1. Jordan Lyerly 1, MSPH, Elizabeth F. Racine 2, DrPH, James Laditka 2, PhD 1 University of North Carolina Charlotte, Health Psychology Program 2 University of North Carolina Charlotte, Department of Public Health Sciences

2. Increase in adolescent obesity rates 1 and mothers working outside the home 2 in past 40 years Rationale for relationship Relationship between increased maternal work hours and child and/or adolescent obesity 3-8 Limitations of existing research

3. Are increased hours of maternal employment associated with an increased rate of adolescent obesity? How does income modify this relationship?

4. Data From the Panel Survey of Income Dynamics (1997-2005) and Child Development Survey (1997-2007) Design Longitudinal Participants 1,108 adolescents and their parents

5. Exposure – Maternal employment during childhood Hours/week worked by mothers over all 3 time points (i.e. during childhood) Outcome – Adolescent obesity Weight and height measured by trained staff Considered obese if BMI > 95 th percentile based on sex and age Modifying variable– Income Based on the poverty level, considered 9 : Low income (< 200% of poverty level) Middle income (201%-400% of poverty level) High income (>400% poverty level)

6. Adjusted discrete time series analysis Relative risk 95% confidence intervals Considered several potential covariates Maternal age, maternal education, maternal obesity, marital status, income, child sex, child birth weight, and child physical activity level Interaction between maternal work hours and income

7. At baseline (1996) Median age of child – 3.5 yrs Median maternal work hrs/wk – 30 Median paternal work hrs/wk – 45 Income 42.7% low income 32.0% middle income 25.4% high income In 2007 20.7% of adolescents were obese

8. RR95% CI Maternal work hrs/wk1.751.01-3.03 Paternal work hrs/wk1.000.61-1.09 Maternal Work Hours by income 0-200% PL vs not 1.450.76-2.79 201-400% PL vs. not 2.741.15-6.53 ≥ 401% PL vs. not 2.170.53-8.86 No interactive effect of paternal work hours and income on risk of adolescent obesity. Maternal obesity was also associated with an increased risk of adolescent obesity (RR = 2.89, 95% CI=2.16-3.87)

9. As maternal work hours increased, the risk of adolescent obesity increased Income modified this relationship The association between maternal work hours and adolescent obesity was particularly strong among middle income families There was no association between paternal work hours and risk of adolescent obesity

10. Strengths Longitudinal data with detailed information regarding employment and income Measured height and weight Extended research by examining how income modifies the relationship Limitations Attrition Does not address causal mechanism

11. Better support and services for working mothers to assist in promoting healthy behaviors in children Interventions could address ideas and support for: Quick and healthy meals Healthy eating practices for children Focus groups with mothers from different income levels to understand barriers to healthy eating

12. 1. Ogden, C., & Carroll, M. Prevalence of obesity among children and adolescents: United States, trends 1963-1965 through 2007-2008. In: NCHS Health and Stats: National Center for Health Statistics; 2010. 2. US Department of Labor. Women in the laborforce: A databook. http://www.bls.gov/cps/wlf- databook-2012.pdfhttp://www.bls.gov/cps/wlf- databook-2012.pdf 3. Anderson, P. M., Butcher, K. F., & Levine, P. B. (2003). Maternal employment and overweight children. Journal of Health Economics, 22, 477-504. 4. Fertig, A., Glomm, G., & Tchernis, R. (2009). The connection between maternal employment and childhood obesity: Inspecting the mechanisms. Review of Economics of the Household, 7, 227-255. 5. Hawkins, S. S., Cole, T. J., & Law, C. (2008). Maternal employment and early childhood overweight: Findings from the UK Millennium Cohort Study. International Journal of Obesity, 32(1), 30-38. 6. Morrissey, T. W. (2012). Trajectories of growth in body mass index across childhood: Associations with maternal and paternal employment. Social Science and Medicine, in press. 7. Von Hinke Kessler Scholder, S. (2008). Maternal employment and overweight children: Does timing matter? Health Economics, 17, 889-906. 8. Ziol-Guest, K. M., Dunifon, R. E., & Kalil, A. (2012). Parental employment and children’s body weight: Mothers, others, and mechanisms. Social Science and Medicine, in press. 9. National Center for Health Statistics. Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD. 2011.