Building a healthier environment: A quasi-experiment analysis on the impact of a community health initiative on childhood obesity

It takes a village to raise a child!  This is true also with respect to raising a healthy child.  It takes a community to offer a healthy environment so children, and their parents, are encouraged to make the best decisions for their overall well-being.  One of every three kids aged 2-17 is obese or overweight in the country, totaling more than 23 million children and adolescents in 2007.  This rate has been growing in a rate that has alarmed public health policymakers.  Multiple reports nationwide have highlighted the seriousness of this issue by identifying obesity as a leading cause for other health problems: cardiovascular disease, type 2 diabetes, high blood pressure, sleep apnea, and depression.  Using clinical data from 2008 to 2015 from a large health system in Central Minnesota (CentraCare), we estimate the effect of a series of region-wide health programs designed by the institution and the community on child’s obesity rate. After accounting for individual characteristics and non-linearity, our identification approach isolates the geographic areas where the programs were designed and implemented and compares them against surrounding areas.  The analysis does not only compare across years using the number of programs implemented but also the amount of dollars invested in them.  We consider not only the aggregate effect of the programs, but also its intensity and variation across time. This analysis is remarkable in two ways.  One the one hand, it uses clinic base BMI information of a large served children population to account for the impact of a large community organized health program.  On the other hand, it follows across time this population.