Income and neighbourhood deprivation in relation to obesity in urban dwelling children 0–12 years of age: a cross-sectional study from 2013 to 2019

Abstract

BackgroundChildhood obesity is a major public health concern. This study evaluated the independent and joint associations of family-level income, neighbourhood-level income and neighbourhood deprivation, in relation to child obesity.MethodsA cross-sectional study was conducted in children ≤12 years of age from TARGet Kids! primary care network (Greater Toronto Area, 2013–2019). Parent-reported family income was compared with median neighbourhood income and neighbourhood deprivation measured using the Ontario Marginalization Index. Children’s height and weight were measured and body mass index (BMI) z-scores (zBMI) were calculated. ORs and 95% CIs were estimated for the three exposure variables separately using multilevel multinomial logistic regression models with zBMI categories as the outcome, adjusting in model 1 for age, sex, ethnicity and number of family members and in model 2 adding family income. A joint measure was derived combining income and deprivation measures.ResultsA total of 5962 children were included. Low family income (Q1 vs Q5: OR=4.69, 95% CI 2.65 to 8.29), low neighbourhood income (Q1 vs Q5: OR=2.18, 95% CI 1.33 to 3.58) and high neighbourhood deprivation (Q1 vs Q5: OR=2.45, 95% CI 1.52 to 3.95) were each associated with increased OR of child obesity. However, after adjustment for family income, the association for both neighbourhood income (OR=1.39, 95% CI 0.82 to 2.34) and deprivation (OR=1.56, 95% CI 0.94 to 2.58) and obesity was attenuated. Children from low-income families living in low-income or high deprivation neighbourhoods had higher OR of obesity.ConclusionChild obesity was independently associated with low family-level income and a joint measure suggests that neighbourhood also matters. Socioeconomic inequalities at both individual and neighbourhood levels should be addressed in childhood obesity interventions.

Obesity and weight change during the COVID‐19 pandemic in children and adults: A systematic review and meta‐analysis

“…Depression and anxiety have also increased during the pandemic and are often associated with obesity 16–18 . Social determinants of health, including loss of income and job loss, have also increased dramatically and are known risk factors for obesity 19,20 . Lastly, in many places around the world, these experiences occurred simultaneously with an increase in unmet healthcare needs and a lack of routine child growth monitoring during the pandemic 21 .…”

“…[16][17][18] Social determinants of health, including loss of income and job loss, have also increased dramatically and are known risk factors for obesity. 19,20 Lastly, in many places around the world, these experiences occurred simultaneously with an increase in unmet healthcare needs and a lack of routine child growth monitoring during the pandemic. 21 Healthcare services for diabetes and obesity management were also disrupted during the pandemic.…”

Trends in school‐neighbourhood inequalities and youth obesity: Repeated cross‐sectional analyses of the public schools in the state of California

“…Low‐income neighbourhoods experience higher burden of childhood obesity 5,20 . These neighbourhoods, by definition, consist of a large number of low‐income households and often suffer from higher exposure to obesogenic environments, such as greater concentrations of unhealthy food outlets and lack of safe environments for physical activity 12,21,22 .…”

Maternal BMI in the preconception period, and association with child zBMI growth rates

“…Data were collected through parent‐completed, standardized questionnaires adapted from the Canadian Community Health Survey 32 . Potential confounders in each model included maternal age at child's birth, maternal ethnicity, self‐reported household income, and maternal smoking during pregnancy 33–35 . Maternal ethnicity was categorized as: European, East Asian, South or Southeast Asian, African, or other (including Arab, Latin American, mixed ethnicity, or other).…”

“…32 Potential confounders in each model included maternal age at child's birth, maternal ethnicity, self-reported household income, and maternal smoking during pregnancy. [33][34][35] Maternal ethnicity was categorized as: European, East Asian, South or Southeast Asian, African, or other (including Arab, Latin American, mixed ethnicity, or other). Potential effect modifiers included child sex and GWG.…”