Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China

Abstract Background Socioeconomic inequalities in childhood obesity prevalence differ according to a country’s stage of nutrition transition. The aim of this study was to determine which socioeconomic factors influence inequalities in obesity prevalence in Chinese primary school children living in a...

Full description

Bibliographic Details
Main Authors: Weijia Liu, Wei Liu, Rong Lin, Bai Li, Miranda Pallan, K. K. Cheng, Peymane Adab
Format: Article
Language:English
Published: BMC 2016-06-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-016-3171-1
_version_ 1819195817500606464
author Weijia Liu
Wei Liu
Rong Lin
Bai Li
Miranda Pallan
K. K. Cheng
Peymane Adab
author_facet Weijia Liu
Wei Liu
Rong Lin
Bai Li
Miranda Pallan
K. K. Cheng
Peymane Adab
author_sort Weijia Liu
collection DOAJ
description Abstract Background Socioeconomic inequalities in childhood obesity prevalence differ according to a country’s stage of nutrition transition. The aim of this study was to determine which socioeconomic factors influence inequalities in obesity prevalence in Chinese primary school children living in an urban setting. Methods We assessed obesity prevalence among 9917 children aged 5–12 years from a stratified random sample of 29 state-funded (residents) and private (migrants) schools in Guangzhou, China. Height and weight were objectively measured using standardised methods and overweight (+1 SD < BMI-for-age z-score ≤ +2 SD) and obesity (BMI-for-age z-score > +2 SD) were defined using the World Health Organisation reference 2007. Socioeconomic characteristics were ascertained through parental questionnaires. Generalised Linear Mixed Models with schools as a random effect were used to compare likelihood of overweight/obesity among children in private, with public schools, adjusting for child age and sex, maternal and paternal BMI and education level, and household per-capita income. Results The prevalence of overweight/obesity was 20.0 % (95 % CI 19.1 %–20.9 %) in resident compared with 14.3 % (95 % CI 13.0 %–15.4 %) in migrant children. In the adjusted model, the odds of overweight/obesity remained higher among resident children (OR 1.36; 1.16–1.59), was higher in boys compared with girls (OR 2.56; 2.24–2.93), and increased with increasing age (OR 2.78; 1.95–3.97 in 11–12 vs 5–6 year olds), per-capita household income (OR 1.27; 1.01–1.59 in highest vs lowest quartile) and maternal education (OR 1.51; 1.16–1.97 in highest vs lowest). Socioeconomic differences were most marked in older boys, and were only statistically significant in resident children. Conclusions The socioeconomic gradient for childhood obesity in China is the reverse of the patterns seen in countries at more advanced stages of the obesity epidemic. This presents an opportunity to intervene and prevent the onset of social inequalities that are likely to ensue with further economic development. The marked gender inequality in obesity needs further exploration.
first_indexed 2024-12-23T02:18:47Z
format Article
id doaj.art-942402b77e734e71bc9a51115c57e671
institution Directory Open Access Journal
issn 1471-2458
language English
last_indexed 2024-12-23T02:18:47Z
publishDate 2016-06-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj.art-942402b77e734e71bc9a51115c57e6712022-12-21T18:03:36ZengBMCBMC Public Health1471-24582016-06-011611810.1186/s12889-016-3171-1Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, ChinaWeijia Liu0Wei Liu1Rong Lin2Bai Li3Miranda Pallan4K. K. Cheng5Peymane Adab6Faculty of School Health, Guangzhou Centre for Disease Control and PreventionFaculty of School Health, Guangzhou Centre for Disease Control and PreventionFaculty of School Health, Guangzhou Centre for Disease Control and PreventionPublic Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of BirminghamPublic Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of BirminghamPublic Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of BirminghamPublic Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of BirminghamAbstract Background Socioeconomic inequalities in childhood obesity prevalence differ according to a country’s stage of nutrition transition. The aim of this study was to determine which socioeconomic factors influence inequalities in obesity prevalence in Chinese primary school children living in an urban setting. Methods We assessed obesity prevalence among 9917 children aged 5–12 years from a stratified random sample of 29 state-funded (residents) and private (migrants) schools in Guangzhou, China. Height and weight were objectively measured using standardised methods and overweight (+1 SD < BMI-for-age z-score ≤ +2 SD) and obesity (BMI-for-age z-score > +2 SD) were defined using the World Health Organisation reference 2007. Socioeconomic characteristics were ascertained through parental questionnaires. Generalised Linear Mixed Models with schools as a random effect were used to compare likelihood of overweight/obesity among children in private, with public schools, adjusting for child age and sex, maternal and paternal BMI and education level, and household per-capita income. Results The prevalence of overweight/obesity was 20.0 % (95 % CI 19.1 %–20.9 %) in resident compared with 14.3 % (95 % CI 13.0 %–15.4 %) in migrant children. In the adjusted model, the odds of overweight/obesity remained higher among resident children (OR 1.36; 1.16–1.59), was higher in boys compared with girls (OR 2.56; 2.24–2.93), and increased with increasing age (OR 2.78; 1.95–3.97 in 11–12 vs 5–6 year olds), per-capita household income (OR 1.27; 1.01–1.59 in highest vs lowest quartile) and maternal education (OR 1.51; 1.16–1.97 in highest vs lowest). Socioeconomic differences were most marked in older boys, and were only statistically significant in resident children. Conclusions The socioeconomic gradient for childhood obesity in China is the reverse of the patterns seen in countries at more advanced stages of the obesity epidemic. This presents an opportunity to intervene and prevent the onset of social inequalities that are likely to ensue with further economic development. The marked gender inequality in obesity needs further exploration.http://link.springer.com/article/10.1186/s12889-016-3171-1Socioeconomic statusObesitySchool childrenChina
spellingShingle Weijia Liu
Wei Liu
Rong Lin
Bai Li
Miranda Pallan
K. K. Cheng
Peymane Adab
Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
BMC Public Health
Socioeconomic status
Obesity
School children
China
title Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
title_full Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
title_fullStr Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
title_full_unstemmed Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
title_short Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China
title_sort socioeconomic determinants of childhood obesity among primary school children in guangzhou china
topic Socioeconomic status
Obesity
School children
China
url http://link.springer.com/article/10.1186/s12889-016-3171-1
work_keys_str_mv AT weijialiu socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT weiliu socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT ronglin socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT baili socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT mirandapallan socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT kkcheng socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina
AT peymaneadab socioeconomicdeterminantsofchildhoodobesityamongprimaryschoolchildreninguangzhouchina