Economic Influences on Child Growth Status, from the Children’s Healthy Living Program in the US-Affiliated Pacific Region
The US-affiliated Pacific region needs policies that promote an active lifestyle and healthy food environment.
Mean obesity level of the 2–8-year-old children in the region was 14.4%, 14.1% were overweight, 2.7% were underweight, 1.4% were stunted, and 6.8% were stunted at birth. Acanthosis nigricans prevalence was 5%, an indicator of pre-diabetes. Sixty-one percent of the children were Native Hawaiian or Pacific Islander and 20% were of more than one race. Food insecurity was common. It was especially high in the Federated States of Micronesia and the Republic of the Marshall Islands at over 70%. Twenty-five percent of households in the region earned less than $10,000 per year. World Bank-defined upper middle-income jurisdictions had relatively high levels of both undernutrition and obesity. Jurisdiction income level was the most important factor influencing growth status in multivariate models. Policies and strategies for jurisdiction economic development and improvement of child growth status should protect local food systems and active living during economic transition. The terms of the renegotiated compact of free association with the US, especially in the upper middle-income countries (Palau and the Republic of the Marshall Islands) that are experiencing a dual burden of undernutrition and overnutrition, are expected to play a key role in the future health of residents of these jurisdictions.