Background: The prevalence of overweight and obesity was examined in African-American and Hispanic children compared with white children. Methods: Multivariate analyses were performed on cross-sectional data from the National Survey of Children's Health collected in 2003 to 2004. Results: Analyses found that overweight children were more likely to be African American and Hispanic than white, be male, live in households with incomes below 150% of the Federal poverty level, watch television 3 or more hours daily, and not have received preventive care in the past 12 months. Overweight children were less likely to get minimum levels of moderate physical activity or have participated on a sports team. Conclusions: Poverty impacts childhood body mass index in at least 2 specific ways: unsafe neighborhoods and the cost and accessibility of healthy foods in low income communities. Addressing these issues require the concerted efforts of policy makers. The same is true for resolving the issues of children not receiving preventive care. Increasing the number of well child check-ups mandated by the government and required by school systems may be a beneficial policy. Furthermore, policymakers concerned with issues of childhood obesity may pursue the creation of school-based health clinics in schools where at least 50% of the student body live in households with incomes <150% of the Federal poverty level.