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Disparities across racial and ethnic groups are present for a range of health outcomes. In this opinion piece, we consider the origin of racial and ethnic groupings, a history that highlights the sociopolitical nature of these terms. Indeed, the terms race and ethnicity exist purely as social constructs and must not be used interchangeably with genetic ancestry. There is no scientific evidence that the groups we traditionally call "races/ethnicities" have distinct, unifying biological or genetic basis. Such a focus runs the risk of compounding equity gaps and perpetuating erroneous conclusions. That said, we suggest that the terms race and ethnicity continue to have purpose as lenses through which to quantify and then close racial and ethnic disparities. Understanding the root cause of such health disparities—namely, longstanding racism and ethnocentrism—could promote interventions and policies poised to equitably improve population health.

This salient resource offers clinicians a comprehensive multi-tiered framework for identifying, addressing, and reducing food insecurity among children and their families. Reinforcing the importance of food insecurity as a key social determinant of health, this monograph reviews the epidemiology and presents in-depth guidelines for screening for food insecurity and hunger. Recommendations for screening in a busy clinical setting as well as the strengths and limitations of widely-used instruments are discussed. The monograph also outlines a variety of clinic-level interventions, potential community-based resources, and opportunities for clinical-community partnerships to improve families' food access and security. Further, contributors provide workable plans for large-scale advocacy through greater engagement with professional and community resources as well as policymakers. The monograph concludes with an outline of the critical steps to implement a food insecurity screening process and the key components to train the next generation of provider-advocates. Included in the coverage: Epidemiology and pathophysiology of food insecurity Screening tools and training Scope of interventions to address food insecurity Creation and evaluation of the impact of food insecurity-focused clinical-community partnerships on patients and populations Development of an action plan to fight food insecurity Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings will find an engaged audience among physicians and other clinicians who want to address food insecurity in their healthcare and/or community setting. Institutions that are starting to address social determinants of health, including food insecurity, will find guidance on screening tools, processes and evaluation of impact.

Purpose To identify associations between age of onset of overweight/obesity, a child's sociodemographic characteristics, and characteristics of a child's home census tract. Design Retrospective electronic health record review of children with overweight/obesity. Setting Three primary care centers associated with a free-standing, tertiary-care pediatric institution in Cincinnati. Subjects Patients born between August 1, 2013 and July 31, 2014, who had a body mass index (BMI) ≥85th percentile before 5 years of age (n = 794). Measures Primary outcome was the patient's age at the first encounter when BMI was ≥85th percentile. Patient-level predictors were sex, age, race/ethnicity, health insurance, and number of moves captured in the health record. Census tract-level predictors were density of bus stops, presence of grocery stores, and a Socioeconomic Deprivation Index. Analysis Multivariable linear regression models assessed for independent associations between age of onset of overweight/obesity and predictors. Results Patients were 55.8% female, 73.6% black, and 79.1% publicly insured. Each additional move per year was associated with onset of overweight/obesity occurring 4.05 months earlier ( P < .0001). No significant associations between age of onset of overweight/obesity and census tract-level density of bus stops ( P = .82), presence of grocery stores ( P = .39), and socioeconomic deprivation ( P = .53) were demonstrated. Conclusion Public policy efforts toward improving access to grocery stores or public transportation may not be sufficient to prevent childhood obesity. Population-level interventions related to improving housing may also reduce obesity.