Risk behaviors and sports facilities do not explain socioeconomic differences in childhood obesity: a cross-sectional study

BMC Public Health

Enrique Regidor²  Paloma Astasio¹  Paloma Ortega¹  Lourdes Navalpotro³  Rosa Villanueva¹  Romana Albaladejo¹ 

[1] Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain;CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Health’s Sciences, Universidad Antonio de Nebrija, Madrid, Spain

关键词: Childhood obesity;    Childhood overweight;    Sports facilities;    Obesity risk behaviors;    Socioeconomic context;   

Others  :  1122946
DOI  :  10.1186/1471-2458-14-1181

 received in 2014-09-25, accepted in 2014-11-04,  发布年份 2014

【 摘 要 】

Background

To assess whether the relationship between neighborhood socioeconomic context of residence and childhood obesity is explained by family socioeconomic position, risk behaviors and availability of sports facilities.

Methods

Based on the income and educational level of residents in the neighborhoods of the city of Madrid, two indicators of socioeconomic context were calculated using the information about income and education and grouped into quartiles. In a sample of 727 children aged 6–15 years, the relationship of these indicators with overweight and obesity was studied using multilevel logit models.

Results

With respect to children and adolescents living in neighborhoods having higher per capita incomes or higher population percentages with university education those living in neighborhoods having lower per capita incomes or lower population percentages with university education had age- and sex-adjusted odds ratios (ORs) of overweight that were 1.84 (95% CI, 1.03-3.29) and 1.68 (0.95-2.94) times higher, respectively. After adjustment for family socioeconomic position, unhealthy diet and physical inactivity, these ORs fell to 1.80 (0.99-3.29) and 1.56 (0.87-2.79), respectively. In the case of obesity, the age- and sex-adjusted ORs in these quartiles of both indicators of socioeconomic context were 3.35 (1.06-10.60) and 3.29 (1.03-10.52), respectively, rising to 3.77 (1.12-12.70) and 3.42 (1.00-11.68) after adjustment for the remaining variables. The highest OR was observed in the third quartile, except in the case of the relationship between per capita income and obesity. No relationship between the number of sport facilities per 1,000 population and physical inactivity was observed.

Conclusion

The socioeconomic context is associated with obesity but not with overweight children in Madrid. The relationship is not explained by family socioeconomic position, risk behaviors and availability of sports facilities.

