Abstract
Parents’ education and household wealth cannot be presumed to operate independently of each other. However, in traditional studies on the impact of social inequality on obesity, education and financial wealth tend to be viewed as separable processes. The present study examines the interaction of parents’ education and household wealth in relation to childhood obesity. Anthropometric measurement and questionnaire surveys were carried out on 3670 children (aged 9–12 years) and their parents from 26 elementary schools in northeast China. Results showed that the interaction term was significant for household wealth and father’s education (p < 0.01), while no significant interaction between household wealth and mother’s education was found. In a separate analysis, the interaction was statistically significant among girls for obesity risk based on BMI (p = 0.02), and among urban children for both obesity risk based on BMI (p = 0.01) and abdominal obesity risk based on WHR (p = 0.03). Specifically, when household wealth increased from the first quintile to the fifth quintile, OR for father’s education decreased from higher than 1 (OR = 1.95; 95% CI: 1.12–3.38) to non-significant for girl’s obesity risk, from non-significant to lower than 1 for urban children’s obesity risk (OR = 0.52; 95% CI: 0.32–0.86 for the fourth quintile; OR = 0.37; 95% CI: 0.19–0.73 for the fifth quintile) and from higher than 1 (OR = 1.61; 95% CI: 1.04–2.05) to non-significant for urban children’s abdominal obesity risk. These findings indicate that father’s education level interacts with household wealth to influence obesity among girls and urban children in northeast China.
Highlights
In the last 40 years, obesity has become one of the most serious nutritional concerns for children and adolescents, affecting countries rich and poor, with the global number of obese children and adolescents rising more than tenfold, from 11 million in 1975 to 124 million in 2016 [1,2]
There was no significant difference in childhood obesity prevalence between different household wealth levels, father’s education levels, mother’s education levels, or residence registration area
There was no significant difference in childhood abdominal obesity prevalence between different sexes, household wealth levels, father’s education levels or mother’s education levels or residence registration area
Summary
In the last 40 years, obesity has become one of the most serious nutritional concerns for children and adolescents, affecting countries rich and poor, with the global number of obese children and adolescents rising more than tenfold, from 11 million in 1975 to 124 million in 2016 [1,2]. Socioeconomic status (SES) and economic insecurity were hypothesized to be one of the key determinants of obesity prevalence and other chronic diseases [4]. Tackling social distribution of obesity risk in early life is a main challenge in childhood obesity prevention and has been recommended as an effort to tackle inequalities in mean BMI and obesity status across all ages [5]. Household wealth and parents’ education were the most reported economic and social dimensions of SES that could influence children’s obesity risk [6,7,8]. Household wealth influences the material environment to which children are exposed. Parent education levels affect parents’ ability to process health information, which leads to improved health-related decisions
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