Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI–2008)

Abstract

Background:Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity.Subjects and Methods:In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative.Results:Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators.Conclusions:These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.

Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6–8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort)

“…A high level of employment is often correlated with a high level of education as well as a greater level of socio-economic well-being, which also entails access to goods and services (gymnasia, swimming pools, and other structures specialising in physical well-being, domestic help, etc. ), which can create a protective environment in terms of various health problems, including obesity [19,41,42]. In addition, dieting and healthy weight-control practices such as reducing high energy food and fat intake and a high level of exercise are more common in women of a higher socio-economic status, who may transfer such behaviours to their children [22,43].…”

Mediterranean Diet Index (KIDMED) Adherence, Socioeconomic Determinants, and Nutritional Status of Portuguese Children: The Eat Mediterranean Program

“…Although no statistically significant association was found between an impaired nutritional status, according to BMI, and the KIDMED index, the vast literature has shown that low parental education, particularly maternal education, is associated with children’s malnutrition [21]. This combined with low socioeconomic status represents a challenge to be addressed.…”

“…Socioeconomic status was set according to two indicators: maternal educational level and monthly household income level, as these have been the ones most frequently used in association with childhood obesity prevalence studies [21]. Maternal education referred to the highest level of education that had been completed by the child’s mother.…”

“…Among 13-year-olds, the corresponding figures were 28% for boys and 24% for girls, and among 15-year-olds, 21 and 16%, respectively [20]. The vast literature has demonstrated that children and adolescents’ eating habits are strongly influenced by several factors in which socioeconomic and lifestyle factors (parental occupational status, maternal level of education, income) strongly influence eating habits in children and adolescents [21-24]. Children belonging to families that do not have adequate resources are more likely to be obese, have a poor dietary pattern, and face a greater burden of ill-health than children who grow up in families that are better off [25].…”

Surveillance Systems to Track and Evaluate Obesity Prevention Efforts

“…representative and standardized data on obesity prevalence among primary-school children in European countries (68). It includes direct measurement of children's heights and weights, along with survey information on numerous individual-level risk factors related to obesity.…”