The obesity rate among American Indian children seen at an off-reservation Wisconsin clinic was double that of white children seen at the same health clinic, according to a study from the University of Wisconsin.

Tribe-and reservation-based data show disproportionally high obesity rates among American Indian children. The current study suggests that American Indian children living off-reservation may also be at high risk of obesity.

Researchers used the Public Health Information Exchange, a data set linking electronic health record data to community characteristics, to examine childhood obesity rates among American Indian children seeking off-reservation health care in Wisconsin. They found that 20 percent of American Indian children were obese compared to 10.6 percent of non-Hispanic white children. American Indian children also more likely to be overweight compared to their white counterparts.

The authors note that these high rates of both overweight and obesity are also prevalent nationwide among American Indian children living in tribal communities.

Researchers believe the higher numbers can be attributed to a number of factors, including poverty, racism, historic trauma, rural isolation, urban loss of community, stress, lack of access to healthy foods and physical activity opportunities, and safety issues that may prevent physical activity.

American Indian children were also more likely to have Medicaid, to live in urban settings, and more likely to experience financial hardship than non-Hispanic white children. American Indian children are also have a greater risk of developing obesity-related chronic diseases such as diabetes and heart disease.