Different domains of deprivation and their relationship with obesity in New Zealand 4‐year‐old children

Abstract

Summary Background There is a relationship between childhood obesity and area‐level deprivation. While the New Zealand Index of Deprivation (NZDep) has been used widely in research for the past 20 years, the Index of Multiple Deprivation (IMD) was released in 2017. This study aims to investigate the association between deprivation and childhood obesity in New Zealand and compare measures of deprivation. Methods Data from 316 794 4‐year‐olds in New Zealand undertaking the B4 School Check in 2010 to 2016, a national health and development screen, were analysed. Multilevel logistic regression models assessed the relationship between area‐level deprivation and individual‐level child obesity. Models were adjusted for age, sex, immigration status, ethnicity, and year. Deprivation was measured using the census‐based NZDep2013 (deciles) and the administrative data‐based IMD (deciles). The seven domains of the IMD were also considered. Results The relationship between deprivation and obesity was very similar for the IMD and NZDep2013, point estimates were near identical, and confidence intervals overlapped substantially. Higher levels of deprivation were associated with a higher prevalence of child obesity. The relationship between deprivation and child obesity varied considerably across IMD domains. The education domain had the strongest association with child obesity and had an association with child obesity independent of the other domains of deprivation. Conclusion Overall, there was little difference between the NZDep and IMD. However, the IMD's domains and IMD‐1 approach reveal more nuanced understandings of the deprivation‐obesity gradient, including the importance of area‐level education deprivation for predicting child obesity rates.

Payment Structures That Support Social Care Integration With Clinical Care: Social Deprivation Indices and Novel Payment Models

“…Researchers have demonstrated differences in health factors based on NZDep scores but have yet to demonstrate changes in outcomes for those at highest social risk. For example, in areas of significant deprivation, rates of childhood obesity are higher, 12 appropriate medication use is lower, 13 and access to specialized care is limited (e.g., implantable cardioverter defibrillators). 14 The index has also been used to identify geographic equity differences; for example, in areas of significant deprivation, there is a higher mortality 15 and low primary healthcare utilization.…”

Neighbourhood deprivation and obesity among 5656 pre-school children—findings from mandatory school enrollment examinations

“…A further limitation is that only a small number of studies used large-scale representative samples. They analysed the influence of neighbourhood on child obesity in the context of school enrollment medical screenings [8,9,12,37]. These offer the advantages of large samples and the participation of families from all social positions resulting in little selection bias [42].…”

“…These studies show that children from disadvantaged neighbourhoods are more frequently obese [ 7 – 9 , 12 , 24 , 37 , 39 ]. However, the effect of the neighbourhood is attenuated after the individual SEP is taken into account [ 8 , 12 – 14 , 37 , 43 ]. Instead of continuing to investigate if neighbourhood deprivation influences child obesity, attention should be turned to focus on the conditions under which this is relevant [ 22 , 26 ] and whether a high individual SEP might be protective in high deprived neighbourhoods.…”

Associations between Neighborhood Deprivation Index, Parent Perceptions and Preschooler Lifestyle Behaviors

“…Understanding the individual aspects of the neighborhood environment associated with the diet and physical activity/sedentary behaviors of children could have significant positive health effects from a public health perspective. Increased knowledge of the influence of the neighborhood deprivation index, which has demonstrated strong correlations with a range of health and social outcomes measures [22,25,26], and parental perceptions of their local neighborhood on pre-school children's dietary intakes, physical activity, and screen time behaviors can inform the creation of a healthy environment for this age group [27]. Therefore, the aim of this study was to examine the neighborhood deprivation index and to investigate whether parental perceptions of their neighborhood environment were associated with their pre-school children's physical activity, TV screen time, and healthy/unhealthy markers of dietary intake.…”