Abstract
The risk of child obesity is strongly related to socioeconomic factors such as individual socioeconomic position (SEP) and neighbourhood deprivation. The present study analyses whether the relationship between neighbourhood deprivation and child obesity differs by child’s individual SEP. Data from 5656 children (5–7 years) from the mandatory school enrollment examinations of the pre-school cohorts 2017/2018 in Düsseldorf were analysed. Obesity was determined by the age- and gender-specific body mass index (BMI); neighbourhood deprivation by using the socio-spatial degree of deprivation of the children’s residential addresses; and individual SEP by the level of parental education. Using Poisson regression, we estimated prevalence ratios (PR with 95% confidence interval (CI)) of child obesity by neighbourhood deprivation and parental education. Interactions between neighbourhood deprivation and parental education were tested. The prevalence of child obesity increases with the degree of neighbourhood deprivation. Compared to children living in low deprivation neighbourhoods, the proportion of obese children was twice as high in high deprivation neighbourhoods (PR=2.02; CI=1.46–2.78). Likewise, children from families with medium and low education have twice the risk for obesity compared to children with high parental education (PR=2.05; CI=1.46–2.78). The relationship between neighbourhood deprivation and child obesity was significantly moderated by parental education; it was stronger for higher parental education than for medium and low parental education (p<.001).Conclusion: Our findings suggest that children from deprived neighbourhoods and families with lower education have a higher risk for child obesity. The identification of particularly deprived neighbourhoods with structural interventions in combination with the strengthening of parental health literacy seems reasonable.What is Known:• Studies show that children from disadvantaged neighbourhoods are more frequently obese.What is New:• The relationship between neighbourhood deprivation and child obesity is significantly moderated by parental education. It is stronger for children with higher parental education than for children with medium and low parental education.
Highlights
About every fifth child in Europe is overweight or obese [2]
Our findings suggest that children from deprived neighbourhoods and families with lower education have a higher risk for child obesity
The differences in the prevalences between very low and high deprived neighbourhoods were higher for children with higher educated parents (2.8% vs. 12%; p
Summary
About every fifth child in Europe is overweight or obese [2]. the prevalence of overweight and obesity has plateaued [1], a considerable percentage of children is affected.Overweight and obesity in childhood increase the risk for obesity in adulthood [42] and chronic diseases such as type 2 diabetes and coronary heart disease [34]. About every fifth child in Europe is overweight or obese [2]. The prevalence of overweight and obesity has plateaued [1], a considerable percentage of children is affected. The World Health Organization has identified child obesity as one of the “most serious public health challenges of the 21st century” [16]. Identifying risk factors is crucial to developing preventive measures. Social ecological models of child obesity contain individual and environmental factors [27] including neighbourhood. Neighbourhood SEP influences the spatial and social environment (e.g. walkability, organised programmes, safety), which, in turn, affects the individual situation (e.g. health behaviour, utilisation, stress) and, as a result, child body weight [10, 13, 44]
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