School-based obesity screening in rural Appalachia

Ellen Demerath, Viktorina Muratova, Emily Spangler, Jianrong Li, Valerie Evans Minor, William A. Neal

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background. Although identification of obesity during childhood is strongly recommended for the prevention of adult disease, access to obesity screening for children is almost exclusively through physicians' office visits. We examined the feasibility and utility of conducting a school-based obesity and cardiovascular disease (CVD) risk factor screening program in a rural Appalachian population. Methods. Height, weight, blood pressure, total cholesterol (TC), and high-density lipoprotein (HDL) cholesterol were measured in 1338 fifth-grade children (631 boys and 707 girls) in 14 rural West Virginia counties in 2000-2001. Results. We found a high prevalence of overweight (17.5%) and obesity (27.0%). Compared with non-overweight children, obese children had greater risk of high TC (OR 2.4), low HDL cholesterol (OR 5.3), high systolic blood pressure (OR 3.3), and high diastolic blood pressure (OR 2.4) (all OR >1.0, P < 0.05). Only 63% of obese and 26% of overweight children were identified by their physician as having a weight above recommended values. Conclusions. The high prevalence of obesity, the associated clustering of CVD risk factors, and the low obesity identification rate by physicians suggest that alternative approaches to obesity screening, such as universal school-based programs, may be warranted in high-risk communities.

Original languageEnglish (US)
Pages (from-to)553-560
Number of pages8
JournalPreventive medicine
Issue number6
StatePublished - Dec 2003

Bibliographical note

Copyright 2017 Elsevier B.V., All rights reserved.


  • Blood pressure
  • Child
  • Epidemiology
  • Hyperlipidemia
  • Mass screening
  • Obesity
  • Poverty
  • Prevention and control
  • Professional practice


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