Positive School Climate Is Associated With Lower Body Mass Index Percentile Among Urban Preadolescents

Childhood obesity in the United States (US) continues to be a major public health concern with approximately 1 of 3 children classified as overweight or obese.1 Although childhood obesity affects children from all backgrounds, it disproportionately affects children of low socioeconomic status (SES) and those who are Black or Latino.2 Preadolescents are a particularly important group for obesity research and interventions, as obesity rates nearly double during preadolescence.3 It is also an age when children are developing lifelong dietary and exercise habits.4 In public health, obesity is often understood within a social ecological framework, which looks beyond individual-level factors to the complex web of broader social and environmental factors that contribute to obesity.5 Schools are an important environmental context in children’s lives. In its recent report on obesity prevention, the Institute of Medicine identified schools as a “national focal point for obesity prevention,” recommending that schools adopt strong physical activity and nutrition standards and provide nutrition education.1 Increasingly, attention has been placed on the importance of school climate as one domain of school environment beyond health policies and education that may have implications for student health outcomes.6,7 Although one clear and concise definition of school climate does not exist in the literature, we use the National School Climate Center’s definition: “School climate refers to the quality and character of school life. School climate is based on patterns of students’, parents’, and school personnel’s experience of school life and reflects norms, goals, values, interpersonal relationships, teaching and learning practices, and organizational structures.”8 More positive school climate is associated with fewer risky health behaviors (ie, alcohol use, reckless driving, and violence),6 increased physical activity among girls,9 and emotional well-being.7 The association of school climate with positive health behaviors and emotional well-being suggests that school climate could also have an association with positive physical health outcomes. Indeed, an association of school climate with physical health symptoms has been documented,7 but there are limited studies that have examined the association between school climate and obesity. Most prior studies have focused on school food or physical activity environments instead of school climate,10 or on health behaviors rather6,9 than health outcomes, such as body mass index (BMI). In this study, we tested the hypothesis that a more positive school climate would be associated with lower BMI in an at-risk sample of preadolescents in a low-income, ethnically diverse urban New England school district.