Neighborhood Opportunity and Obesity in Early Adolescence: Differential Associations by Sex

Karen A. Ertel, Sakurako S. Okuzono, Logan Nicole Beyer, Kedie Pintro, Adolfo G. Cuevas, Natalie Slopen

Research output: Contribution to journalArticlepeer-review


Purpose: Though research indicates that certain aspects of adverse neighborhood conditions may influence weight development in childhood and adolescence, it is unknown if the Child Opportunity Index (COI), a composite measure of 29 indicators of neighborhood conditions, is associated with weight outcomes in adolescence. We hypothesized that lower COI would be associated with higher overweight and obesity in cross-sectional and longitudinal modeling in a national sample of 9 year olds and 10 year olds and that this association would be different by sex. Methods: Using data from the Adolescent Brain Cognitive Development study (n = 11,857), we examined the cross-sectional association between COI quintile and overweight and obesity in 9 year olds and 10 year olds. Additionally, we used hazard ratios to examine incident overweight and obesity across three waves of data collection. Results: Due to the interaction between sex and COI (p < .05), we present sex-specific models. There was a stepwise bivariate association, in which higher COI was associated with lower obesity prevalence. This pattern held in multilevel models, with a stronger association in females. In models adjusted for individual and household characteristics, female adolescents in the lowest quintile COI neighborhoods had 1.81 (95% confidence interval: 1.32, 2.48) times the odds of obesity compared to those in the highest quintile. In longitudinal models, the COI was associated with incident obesity in females only: adjusted hazard ratio = 4.27 (95% confidence interval: 1.50, 12.13) for lowest compared to highest COI. Discussion: Neighborhood opportunity is associated with risk of obesity in pre-adolescence into mid-adolescence. Females may be particularly influenced by neighborhood conditions.

Original languageEnglish (US)
JournalJournal of Adolescent Health
StateAccepted/In press - 2024


  • Adolescent Brain Cognitive Development (ABCD) Study
  • Adolescent overweight and obesity
  • Child Opportunity Index (COI)
  • Neighborhood
  • Sex differences

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


Dive into the research topics of 'Neighborhood Opportunity and Obesity in Early Adolescence: Differential Associations by Sex'. Together they form a unique fingerprint.

Cite this