar to those for obesity, and the largest reductions were among African Americans and Asians. Declines continued in all racial/ethnic groups, except for Hispanics, over the last 3 years. Notably, African American boys and girls experienced significant declines in the prevalence of severe obesity of 18.8% and 8.8% respectively over the 7-year period; most of the reduction for girls occurred in the final 3 years. Hispanic boys and girls experienced nonsignificant increases in the prevalence of severe obesity over the final 3 years and nonsignificant decreases (6.5% for boys and 7.5% for girls) over the entire study period. Boys had rates of severe obesity slightly higher than or equal to girls in all but 1 year.

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