Background

Early childhood obesity is of great concern given its links to adverse health outcomes, social marginalization, and discrimination (Reilly & Kelly, 2010). Accordingly, there has been an increase in national and regional efforts to address early childhood obesity. In LA County, a leading public grant-making and child advocacy organization funded a diverse portfolio of investments to reduce early childhood obesity (RECO). RECO adopted a wide variety of strategies (education, media campaigns, financial incentives, changes to the built environment, policy changes), targeting low-income communities. This study examines the county-level impacts of RECO on early childhood obesity in LA County.

Methods

Given the unique characteristics of LA County, particularly its size and diversity, it is difficult to identify appropriate comparison counties in order to estimate county-level impacts. To address this challenge, this study uses the synthetic comparison group method (Abadie, 2010), which relies on a pool of “donor” counties and weights them to create a “synthetic” county that is similar to LA County prior to RECO. We then compare LA County and the synthetic county after RECO to test for a county-level impact. We use overweight/obesity data for children aged 2-5 from Southern California Kaiser Permanente.

Results

Examining early childhood overweight and obesity rates over time in LA County reveals that rates were lower after RECO compared to before. After accounting for what might have happened in the absence of RECO by introducing the synthetic comparison group, we find a significant county-level impact of RECO on early childhood overweight and obesity: RECO significantly reduced early childhood overweight (Impact Estimate = -4.88, p<.001) and obesity (Impact Estimate = -1.52, p<.05) in LA County compared to the synthetic comparison county.

Conclusions

These findings highlight the potential utility of a diverse set of efforts to reduce early childhood obesity at the county-level.