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Casinos associated with decreased risk for overweight, obesity in children
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The opening or expansion of casinos was associated with an increase in economic resources and decreased risk for overweight or obesity among American Indian children, according to researchers at Johns Hopkins Bloomberg School of Public Health.
The goal was to evaluate the extent to which casinos could be associated with childhood overweight or obesity and increased economic resources among residents of tribal lands.
Researchers used repeated cross-sectional anthropometric measurements taken during fitness testing of American Indian children aged 7 to 18 years from 117 school districts associated with tribal lands in California between 2001 and 2012 to determine BMI and BMI z scores. Additionally, they assessed economic and demographic outcomes such as per capita annual income, median household income, percentage of poverty and total population.
Data from school districts that gained or expanded a casino (n=57) were compared with data from districts that contained a pre-existing casino that did not expand (n=24) and from districts in which no casino existed or was built (n=36).
Changes in slots per capita at the mean and median levels were 13 and 3, respectively, in districts where a casino opened or expanded.
Based on mean slots per capita (n=7), researchers reported a 0.19% decrease in overweight or obesity for every slot machine per capita gained (95% CI, –0.26 to –0.11). Every increase in slot machine per capita was also associated with a decrease in BMI z score of 0.003 (95% CI, –0.005 to –0.0002). These findings equated to a decrease in the median prevalence of overweight or obesity by 1.2% and a decrease in the mean prevalence for overweight or obesity by 5.1% which is consistent with other findings, according to the researchers.
Casinos also benefitted economic resources; per capita annual income increased by $541 (59% CI, $245-$836) and percentage of poverty decreased by 0.6% (95% CI, -1.1% to -0.20%) in association with each slot per capita gained. The increase in median household income was not statistically significant.
Limitations in the available data restricted the study to one of an ecological nature, and researchers concede that additional research is needed to identify the mechanisms underlying the association.
In an accompanying editorial, Neal Halfon, MD, MPH, wrote that these findings are interesting, but strategies are needed to improve socioeconomic conditions of children at risk.
“Poverty impedes the development of the neurobiological mechanisms that enable individuals to make appropriate choices and resist the temptations to overeat, smoke, drink excessively and use drugs, thereby placing children in this environment at increased risk for a wide range of health problems throughout their lives,” he wrote. “As childhood poverty becomes a structural element of the U.S. economy, and its influence becomes embedded into a child’s development, it is increasingly difficult for children in low-income communities to climb the ladders of opportunity, the rungs of which are moving farther apart and becoming increasingly unreachable.”
Disclosure: The researchers report no relevant financial disclosures.
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