Abstract 018: New York City Youth Cardiovascular Fitness and Subsequent School Absenteeism Have an Inverse, Dose-Response Relationship, Regardless of How Poverty is Measured
Publication
, Journal Article
D’Agostino, EM; Day, SE; Konty, KJ; Wyka, K
Published in: Circulation
Recent research demonstrates that cardiovascular fitness improvements are associated with lower absenteeism, particularly for girls attending schools located in high poverty neighborhoods. Poverty at the student, school, and neighborhood levels may each have unique effects on both cardiovascular fitness and school absenteeism. There is a need to simultaneously explore the effects of poverty measures collected at different levels of observation on the longitudinal fitness-absenteeism relationship and across gender in order to inform policy targeting reduced school absenteeism.
It was hypothesized that poverty measured at the neighborhood level would have the strongest magnitude of effects on the cardiovascular fitness-absenteeism relationship compared with poverty measured at the school and student levels.
Data for this study were drawn from the New York City Fitnessgram dataset. Inclusion criteria were enrollment in a New York City public school for at least 2 consecutive years in grades 6-8 (2006-2013) while attending a school that collected Fitnessgram measurements. Negative binomial longitudinal mixed models with random-intercepts were run to test the association between the exposure, child-specific change in cardiovascular fitness from the year prior, and the outcome, days absent the subsequent year. Separate crude and adjusted models were run stratified by student (individual household), school (percent of students living in poverty or qualifying for free/reduced price school meals) and neighborhood (home- and school-area) poverty measures, and also by gender. Models were adjusted for individual- and group-level confounders (time, grade, race/ethnicity, place of birth, change in obesity status, and school size), and clustering by individual student and school.
The sample included 360,743 students (67% black or Hispanic, 51% male, 69% qualifying for free/reduced price school meals). Adjusted estimates showed an inverse-dose response fitness-absenteeism relationship across all poverty measures, with the highest magnitude of effects for youth attending schools in high poverty neighborhoods (IRR= -0.12, 95%CI: -0.20, -0.04 in girls; IRR= -.13, 95%CI: -.29, .03 in boys), and in girls attending schools with a high proportion of students qualifying for free/reduced school meals (IRR= -.11, 95%CI: -.23, -.01).
In conclusion, there is an inverse, dose-response trend between cardiovascular fitness and subsequent absenteeism in high poverty youth, regardless of how poverty is measured, and particularly among girls. Future research should examine the potential for distinct youth physical activity interventions tailored to the individual, school and neighborhood levels to reduce school absenteeism associated with poverty.
