| This dissertation, Potential Determinants and Mechanisms Responsible for Obesity Trajectories during Early Childhood, rigorously applied lifecourse perspectives to improve understanding of prenatal, perinatal, and postnatal determinants of obesity trajectories at individual, family, and neighborhood levels. Individual level data were from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Community level data were from the RAND Center for Population Health and Health Disparities and the County Health Rankings & Roadmaps (Rankings). The first aim addressed analytic definitions of 'infant growth status at birth' using birthweight, gestational age, weight-for-gestational age, and combinations thereof. In the second aim, multiple determinants of health and lifecourse perspectives were applied to child growth and the risk of obesity during early childhood. The results showed maternal BMI before pregnancy, weight gain during pregnancy, and infant growth status at birth were among the most influential factors affecting childhood obesity trajectories. The third aim of the dissertation evaluated the potential impact of obesogenic neighborhoods on child growth. The results indicated that not only proximal determinants but also distal determinants such as county-level segregation, socioeconomic status, and adult obesity prevalence influence the risk of obesity during early childhood. The significance of the effects of county characteristics varied depending on analytic approaches were used. In addition, self-selection and duration of residency were potential sources of bias in causal inference between county characteristics and the risk of obesity during early childhood. Overall, this dissertation provides empirical evidence for lifecourse perspectives of early childhood obesity trajectories to better design appropriate interventions to curb the childhood obesity epidemic. |
