Socioeconomic Inequalities in Childhood Obesity in the United Kingdom: A Systematic Review of the Literature

El-Sayed, Abdulrahman M.; Scarborough, Peter; Galea, Sandro

doi:10.1159/000343611

Cited by 77 publications

(69 citation statements)

References 133 publications

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“…This finding is consistent with a study which reported that living with low income was more strongly associated with an increased risk of obesity in women as compared to men [66]. However, Ostbye et al reported that increased years of living in poverty was not associated with trajectory change in any BMI trajectory group after considering other covariates.…”

Section: Discussionsupporting

confidence: 90%

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

Wang

Roebothan

et al. 2015

Advances in Epidemiology

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Knowledge regarding the heterogeneity of BMI trajectories is limited for the Canadian population. Using latent class growth modelling, four distinct BMI trajectories of individuals from young adulthood to middle age were identified for both women and men from the longitudinal data of the National Population Health Survey. The associations between BMI trajectories and the individuals' sociodemographic characteristics and behavioural factors were also examined. Aboriginal women were found more likely to be in the long-term overweight or obese groups. It reveals that increased years of smoking, drinking, and being physically active were associated with lowering the BMI trajectory in all groups for both women and men, with some exceptions in the longterm normal weight group for men. Increased years of rural living, being employed, and living with low income were associated with raising the BMI trajectory in all groups for women and in some groups for men. Food insecurity was associated with raising the BMI trajectory in each group for both women and men.

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Section: Discussionsupporting

confidence: 90%

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

Wang

Roebothan

et al. 2015

Advances in Epidemiology

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“…[11][12][13][14] In the UK, cross-sectional data from a recent Health Survey for England 15 have shown strong associations between adult and childhood obesity and a number of socioeconomic status (SES) indicators (Index of Multiple Deprivation, Income Deprivation Affecting Children Index, eligibility for free school meals, household income and household occupation-based social class). In some areas, childhood obesity rates in the most deprived quintile were almost double those in the least deprived quintile.…”

Section: Inequalities In Obesitymentioning

confidence: 99%

How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews

Bambra

Hillier

Cairns

et al. 2015

Public Health Research

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BackgroundTackling obesity is one of the major contemporary public health policy challenges and is vital in terms of addressing health inequalities.ObjectivesTo systematically review the effectiveness of interventions (individual, community and societal) in reducing socioeconomic inequalities in obesity among (1) children aged 0–18 years (including prenatal) and (2) adults aged ≥18 years, in any setting, in any country, and (3) to establish how such interventions are organised, implemented and delivered.Data sourcesNine electronic databases including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and NHS Economic Evaluation Database were searched from database start date to 10 October 2011 (child review) and to 11 October 2012 (adult review). We did not exclude papers on the basis of language, country or publication date. We supplemented these searches with website and grey literature searches.Review methodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Experimental studies and observational studies with a duration of at least 12 weeks were included. The reviews considered strategies that might reduce existing inequalities in the prevalence of obesity [i.e. effective targeted interventions or universal interventions that work more effectively in low socioeconomic status (SES) groups] as well as those interventions that might prevent the development of inequalities in obesity (i.e. universal interventions that work equally along the SES gradient). Interventions that involved drugs or surgery and laboratory-based studies were excluded from the reviews. The initial screening of titles and abstracts was conducted by one reviewer with a random 10% of the sample checked by a second reviewer. Data extraction was conducted by one reviewer and independently checked by a second reviewer. The methodological quality of the included studies was appraised independently by two reviewers. Meta-analysis and narrative synthesis were conducted focusing on the ‘best-available’ evidence for each intervention type (defined in terms of study design and quality).ResultsOf 56,967 papers of inequalities in obesity in children, 76 studies (85 papers) were included, and of 70,730 papers of inequalities in obesity in adults, 103 studies (103 papers) were included. These studies suggested that interventions that aim to prevent, reduce or manage obesity do not increase inequalities. For children, there was most evidence of effectiveness for targeted school-delivered, environmental and empowerment interventions. For adults, there was most evidence of effectiveness for primary care-delivered tailored weight loss and community-based weight loss interventions, at least in the short term among low-income women. There were few studies of appropriate design that could be included on societal-level interventions, a clear limitation of the evidence base found.LimitationsThe reviews located few evaluations of societal-level interventions and this was probably because they included only experimental study designs. The quality assessment tool, although described as a tool for public health interventions, seemed to favour those that followed a more clinical model. The implementation tool was practical but enabled only a brief summary of implementation factors to be made. Most of the studies synthesised in the reviews were from outside the UK and related to women.ConclusionsThe reviews have found some evidence of interventions with the potential to reduce SES inequalities in obesity and that obesity management interventions do not increase health inequalities. More experimental studies of the effectiveness and cost-effectiveness of interventions (particularly at the societal level) to reduce inequalities in obesity, particularly among adolescents and adult men in the UK, are needed.Study registrationThe studies are registered as PROSPERO CRD42011001740 and CRD42013003612.FundingThe National Institute for Health Research Public Health Research programme.

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“…For example, a previous follow-up study conducted in Sweden found that neighbourhood deprivation was independently associated with increased odds of diagnosed childhood obesity [5]. In addition, a systematic review in the UK found that higher neighbourhood-level deprivation was positively associated with childhood obesity prevalence [6]. …”

Section: Introductionmentioning

confidence: 99%

Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children

Hamano

Li²,

Sundquist³

et al. 2017

Obes Facts

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Objectives: The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. Methods: This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level) were used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: We identified 6,968 obesity cases (3,878 boys and 3,090 girls) during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22) that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13). Conclusions: This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes.

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Socioeconomic Inequalities in Childhood Obesity in the United Kingdom: A Systematic Review of the Literature

Cited by 77 publications

References 133 publications

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women

How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews

Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children

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