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. 2016 May;40(5):796-802.
doi: 10.1038/ijo.2016.12. Epub 2016 Feb 2.

Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008)

L Lissner  1 , T M A Wijnhoven  2 , K Mehlig  1 , A Sjöberg  3 , M Kunesova  4 , A Yngve  5 , A Petrauskiene  6 , V Duleva  7 , A I Rito  8 , J Breda  2
Affiliations

Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008)

L Lissner et al. Int J Obes (Lond). 2016 May.

Abstract

Background: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity.

Subjects and methods: In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative.

Results: Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators.

Conclusions: These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.

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Figures

Figure 1
Figure 1
(a) Prevalence odds ratio for overweight (including obesity) with low maternal and paternal education, compared with reference group with higher education adjusted for sex and age. (b) Prevalence odds ratio for overweight (including obesity) with maternal and paternal unemployment, compared with reference group with employment; adjusted for sex and age. (c) Plot of country-level social indicators (HDI, GINI, GII) in each country, which have been re-scaled to vary between 0% (lowest value) and 100% (highest value), in order to ease the comparison of their variation across the five countries. Absolute values of GINI, HDI and GII at the time of the survey are presented in Table 2. Note: The country codes refer to the International Organization for Standardization (ISO) 3166-1 Alpha 3 country codes: BGR: Bulgaria, CZE: Czech Republic, LTU: Lithuania, PRT: Portugal, SWE: Sweden.
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