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      Childhood obesity and overweight prevalence trends in England: evidence for growing socio-economic disparities

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          Abstract

          Objective

          Previous data indicate a rapidly increasing prevalence of obesity and overweight among English children and an emerging socioeconomic gradient in prevalence. The main aim of this study was to update prevalence trends among school-age children and assess the changing socioeconomic gradient.

          Design

          A series of nationally representative household-based health surveys conducted between 1997 and 2007 in England.

          Subjects

          15,271 white children (7880 boys) aged 5 to 10 years with measured height and weight.

          Measurements

          Height and weight were directly measured by trained fieldworkers. Overweight (including obesity) and obesity prevalence were calculated using the international body mass index cut-offs. Socioeconomic position (SEP) score was a composite score based on income and social class. Multiple linear regression assessed the prevalence odds with time point (1997/8, 2000/1, 2002/3, 2004/5, 2006/7) as the main exposure. Linear interaction terms of time by SEP were also tested for.

          Results

          There are signs that the overweight and obesity trend has levelled off from 2002/3 to 2006/7. The odds ratio (OR) for overweight in 2006/7 compared to 2002/3 was 0.99 (95% CI 0.88 to 1.11) and for obesity OR = 1.06 (0.86 to 1.29). The socioeconomic gradient has increased in recent years, particularly 2006/7. Compared to 1997/8, the 2006/7 age and sex-adjusted OR for overweight was 1.88 (1.52 to 2.33) in low SEP, 1.25 (1.04 to 1.50) in middle SEP, and 1.13 (0.86 to 1.48) in high SEP children.

          Conclusion

          Childhood obesity and overweight prevalence among school-age children in England has stabilised in recent years, but children from lower socio-economic strata have not benefited from this trend. There is an urgent need to reduce socio-economic disparities in childhood overweight and obesity.

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          Most cited references 41

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          Obesity in children and young people: a crisis in public health.

           ,  T Lobstein,  R Uauy (2004)
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            Socioeconomic status in health research: one size does not fit all.

            Problems with measuring socioeconomic status (SES)-frequently included in clinical and public health studies as a control variable and less frequently as the variable(s) of main interest-could affect research findings and conclusions, with implications for practice and policy. We critically examine standard SES measurement approaches, illustrating problems with examples from new analyses and the literature. For example, marked racial/ethnic differences in income at a given educational level and in wealth at a given income level raise questions about the socioeconomic comparability of individuals who are similar on education or income alone. Evidence also shows that conclusions about nonsocioeconomic causes of racial/ethnic differences in health may depend on the measure-eg, income, wealth, education, occupation, neighborhood socioeconomic characteristics, or past socioeconomic experiences-used to "control for SES," suggesting that findings from studies that have measured limited aspects of SES should be reassessed. We recommend an outcome- and social group-specific approach to SES measurement that involves (1) considering plausible explanatory pathways and mechanisms, (2) measuring as much relevant socioeconomic information as possible, (3) specifying the particular socioeconomic factors measured (rather than SES overall), and (4) systematically considering how potentially important unmeasured socioeconomic factors may affect conclusions. Better SES measures are needed in data sources, but improvements could be made by using existing information more thoughtfully and acknowledging its limitations.
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              Measuring social class in US public health research: concepts, methodologies, and guidelines.

              Increasing social inequalities in health in the United States and elsewhere, coupled with growing inequalities in income and wealth, have refocused attention on social class as a key determinant of population health. Routine analysis using conceptually coherent and consistent measures of socioeconomic position in US public health research and surveillance, however, remains rare. This review discusses concepts and methodologies concerning, and guidelines for measuring, social class and other aspects of socioeconomic position (e.g. income, poverty, deprivation, wealth, education). These data should be collected at the individual, household, and neighborhood level, to characterize both childhood and adult socioeconomic position; fluctuations in economic resources during these time periods also merit consideration. Guidelines for linking census-based socioeconomic measures and health data are presented, as are recommendations for analyses involving social class, race/ethnicity, and gender. Suggestions for research on socioeconomic measures are provided, to aid monitoring steps toward social equity in health.
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                Author and article information

                Affiliations
                [1 ]University College London, Department of Epidemiology and Public Health
                [2 ]University College London, Institute of Child Health
                Author notes
                Correspondence: Emmanuel Stamatakis, Ph.D., Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. Tel: (44) 20 7679 1721, e.stamatakis@ 123456ucl.ac.uk
                Journal
                101256108
                32579
                Int J Obes (Lond)
                Int J Obes (Lond)
                International journal of obesity (2005)
                0307-0565
                1476-5497
                13 December 2013
                03 November 2009
                January 2010
                17 December 2013
                : 34
                : 1
                EMS27824
                10.1038/ijo.2009.217
                3865596
                19884892
                Funding
                Funded by: Medical Research Council :
                Award ID: G0700961(82436) || MRC_
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                Article

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