【 授权许可】

   
2014 Albaladejo et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Veitch J, Van Stralen MM, Chinapaw MJM, te Velde SJ, Crawford D, Salmon J, Timperio A: The neighborhood social environment and body mass index among youth: a mediation analysis. Int J Behav Nutr Phys Act 2012, 9:31. BioMed Central Full Text
• [2]Singh GK, Kogan MD, van Dyck P: A multilevel analysis of state and regional disparities in childhood and adolescent obesity in the United States. J Community Health 2008, 33:90-102.
• [3]El-Sayed AM, Scarborough P, Galea S: Unevenly distributed: a systematic review of the heath literature about socioeconomic inequalities in adult obesity in the United Kingdom. BMC Public Health 2012, 12:18. BioMed Central Full Text
• [4]Macintyre S: Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? Int J Behav Nutr Phys Act 2007, 4:32. BioMed Central Full Text
• [5]Janssen I, Boyce WF, Simpson K, Pickett W: Influence of individual and area level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents. Am J Clin Nutr 2006, 83:139-145.
• [6]Oliver LN, Hayes MV: Neighbourhood socio-economic status and the prevalence of overweight Canadian children and youth. Can J Public Health 2005, 96:415-420.
• [7]Singh GK, Siahpush M, Kogan MD: Neighborhood socioeconomic conditions, built environments and childhood obesity. Health Aff 2010, 29:503-512.
• [8]Grow HMG, Cook AJ, Arteburn DE, Saelens BE, Drewnowski A, Lozano P: Child obesity associated with social disadvantage of children's neighbourhoods. Soc Sci Med 2010, 71:584-591.
• [9]Harrington DW, Elliott SJ: Weighing the importance of neighbourhood: a multilevel exploration of the determinants of overweight and obesity. Soc Sci Med 2009, 68:593-600.
• [10]Michimi A, Wimberly MC: Natural environments, obesity and physical activity in nonmetropolitan areas of the United States. J Rural Health 2012, 28:398-407.
• [11]Navalpotro L, Regidor E, Ortega P, Martínez D, Villanueva R, Astasio P: Area-based socioeconomic environment, obesity risk behaviours, area facilities and childhood overweight and obesity. Socioeconomic environment and childhood overweight. Prev Med 2012, 55:102-107.
• [12]Nelson NM, Woods CD: Obesogenic environments: are neighbourhood environments that limit physical activity obesogenic? Health Place 2009, 15:917-924.
• [13]Townshend T, Lake AA: Obesogenic urban form: theory, police and practice. Health Place 2009, 15:909-916.
• [14]Saelens BE, Sallis JF, Lawrence DF, Couch SC, Zhou CH, Colburn T, Cain KE, Chapman J, Glanz K: Am J Prev Med. 2012, 42:e57-e64.
• [15]Smoyer-Tomic KE, Spence JC, Raine KD, Amrhein C, Cameron N, Yasenovsky V, Cutumisu N, Hemphill E, Healy J: The association between neighbourhood socioeconomic status and exposure to supermarkets and fast food outlets. Health Place 2008, 14:740-754.
• [16]Li F, Harmer P, Cardinal DJ, Bosworth M, Johson-Shelton D: Obesity and the built environment: does the density of neighbourhood fast-food outlets matter? Am J Health Promot 2009, 23:203-209.
• [17]Boone-Heinonen J, Gordon-Larsen P: Obesogenic environments in youth. Concepts and methods from a longitudinal national sample. Am J Prev Med 2012, 42:e37-e46.
• [18]van Lenthe FJ, Brug J, MacKenbach JP: Neighbourhood inequalities in physical inactivity: the role of neighbourhood attractiveness proximity to local facilities and safety in the Netherlands. Soc Sci Med 2005, 60:763-775.
• [19]Casey R, Chaix B, Weber C, Schweitzer B, Charreire H, Saize P, Badariotti D, Banos A, Oppert JM, Simon C: Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth. Int J Obes 2012, 36:914-919.
• [20]Leal C, Bean K, Thomas F, Chaix B: Multicollinearity in associations between multiple environmental features and body weight and abdominal fat: using matching techniques to assess whether the associations are separable. Am J Epidemiol 2012, 175:1152-1162.
• [21]Duarte-Salles T, Pasarín MI, Borrell C, Rodríguez-Sanz M, Rajmil L, Ferrer M, Pellisé F, Balagué F: Social inequalities in heath among adolescents in a large southern European city. J Epidemiol Community Health 2011, 65:166-2012. 173
• [22]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity world-wide. International survey. BMJ 2000, 320:1240-1245.
• [23]Lasheras L, Aznar S, Merino B, López EG: Factors associated with physical activity among Spanish youth through the National Health Survey. Prev Med 2001, 32:455-464.
• [24]National Statistics Institute (NSI): Madrid:Social Indicators. 2011. Available at: http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t25/p444&file=inebase&L=0 webcite (accessed 28 September)
• [25]Consejo Superior de Deportes: Madrid: Censo Nacional de Instalaciones Deportivas. 2009. Available at:http://www.csd.gob.es/csd/1CenInstDep webcite (accessed 6 September)
• [26]S.A.S. Institute Inc.: System for Windows V8. Cary: SAS Institute Inc.; 1999.
• [27]Carter MA, Dubois L: Neighbourhoods and child adiposity: a critical appraisal of the literature. Health Place 2010, 16:616-628.
• [28]Wolf SH: Future health consequences of the current decline in US family income. JAMA 2007, 298:1931-1933.
• [29]Chen E, Paterson LQ: Neighborhood, family and subjective socioeconomic status: how do they relate to adolescent health? Health Psychol 2006, 25:704-714.
• [30]Krimbo RT, Brooks-Gunn J, McLanahan S: Young children in urban areas: links among neighbourhood characteristics, weight status, outdoor play and television watching. Soc Sci Med 2011, 72:668-676.
• [31]Sturm R, Cohen DA: Zoning for health? The year-old ban on new fast-food restaurants in south LA. Health Aff (Millwood) 2009, 28:w1088-w1097.
• [32]Larson NI, Story MT, Nelson MC: Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med 2009, 36:74-81.
• [33]Cummins S, McKay L, Macintyre S: McDonald's restaurants and neighbourhood deprivation in Scotland and England? Am J Prev Med 2005, 29:308-310.
• [34]Mcdonald L, Cummins S, Macintyre S: Neighbourhood fast food environment and area deprivation-substitution or concentration? Appetite 2007, 49:251-254.
• [35]Casey R, Oppert JM, Weber C, Charreire H, Salze P, Badariotti D, Banos A, Fischler C, Giacoman Hernandez C, Chaix B, Simon C: Determinants of childhood obesity: what can we learn from built environment studies? Food Qual Prefer 2011. doi:10.1016/j.foodquai.2011.06.003. e-pub ahead of print 22 June 2011
• [36]Beenackers MA, Kamphuis CBN, Giskes K, Brug J, Kunst AE, Burdorf A, Van Lenthe FJ: Socioeconomic inequalities in occupational, leisure-time and transport-related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act 2012, 9:116. BioMed Central Full Text
• [37]Kirby J, Levin KA, Inchley J: Associations between the school environment and adolescent girls' physical activity. Health Educ Res 2012, 27:101-114.
• [38]Binns HJ, Forman JA, Karr CJ, Osterhoudt K, Paulson JA, Roberts JR, Sandel MT, Seltzer JM, Wright RO: The built environment: designing communities to promote physical activity in children. Pediatrics 2009, 123:1591-1598.
• [39]Veugelers PJ, Sithole F, Zhang S, Muhajarine N: Neighborhood characteristics in relation to diet, physical activity and overweight in Canadian children. Int J Pediatr Obes 2008, 3:152-159.
• [40]Davidson Z, Simen-Kapeu A, Veugelers PJ: Neighborhood determinants of self-efficacy, physical activity, and body weights among Canadian children. Health Place 2010, 16:567-572.
• [41]Slater SJ, Ewing R, Powell LM, Chaloupka FJ, Johnston LLD, O'Malley PM: The association between community physical activity settings and youth physical activity, obesity and BMI. J Adolesc Health 2010, 47:496-503.