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Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China.
BMC Public Health. 2016 06 08; 16:482.BP

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.

Authors+Show Affiliations

Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. M.J.Pallan@bham.ac.uk.Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27277601

Citation

Liu, Weijia, et al. "Socioeconomic Determinants of Childhood Obesity Among Primary School Children in Guangzhou, China." BMC Public Health, vol. 16, 2016, p. 482.
Liu W, Liu W, Lin R, et al. Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China. BMC Public Health. 2016;16:482.
Liu, W., Liu, W., Lin, R., Li, B., Pallan, M., Cheng, K. K., & Adab, P. (2016). Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China. BMC Public Health, 16, 482. https://doi.org/10.1186/s12889-016-3171-1
Liu W, et al. Socioeconomic Determinants of Childhood Obesity Among Primary School Children in Guangzhou, China. BMC Public Health. 2016 06 8;16:482. PubMed PMID: 27277601.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China. AU - Liu,Weijia, AU - Liu,Wei, AU - Lin,Rong, AU - Li,Bai, AU - Pallan,Miranda, AU - Cheng,K K, AU - Adab,Peymane, Y1 - 2016/06/08/ PY - 2016/01/02/received PY - 2016/05/19/accepted PY - 2016/6/10/entrez PY - 2016/6/10/pubmed PY - 2017/9/2/medline KW - China KW - Obesity KW - School children KW - Socioeconomic status SP - 482 EP - 482 JF - BMC public health JO - BMC Public Health VL - 16 N2 - 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. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/27277601/Socioeconomic_determinants_of_childhood_obesity_among_primary_school_children_in_Guangzhou_China_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3171-1 DB - PRIME DP - Unbound Medicine ER -