Household Income Moderates Longitudinal Relations Between Neighborhood Child Opportunity Index and BMI Growth

<b><i>Background:</i></b> To examine longitudinal associations of early neighborhood Child Opportunity Index 2.0 (COI) with children's BMI trajectories and identify whether household economic resources moderate relations of COI in infancy/toddlerhood and the preschool years to longitudinal BMI growth between 2 and 12 years. <b><i>Methods:</i></b> Family data (<i>n</i> = 1091) were drawn from the Family Life Project, a longitudinal study of families residing in rural high-poverty areas. Neighborhood COI was obtained for each developmental period: infancy/toddlerhood (2-15 months) and the preschool years (2-5 years). BMIs were created from anthropometrics collected at six time points. <b><i>Results:</i></b> Higher neighborhood COIs during the infancy/toddlerhood (<i>β</i> = -0.0130, <i>p</i> < 0.01) and preschool years (<i>β</i> = -0.0093, <i>p</i> < 0.05) were associated with lower BMI at 5 years of age; although the latter became nonsignificant after adjusting for infancy/toddlerhood COI. Both household income and time spent in poverty moderated associations of infancy/toddlerhood exposure to neighborhood COI with BMI change. Among children residing in not poor households, higher neighborhood level child opportunity was associated with a slower increase in BMI from 2 to 12 years (<i>β</i> = -0.0369, <i>p</i> < 0.05), and a lower BMI at 12 years (<i>β</i> = -0.0395, <i>p</i> < 0.05). <b><i>Conclusions:</i></b> Neighborhood COI during the infant and toddler years is longitudinally associated with child growth, and long-term associations are evident among children residing in not poor households. Future work is needed to better understand how family and neighborhood-level resources interact to influence obesity risk, particularly for those at high risk.