Abstract
One third of youth aged 2-19 are overweight or obese, 3.6% of children between the ages of 3 and 18 are found to have stage 1 hypertension, and 3.4% are found to have elevated blood pressure. As children and adolescents spend a majority of their time in school, it is especially important to examine the influence of school contextual factors on body size and blood pressure status. The goal of the present study was to identify how environmental factors, such as school SES, school academic achievement, and school perceived safety influence health status in a sample of ethnically diverse students (N = 12,559) who participated in the 2003-2004 annual hypertension screening program for 10th grade students in Miami-Dade County Public Schools. Additionally, this study examined the relationship among school-level SES and school-level academic achievement to further examine how the availability of social and economic resources that extend beyond the home influence academic performance. Adolescents in the sample were students attending various public high schools in Miami-Dade County and thus, data collected from this sample are nested by school. Consequently, multilevel modeling was used to investigate the contribution of school effects to the overall variance in adolescents’ BMI percentile and systolic blood pressure. Analysis at the school level included SES, achievement, and student perceived safety to the model to estimate the impact of these factors. Screen time, school stress, physical activity, and healthy eating consumption scores were positively associated with BMI percentile, while group mean stress ratings and unhealthy eating consumption scores were negatively associated with BMI percentile. Boys and ethnic minorities were found to have higher BMI percentile scores when compared to girls and Non-Hispanic White children, respectively. Screen time was positively associated with systolic blood pressure, while physical activity and unhealthy food consumption scores were found to be negatively associated with systolic blood pressure. Boys were found to have higher systolic blood pressure when compared to girls. Lastly, multiple regression analyses indicated that age, ethnicity, and school level SES significantly predicted school-level academic achievement. The results of the present study underscore the importance of individual level behaviors and demographic factors in adolescent health outcomes, as well as the important role that school stress can play in academic outcomes as well as health. As such, it is important to further examine the impact of environmental indicators on individual stress and health behaviors so effective strategies for prevention and intervention within health and education promotion programs can be identified.