Socioeconomic patterning of childhood overweight status in Europe.

Cécile Knai,Martin Mckee,Nicole Darmon,Tim Lobstein,Harry Rutter

doi:10.3390/ijerph9041472

Abstract

There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations.

Highlights

A social gradient in overweight runs through European and other developed countries, with those who are poorest the most likely to be overweight [1,2,3,4,5,6,7,8,9]
Is there an association between socioeconomic inequality and prevalence of child overweight in European countries? Second, is there evidence that social disparities in child overweight are changing over time? We address the first question by means of a cross-sectional comparison of data on inequality and overweight, and the second question by means of a review of published literature
Self-reported heights and weights gave a range of overweight prevalence values from 5% of children (Switzerland) to 23% (Portugal)

Summary

Introduction

A social gradient in overweight runs through European and other developed countries, with those who are poorest the most likely to be overweight [1,2,3,4,5,6,7,8,9]. The prevalence of overweight has increased across the population of these countries, the rise has not been as severe among the wealthiest parts of the population, leading to widening social disparities among adults [4,8,10,11,12,13,14,15,16]. The reasons underpinning these trends are varied, and differ across contexts and cultures. These trends may in part be due to socio-economic differences, including greater exposure to environments conducive to weight gain, but may reflect culturally-specific health-related behaviour patterns [19,20,21] and, in a few cases, differences in genetic susceptibility [22]

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Results

Discussion

Conclusion