Racial/ethnic disparity in obesity among US youth, 1999-2013

Background: One fundamental goal in the Healthy People 2020 is to achieve health equity and eliminate disparities. Objective: To examine the annual trends in racial/ethnic disparity in obesity among US youth from 1999 to 2013. Subjects: Nationally representative sample of 108,811 students in grades 9th-12th from the Youth Risk Behavior Surveillance System (YRBSS) 1999-2013 surveys. Methods: Body mass index (BMI) was calculated based on self-reported height and weight. Obesity in youth is defined as BMI at or above 95th sex- and age-specific percentile of the 2000 Centers for Disease Control and Prevention growth charts. Multiple logistic regressions were conducted to estimate the annual prevalence of obesity by race/ethnicity, adjusted for gender and age group and accounted for the YRBSS survey design. Between-group variance (BGV) was used to measure absolute racial/ethnic disparity in obesity, and the mean log deviation (MLD) and the Theil Index (T) were used to measure relative racial/ethnic disparity in obesity, weighted by corresponding racial/ethnic population size. Results: The obesity prevalence among non-Hispanic Whites, non-Hispanic African Americans, non-Hispanic other race or multi-race, and Hispanic increased from 10.05%, 12.31%, 10.25%, and 13.24% in 1999 to 13.14%, 15.76%, 10.87%, and 15.20% in 2013, respectively. Both absolute and relative racial/ethnic disparity in obesity increased initially since 1999 but then steadily declined starting from mid-2000s back to around its original level by 2013. Conclusion: The obesity epidemic in youth is marked by salient and persistent disparity pertaining to race/ethnicity. No improvement on racial/ethnic disparity in obesity among American youth was observed during 1999-2013.