Resumen de Association Between Casino Opening or Expansion and Risk of Childhood Overweight and Obesity
Jessica C. Jones-Smith, William H. Dow, Kristal Chichlowska
Importance Economic resources have been inversely associated with risk of childhood overweight/obesity. Few studies have evaluated whether this association is a direct effect of economic resources or is attributable to unmeasured confounding or reverse causation. American Indian–owned casinos have resulted in increased economic resources for some tribes and provide an opportunity to test whether these resources are associated with overweight/obesity.
Objective To assess whether openings or expansions of American Indian–owned casinos were associated with childhood overweight/obesity risk.
Design, Setting, and Participants We used repeated cross-sectional anthropometric measurements from fitness testing of American Indian children (aged 7-18 years) from 117 school districts that encompassed tribal lands in California between 2001 and 2012. Children in school districts encompassing American Indian tribal lands that either gained or expanded a casino were compared with children in districts with tribal lands that did not gain or expand a casino.
Main Outcomes and Measures Per capita annual income, median annual household income, percentage of population in poverty, total population, child overweight/obesity (body mass index [BMI] ≥85th age- and sex-specific percentile) and BMI z score.
