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Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community

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  • Patrick Ip
  • Frederick Ka Wing Ho
  • Hung-Kwan So
  • Dorothy Fung-ying Chan
  • Matthew Ho
  • Winnie Tso
  • E Anthony S Nelson

Abstract

Background: This study aims to assess evidence for any socioeconomic gradients in childhood obesity and hypertension in a population-representative sample in Hong Kong, China. Methods: The data of a stratified random sampled growth survey collected in 2005–2006 was matched with a population by-census. Obesity was defined using the International Obesity Task Force standard and hypertension was defined using the Hong Kong norm table. Family socioeconomic status (SES) was measured by maternal education level. Neighbourhood SES was measured by median household income of the neighbourhood. Multilevel Poisson regression models with robust standard error were used to test the association. Body mass indices of children’s parents were included as potential confounders. Intra-school/neighbourhood correlations were adjusted using random factors. Results: Totally 14842 children (age 6–19 years) included in the analysis, in which 16.6% of them were overweight or obese. Children whose mother only completed secondary school or below had higher risk of childhood obesity (RR 1.41, 95% CI 1.13–1.76, p = 0.003) and hypertension (RR 1.18, 95% CI 1.01–1.36, p = 0.03). Meanwhile, children in the lowest neighbourhood SES group had higher risk of childhood underweight (RR 1.61, 95% CI 1.04–2.49, p = 0.03), overweight (RR 1.35, 95% CI 1.05–1.72, p = 0.02), and obesity (RR 2.07, 95% CI 1.11–3.88, p = 0.02). Conclusions: Socioeconomic gradient in childhood obesity and hypertension existed in Hong Kong, one of the most developed cities in China. These results have implications for policymakers and public health experts and highlight the need to monitor trends in other parts of China.

Suggested Citation

  • Patrick Ip & Frederick Ka Wing Ho & Hung-Kwan So & Dorothy Fung-ying Chan & Matthew Ho & Winnie Tso & E Anthony S Nelson, 2016. "Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0156945
    DOI: 10.1371/journal.pone.0156945
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    References listed on IDEAS

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    1. Imai, Kosuke & Keele, Luke & Tingley, Dustin & Yamamoto, Teppei, 2011. "Unpacking the Black Box of Causality: Learning about Causal Mechanisms from Experimental and Observational Studies," American Political Science Review, Cambridge University Press, vol. 105(4), pages 765-789, November.
    2. Rockhill, B. & Newman, B. & Weinberg, C., 1998. "Use and misuse of population attributable fractions," American Journal of Public Health, American Public Health Association, vol. 88(1), pages 15-19.
    3. Tingley, Dustin & Yamamoto, Teppei & Hirose, Kentaro & Keele, Luke & Imai, Kosuke, 2014. "mediation: R Package for Causal Mediation Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 59(i05).
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    Cited by:

    1. Michael Osei Mireku & Alina Rodriguez, 2020. "Family Income Gradients in Adolescent Obesity, Overweight and Adiposity Persist in Extremely Deprived and Extremely Affluent Neighbourhoods but Not in Middle-Class Neighbourhoods: Evidence from the UK," IJERPH, MDPI, vol. 17(2), pages 1-12, January.
    2. Jianwei Shi & Duxun Tan & Huilin Xie & Beilei Yang & Rui Liu & Dehua Yu & Yuan Lu & Bing Mei & Zhaoxin Wang, 2017. "Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China," IJERPH, MDPI, vol. 14(3), pages 1-15, March.

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