Objective: To examine changes in state-specific obesity and overweight prevalence among US children and adolescents between 2003 and 2007.
Design: Temporal cross-sectional analysis of the 2003 and 2007 National Survey of Children's Health data.
Setting: The 50 states and the District of Columbia.
Participants: A total of 46 707 and 44 101 children aged 10 to 17 years in 2003 and 2007, respectively.
Main outcome measures: Prevalence and odds of obesity and overweight, differentials in which were examined by bivariate and logistic regression analyses.
Results: In 2007, 16.4% of US children were obese and 31.6% were overweight. The prevalence of obesity varied substantially across the states, with Mississippi having the highest prevalence (21.9%) and Oregon the lowest prevalence (9.6%). Overweight prevalence varied from a low of 23.1% for children in Utah to a high of 44.5% for children in Mississippi. Between 2003 and 2007, obesity prevalence increased by 10% for all US children and by 18% for female children, declined by 32% for children in Oregon, and doubled among female children in Arizona and Kansas. Children in Illinois, Tennessee, Kentucky, West Virginia, Georgia, and Kansas had more than twice the adjusted odds of being obese than children in Oregon. Individual, household, and neighborhood social and built environmental characteristics accounted for 45% and 42% of the state variance in childhood obesity and overweight, respectively.
Conclusions: Substantial geographic disparities in childhood obesity and overweight exist, with an apparent shift toward higher prevalence in 2007 for several states. Marked geographic disparities indicate the potential for considerable reduction in US childhood obesity.