Abstract
ObjectiveTo report the cross-sectional prevalence and 18-year trends in overweight, obesity and abdominal obesity among Australian children from culturally and linguistically diverse (CALD) backgrounds.Subjects/MethodsFour cross-sectional population health surveys conducted among children (age 4-16 years; n=26, 449) in 1997-2004-2010-2015 in New South Wales, (NSW) Australia. Adiposity outcomes were measured by trained field staff using standard procedures. Binomial regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for overweight and obesity, obesity, and waist-to-height ratio (WHtR) ≥ 0.5 for children from Asian, European, and Middle Eastern language backgrounds compared with children from English-speaking backgrounds, adjusted for sociodemographic characteristics.ResultsOver time, children from Middle Eastern language backgrounds were consistently more likely to be overweight-obese (PR: 1.29–1.42), obese (PR: 1.49–1.65), and have WHtR ≥ 0.5 (PR: 1.42–1.90), compared with children from English-speaking backgrounds. Children from European language backgrounds generally had higher prevalence and children from Asian language backgrounds had lower prevalence, compared with children from English-speaking backgrounds. Between 1997 and 2015, there were significant trends in the prevalence of overweight and obesity combined among children from English-speaking (PR: 1.06, 95%CI: 1.02, 1.09), Middle Eastern (PR: 1.14, 95%CI: 1.05, 1.24), and Asian language backgrounds (PR: 1.14, 95%CI: 1.05, 1.24). The prevalence of WHtr ≥ 0.5 increased among children from English-speaking (PR: 1.21, 95%CI: 1.13, 1.31) and Middle Eastern (PR: 1.35, 95%CI: 1.16, 1.56) language backgrounds.ConclusionsOverall, the prevalence of overweight and obesity and abdominal obesity is high among NSW children from CALD backgrounds and has increased over time. This suggests that there is a greater scope in understanding, developing, and implementing interventions across the early life-course of children from CALD backgrounds.
Highlights
The high prevalence of child obesity remains a global public health concern, but appears to be plateauing in many high-income countries, including Australia [1]
Australia is a nation with high rates of immigration and a recent government inquiry reported that people from culturally and linguistically diverse (CALD) backgrounds face a disproportionate disadvantage on many social indicators
Information on the distribution of CALD communities for NSW and Australia were not available in 1997, for the rest of survey years, the proportions of children from CALD communities were similar to the NSW and Australian CALD population of children aged 5–16 years based on language spoken most at home estimated from the most proximal Census to the survey year [26]
Summary
The response rates and sociodemographic characteristics of the children by survey year are provided in Table 1 and 2. The differences in adiposity outcomes by language background for each survey year are presented as PR (95%CI) with children from English-speaking backgrounds as the reference group (Table 3). The prevalence of adiposity outcomes was consistently and significantly higher among children from Middle Eastern backgrounds. For children from Asian backgrounds, the risk of adiposity outcomes was generally lower than children from English-speaking backgrounds, albeit this was only statistically significant for obesity in 2015. Between 1997 and 2015, the prevalence of overweight and obesity combined has increased among children from English-speaking (PR for trend: 1.06; 95%CI: 1.02, 1.09), Middle Eastern (PR for trend: 1.14; 95%CI: 1.05, 1.24), and Asian (PR for trend: 1.14; 95%CI: 1.05, 1.24) backgrounds. The PR trends indicate, between 1997 and 2015, the prevalence WtHR ≥ 0.5 increased by 21% (95%CI: 1.13, 1.31) and 35% (95%CI: 1.16, 1.56) in children from Englishspeaking and Middle Eastern language backgrounds, respectively
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