Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)
189 Downloads (Pure)


Background: Socioeconomic inequalities in childhood obesity prevalence differ according to a country’s stage ofnutrition transition. The aim of this study was to determine which socioeconomic factors influence inequalities inobesity prevalence in Chinese primary school children living in an urban setting.Methods: We assessed obesity prevalence among 9917 children aged 5–12 years from a stratified random sample of29 state-funded (residents) and private (migrants) schools in Guangzhou, China. Height and weight were objectivelymeasured using standardised methods and overweight (+1 SD < BMI-for-age z-score ≤ +2 SD) and obesity (BMI-for-agez-score > +2 SD) were defined using the World Health Organisation reference 2007. Socioeconomic characteristics wereascertained through parental questionnaires. Generalised Linear Mixed Models with schools as a random effect wereused to compare likelihood of overweight/obesity among children in private, with public schools, adjusting for childage and sex, maternal and paternal BMI and education level, and household per-capita income.Results: The prevalence of overweight/obesity was 20.0 % (95 % CI 19.1 %–20.9 %) in resident compared with 14.3 %(95 % CI 13.0 %–15.4 %) in migrant children. In the adjusted model, the odds of overweight/obesity remained higheramong resident children (OR 1.36; 1.16–1.59), was higher in boys compared with girls (OR 2.56; 2.24–2.93), andincreased with increasing age (OR 2.78; 1.95–3.97 in 11–12 vs 5–6 year olds), per-capita household income (OR 1.27; 1.01–1.59 in highest vs lowest quartile) and maternal education (OR 1.51; 1.16–1.97 in highest vs lowest). Socioeconomicdifferences were most marked in older boys, and were only statistically significant in resident children.Conclusions: The socioeconomic gradient for childhood obesity in China is the reverse of the patterns seen incountries at more advanced stages of the obesity epidemic. This presents an opportunity to intervene and prevent theonset of social inequalities that are likely to ensue with further economic development. The marked gender inequalityin obesity needs further exploration.Keywords: Socioeconomic status, Obesity, School children, China
Original languageEnglish
Pages (from-to)482
JournalBMC Public Health
Issue number482
Publication statusPublished - 8 Jun 2016


  • Socioeconomic status
  • Obesity
  • School children
  • China


Dive into the research topics of 'Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China'. Together they form a unique fingerprint.

Cite this