Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region

Marta Buoncristiano¹, Julianne Williams¹, Philippa Simmonds¹, Eha Nurk², Wolfgang Ahrens^{3

4}, Paola Nardone⁵, Ana Isabel Rito⁶, Harry Rutter⁷, Ingunn Holden Bergh⁸, Gregor Starc⁹, Kenisha Russell Jonsson¹⁰, Angela Spinelli⁵, Stefanie Vandevijvere¹¹, Päivi Mäki¹², Sanja Musić Milanović^{13

14}, Benoît Salanave^{15

16}, Mahmut S Yardim¹⁷, Tatjana Hejgaard¹⁸, Anna Fijałkowska¹⁹, Shynar Abdrakhmanova^{20

21}, Zulfiya Abdurrahmonova²², Vesselka Duleva²³, Victoria Farrugia Sant'Angelo²⁴, Marta García-Solano²⁵, Andrea Gualtieri²⁶, Enrique Gutiérrez-González²⁵, Constanta Huidumac-Petrescu²⁷, Jolanda Hyska²⁸, Cecily C Kelleher²⁹, Enisa Kujundžić³⁰, Valentina Peterkova³¹, Ausra Petrauskiene³², Iveta Pudule³³, Elena Sacchini²⁶, Lela Shengelia³⁴, Maya Tanrygulyyeva³⁵, Radka Taxová Braunerová³⁶, Zhamilya Usupova³⁷, Katharina Maruszczak³⁸, Sergej M Ostojic³⁹, Igor Spiroski^{40

41}, Dragana Stojisavljević^{42

43}, Kremlin Wickramasinghe¹, João Breda¹

Affiliations

¹ World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
² Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia.
³ Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.
⁴ Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
⁵ National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.
⁶ WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
⁷ Department of Social and Policy Sciences, University of Bath, Bath, UK.
⁸ Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
⁹ Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
¹⁰ Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden.
¹¹ Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
¹² Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
¹³ Croatian Institute of Public Health, Zagreb, Croatia.
¹⁴ School of Medicine, University of Zagreb, Zagreb, Croatia.
¹⁵ Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.
¹⁶ Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France.
¹⁷ Faculty of Medicine, Hacettepe University, Ankara, Turkey.
¹⁸ Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark.
¹⁹ Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
²⁰ Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.
²¹ Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan.
²² Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan.
²³ Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria.
²⁴ Primary Child Health Unit, Primary Health Care, Floriana, Malta.
²⁵ Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain.
²⁶ Health Authority, Ministry of Health, San Marino, San Marino.
²⁷ National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania.
²⁸ Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania.
²⁹ College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland.
³⁰ Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro.
³¹ Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
³² Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³³ Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia.
³⁴ Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
³⁵ Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan.
³⁶ Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
³⁷ Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
³⁸ Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria.
³⁹ Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
⁴⁰ Institute of Public Health, Skopje, North Macedonia.
⁴¹ Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia.
⁴² Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁴³ Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina.

PMID: 34184399
DOI: 10.1111/obr.13213

Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region

Marta Buoncristiano et al. Obes Rev. 2021 Nov.

. 2021 Nov:22 Suppl 6:e13213.

doi: 10.1111/obr.13213. Epub 2021 Jun 28.

Authors

Affiliations

¹ World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
² Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia.
³ Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.
⁴ Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
⁵ National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.
⁶ WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
⁷ Department of Social and Policy Sciences, University of Bath, Bath, UK.
⁸ Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
⁹ Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
¹⁰ Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden.
¹¹ Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
¹² Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
¹³ Croatian Institute of Public Health, Zagreb, Croatia.
¹⁴ School of Medicine, University of Zagreb, Zagreb, Croatia.
¹⁵ Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.
¹⁶ Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France.
¹⁷ Faculty of Medicine, Hacettepe University, Ankara, Turkey.
¹⁸ Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark.
¹⁹ Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
²⁰ Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.
²¹ Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan.
²² Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan.
²³ Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria.
²⁴ Primary Child Health Unit, Primary Health Care, Floriana, Malta.
²⁵ Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain.
²⁶ Health Authority, Ministry of Health, San Marino, San Marino.
²⁷ National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania.
²⁸ Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania.
²⁹ College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland.
³⁰ Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro.
³¹ Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
³² Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³³ Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia.
³⁴ Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
³⁵ Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan.
³⁶ Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
³⁷ Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
³⁸ Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria.
³⁹ Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
⁴⁰ Institute of Public Health, Skopje, North Macedonia.
⁴¹ Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia.
⁴² Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁴³ Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina.

PMID: 34184399
DOI: 10.1111/obr.13213

Abstract

Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.

Keywords: children; obesity; overweight; socioeconomic status.

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References

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Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region

Affiliations

Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical