Abstract
We aimed to evaluate the association between family socioeconomic status and repeatedly measured child television viewing time from early childhood to the school period. We analyzed data on 3,561 Dutch children from the Generation R Study, a population-based study in the Netherlands. Parent-reported television viewing time for children aged 2, 3, 4, 6 and 9 years were collected by questionnaires sent from April 2004 until January 2015. Odds ratios of watching television ≥1 hour/day at each age were calculated for children of mothers with low, mid-low, mid-high and high (reference group) education and children from low, middle and high (reference group) income households. A generalized logistic mixed model was used to assess the association between family socioeconomic status and child television viewing time trajectory. The percentage of children watching television ≥1 hour/day increased from age 2 to 9 years for all children (24.2%-85.0% for children of low-educated mothers; 4.7%-61.4% for children of high-educated mothers; 17.2%-74.9% for children from low income households; 6.2%-65.1% for children from high income households). Independent socioeconomic effect in child television viewing time was found for maternal educational level. The interaction between net household income and child age in longitudinal analyses was significant (p = 0.01), indicating that the television viewing time trajectories were different in household income subgroups. However the interaction between maternal educational level and child age was not significant (p = 0.19). Inverse socioeconomic gradients in child television viewing time were found from the preschool period to the late school period. The educational differences between the various educational subgroups remained stable with increasing age, but the differences between household income groups changed over time. Intervention developers and healthcare practitioners need to raise awareness among non-highly educated parents that the socioeconomic gradient in television viewing time has a tracking effect starting from preschool age.
Highlights
Sedentary behaviors, including screen-related behaviors and non-screen related behaviors, are highly prevalent during childhood [1, 2]
We aimed to evaluate the association between family socioeconomic status and repeatedly measured child television viewing time from early childhood to the school period
The increase of child TV viewing time we found in all socioeconomic status (SES) groups from age 2 to 9 years is supported by a recent Swedish study, which found that in 7-to-9-year-old school children sedentary behavior increased in both high and low SES groups [19]
Summary
Sedentary behaviors, including screen-related behaviors (i.e. watching television [TV] and playing computer / electronic games) and non-screen related behaviors (i.e. reading), are highly prevalent during childhood [1, 2]. As a key children’s sedentary leisure time pursuit, parent-reported screen time behavior has been linked with adverse health outcomes in childhood including obesity [3], cardiovascular diseases and increased metabolic risk [4, 5]. The recommendation from the American Academy of Pediatrics limits screen use to 1 hour per day in children 2 to 5 years of age [6]. Australia and Canada government health authority guidelines recommend that children aged 5–12 years should spend no more than 2 hours a day on electronic media for entertainment [7, 8]. Children who watch more TV at young childhood tend to stay high level of TV viewing time in adolescence [11, 12]. Longitudinal studies evaluating child TV viewing time trajectory may provide important information to policy makers and researchers regarding the optimal timing of preventive interventions aimed to reduce screen time in childhood
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