Diversity & Equality in Health and Care Open Access

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Abstract

Social Inequality and Overweight in German Primary School Children: A Cross-Sectional Analysis

Susanne Kobel*, Lina Hermeling, Christine Lämmle, Olivia Wartha, Jürgen M. Steinacker

Objective: Overweight and obesity lead to adverse health outcomes and track from childhood into adulthood. There is growing evidence that social disparities in overweight already exist in childhood. This study examines associations between weight status in childhood, parental cultural background and socioeconomic status (SES).

Methods: Height and weight were measured in 1646 primary school children (7.1 ± 0.6 years, 50.1% male), of which 489 (29.8%) had a migration background. Body mass index (BMI) was calculated and weight status was de- termined based on national and international percentile curves. Migration status and SES were obtained through a parental questionnaire. Logistic regression was used to estimate odds of overweight, adjusted for age, gender and parental BMI.

Results: Prevalence of overweight including obesity was 18.5%. It was higher among children with migration background (26.5% p<0.001). Children whose parents emigrated from Turkey exhibited the highest overweight prevalence (34.8%, p<0.001). Children with migration background had an 81.9% higher risk of being overweight (p<0.001) while children from families with low income had a 114.9% higher risk of being overweight (p<0.001). The combination of both revealed no significant effect, showing that the two factors are independently related to childhood overweight.

Conclusion: Migration background and low family income are substantial independent risk factors for childhood overweight. Public health policies need to consider the social gradient in health as well as intracultural differenc- es which are present already in childhood in order to be effective and to avoid further health inequalities.

Published Date: 2022-07-27; Received Date: 2022-06-29