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Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries

Identifieur interne : 002723 ( Pmc/Checkpoint ); précédent : 002722; suivant : 002724

Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries

Auteurs : P. Due [Danemark] ; Mt Damsgaard [Danemark] ; M. Rasmussen [Danemark] ; Be Holstein [Danemark] ; J. Wardle [Royaume-Uni] ; J. Merlo [Suède] ; C. Currie [Royaume-Uni] ; N. Ahluwalia [France] ; Tia S Rensen [Danemark] ; J. Lynch [Australie, Royaume-Uni]

Source :

RBID : PMC:3421462

Abstract

Objective

It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors.

Design

International cross-sectional survey in national samples of schools.

Subjects

A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001–2002 (N = 162 305).

Measurements

The main outcome measure was overweight based on self-reported height and weight (body mass index cut-points corresponding to body mass index of 25 kg/m2 at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries).

Results

There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries.

Conclusion

The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some Central European countries. Macroeconomic factors are associated with the heterogeneity in prevalence and social inequality of adolescent overweight.


Url:
DOI: 10.1038/ijo.2009.128
PubMed: 19621018
PubMed Central: 3421462


Affiliations:


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<sec id="S1">
<title>Objective</title>
<p id="P2">It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors.</p>
</sec>
<sec id="S2">
<title>Design</title>
<p id="P3">International cross-sectional survey in national samples of schools.</p>
</sec>
<sec id="S3">
<title>Subjects</title>
<p id="P4">A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001–2002 (
<italic>N</italic>
= 162 305).</p>
</sec>
<sec id="S4">
<title>Measurements</title>
<p id="P5">The main outcome measure was overweight based on self-reported height and weight (body mass index cut-points corresponding to body mass index of 25 kg/m
<sup>2</sup>
at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries).</p>
</sec>
<sec id="S5">
<title>Results</title>
<p id="P6">There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries.</p>
</sec>
<sec id="S6">
<title>Conclusion</title>
<p id="P7">The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some Central European countries. Macroeconomic factors are associated with the heterogeneity in prevalence and social inequality of adolescent overweight.</p>
</sec>
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<journal-id journal-id-type="nlm-ta">Int J Obes (Lond)</journal-id>
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<article-title>Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries</article-title>
</title-group>
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<contrib contrib-type="author">
<name>
<surname>Due</surname>
<given-names>P</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Damsgaard</surname>
<given-names>MT</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rasmussen</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Holstein</surname>
<given-names>BE</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wardle</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Merlo</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Currie</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ahluwalia</surname>
<given-names>N</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sørensen</surname>
<given-names>TIA</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lynch</surname>
<given-names>J</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
<xref ref-type="aff" rid="A9">9</xref>
<on-behalf-of>the HBSC obesity writing group</on-behalf-of>
<xref ref-type="author-notes" rid="FN1">10</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark</aff>
<aff id="A2">
<label>2</label>
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark</aff>
<aff id="A3">
<label>3</label>
Department of Epidemiology and Public Health, University College London, London, England</aff>
<aff id="A4">
<label>4</label>
Faculty of Medicine, Social Epidemiology (Department of Clinical Science), Lund University, Malmö, Sweden</aff>
<aff id="A5">
<label>5</label>
Child and Adolescent Research Unit, University of Edinburgh, Edinburgh, Scotland</aff>
<aff id="A6">
<label>6</label>
Service Médical du Rectorat de Toulouse, Toulouse, France</aff>
<aff id="A7">
<label>7</label>
Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, Copenhagen, Denmark</aff>
<aff id="A8">
<label>8</label>
School of Health Sciences, University of South Australia, Adelaide, Australia</aff>
<aff id="A9">
<label>9</label>
Department of Social Medicine, University of Bristol, Bristol, UK</aff>
<author-notes>
<corresp id="cor1">Correspondence: Dr P Due, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5 A, 2nd Floor, Copenhagen 1399, Denmark.
<email>pdu@niph.dk</email>
</corresp>
<fn id="FN1">
<label>10</label>
<p id="P1">Members of the HBSC Obesity Writing Group are listed in the
<xref ref-type="app" rid="APP1">Appendix</xref>
.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>23</day>
<month>7</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub">
<day>21</day>
<month>7</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub">
<month>10</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>17</day>
<month>8</month>
<year>2012</year>
</pub-date>
<volume>33</volume>
<issue>10</issue>
<fpage>1084</fpage>
<lpage>1093</lpage>
<permissions>
<copyright-statement>© 2009 Macmillan Publishers Limited All rights reserved</copyright-statement>
<copyright-year>2009</copyright-year>
</permissions>
<abstract>
<sec id="S1">
<title>Objective</title>
<p id="P2">It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors.</p>
</sec>
<sec id="S2">
<title>Design</title>
<p id="P3">International cross-sectional survey in national samples of schools.</p>
</sec>
<sec id="S3">
<title>Subjects</title>
<p id="P4">A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001–2002 (
<italic>N</italic>
= 162 305).</p>
</sec>
<sec id="S4">
<title>Measurements</title>
<p id="P5">The main outcome measure was overweight based on self-reported height and weight (body mass index cut-points corresponding to body mass index of 25 kg/m
<sup>2</sup>
at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries).</p>
</sec>
<sec id="S5">
<title>Results</title>
<p id="P6">There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries.</p>
</sec>
<sec id="S6">
<title>Conclusion</title>
<p id="P7">The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some Central European countries. Macroeconomic factors are associated with the heterogeneity in prevalence and social inequality of adolescent overweight.</p>
</sec>
</abstract>
<kwd-group>
<kwd>overweight</kwd>
<kwd>social inequality</kwd>
<kwd>adolescents</kwd>
<kwd>international comparisons</kwd>
<kwd>macroeconomic factors</kwd>
</kwd-group>
<funding-group>
<award-group>
<funding-source country="United States">National Institute of Child Health & Human Development : NICHD</funding-source>
<award-id>Z99 HD999999 || HD</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Danemark</li>
<li>France</li>
<li>Royaume-Uni</li>
<li>Suède</li>
</country>
<region>
<li>Angleterre</li>
<li>Hovedstaden</li>
<li>Midi-Pyrénées</li>
<li>Occitanie (région administrative)</li>
<li>Écosse</li>
</region>
<settlement>
<li>Copenhague</li>
<li>Toulouse</li>
</settlement>
</list>
<tree>
<country name="Danemark">
<region name="Hovedstaden">
<name sortKey="Due, P" sort="Due, P" uniqKey="Due P" first="P" last="Due">P. Due</name>
</region>
<name sortKey="Damsgaard, Mt" sort="Damsgaard, Mt" uniqKey="Damsgaard M" first="Mt" last="Damsgaard">Mt Damsgaard</name>
<name sortKey="Holstein, Be" sort="Holstein, Be" uniqKey="Holstein B" first="Be" last="Holstein">Be Holstein</name>
<name sortKey="Rasmussen, M" sort="Rasmussen, M" uniqKey="Rasmussen M" first="M" last="Rasmussen">M. Rasmussen</name>
<name sortKey="S Rensen, Tia" sort="S Rensen, Tia" uniqKey="S Rensen T" first="Tia" last="S Rensen">Tia S Rensen</name>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Wardle, J" sort="Wardle, J" uniqKey="Wardle J" first="J" last="Wardle">J. Wardle</name>
</region>
<name sortKey="Currie, C" sort="Currie, C" uniqKey="Currie C" first="C" last="Currie">C. Currie</name>
<name sortKey="Lynch, J" sort="Lynch, J" uniqKey="Lynch J" first="J" last="Lynch">J. Lynch</name>
</country>
<country name="Suède">
<noRegion>
<name sortKey="Merlo, J" sort="Merlo, J" uniqKey="Merlo J" first="J" last="Merlo">J. Merlo</name>
</noRegion>
</country>
<country name="France">
<region name="Occitanie (région administrative)">
<name sortKey="Ahluwalia, N" sort="Ahluwalia, N" uniqKey="Ahluwalia N" first="N" last="Ahluwalia">N. Ahluwalia</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Lynch, J" sort="Lynch, J" uniqKey="Lynch J" first="J" last="Lynch">J. Lynch</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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