Degree Name
DrPH (Doctor of Public Health)
Program
Public Health
Date of Award
12-2025
Committee Chair or Co-Chairs
Hadii Mamudu
Committee Members
Dawn Rowe, Manik Ahuja, Michael G. Smith
Abstract
Obesity is a public health concern in the United States (U.S), with 14.7 million children aged 2-19 years suffering from this condition in 2022. Obesity presents co-occurring health conditions such as mental health (anxiety, depression) and physical disabilities. In 2022, approximately 3.3 million children and adolescents in the U.S. had some form of disability; as it relates to mental health conditions during the period 2021-2023, adolescents aged 12-17 years had higher prevalence of anxiety and depression when compared to children 6-11 years. These co-occurring conditions, results in increased health care expenditure, and poor quality of life for children and adolescents across the U.S. This study has several objectives: 1) conduct a scoping review of available evidence on barriers to mental health care for obese children aged 6 to 17 with physical disabilities, identifying related gaps; 2) examined household mental health and social determinants of health factors on the mental health status of obese children and adolescents; 3) explore the intersection between accessible housing and mental health outcomes in obese children across Appalachian states (North Carolina, Tennessee, and Virginia), and provide recommendations for policy and practice based on identified gaps. This multi-method study employed 1) a scoping review, adhering to the PRISMA ScR guidelines; 2) a cross-sectional analysis of data from the 2022-2023 National Survey of Children’s Health using logistic regression models, and a policy analysis highlighting similarities and gaps between state housing policies, and their implications on population outcomes. The scoping review analyzed 10 articles and revealed barriers to mental health access for obese children with physical disabilities. These barriers, although not exhaustive included, stigma, lack of providers, lack of provider knowledge and training, and family resources. The quantitative study revealed 16% of obese children and adolescents had either anxiety or depression, approximately 4% were physically disabled, 18% had parent with poor mental health and 14% lived in neighborhoods with poor quality housing. The policy analysis highlighted gaps in accessible housing between the three states (North Carolina, Tennessee, and Virginia), including difference in financing of accessible housing, and compounding vulnerabilities evident in increasing mental health burden within the population of children and adolescents. Efforts should be made to improve family level supports, increase mental health screenings for children with obesity or physical disabilities, and supports for renters for accessible modifications to improve mental health outcomes for children and adolescents with obesity and co-occurring physical disabilities.
Document Type
Dissertation - embargo
Recommended Citation
Thomas, Jewel B., "Obesity and Mental Health in U.S. Children and Adolescents: Understanding Access Through Social Determinants" (2025). Electronic Theses and Dissertations. Paper 4620. https://dc.etsu.edu/etd/4620
Copyright
Copyright by the authors.
Included in
Health Services Research Commons, Maternal and Child Health Commons, Other Mental and Social Health Commons
