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

Pernille Due, MT Damsgaard, M Rasmussen, Bjørn Holstein, J Wardle, J Merlo, C Currie, N Ahluwalia, T Sørensen, J Lynch, HBSC writing group, A Borraccino, I Borup, W Boyce, F Elgar, S Gabhainn, R Krølner, Chalida Svastisalee, M Matos, T Nansel, H Al Sabbah, C Vereecken, R Valimaa

    Publikation: Bidrag til tidsskriftTidsskriftsartikelForskningpeer review

    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.
    OriginalsprogEngelsk
    TidsskriftInternational Journal of Obesity
    Vol/bind33
    Udgave nummer10
    Sider (fra-til)1084-1093
    Antal sider10
    ISSN0307-0565
    DOI
    StatusUdgivet - okt. 2009

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