We know that where one lives is associated with how healthy you will be. However, many environmental indices do not reflect both the good and bad in a neighborhood.
The Child Opportunity Index (ChOI) was developed to incorporate neighborhood attributes that both promote and detract from child health–and thus provide a measure of a neighborhood’s overall “opportunity.”
The ChOI uses 29 indicators to create a score of neighborhood opportunity. These indicators are in 3 categories:
- Education (e.g., number of early childhood education centers, percent of 3rd graders who score as proficient on standardized reading and math tests, ratio of adults enrolled in college)
- Health and environment (e.g., percent of households without a car who are located >0.5 miles from supermarket, percent housing units that are vacant, mean estimated 8-hour ozone concentration)
- Social-economic (e.g., percent adults employed, percent workers commuting >1 hour one-way, percent owner-occupied housing units)
This week in Pediatrics, we publish a study by Dr. Izzuddin Aris and colleagues that analyzes the link between the ChOI and cardiometabolic outcomes in a sample of 743 children at mid-childhood (mean age 7.9 years) and early adolescence (mean age 13.1 years) (10.1542/peds.2020-018903). These children were part of a longitudinal study that enrolled pregnant women and followed their children over time.
The authors found that:
- There was no significant association of ChOI and adiposity.
- Children who lived in higher opportunity neighborhoods had lower c-reactive protein (CRP) levels.
- There were also specific associations with various neighborhood attributes and cardiometabolic outcomes, such as percent body fat, insulin resistance, and metabolic risk z-scores.
Importantly, these results were independent of parental education attainment, maternal marital status, household income, and race/ethnicity.
This study illustrates the complexities of the association between neighborhood and health. There are important attributes within each neighborhood that may have positive or negative associations with health – I encourage you to go to the article to learn more about these attributes. While one cannot attribute causation to these associations in a study such as this, efforts to change specific neighborhood attributes may result in meaningful improvements in child health.