Abstract
Purpose of Review
This is a review of the patterns, conceptualization, and suggested mechanisms underlying the relationship of socioeconomic status (SES) to obesity in childhood and the implications of these data for interventions going forward.
Recent Findings
Adiposity and SES are negatively associated in high-income countries and positively associated in medium to low-income countries. Several mechanisms, such as early introduction of solid food and parental behaviors, which may explain the association of SES and adiposity, have been identified. Parental education and adiposity and early pediatric nutrition appear to be particularly salient SES-related effectors on adiposity.
Summary
There is a clear association of SES and adiposity which is affected by population affluence. Evaluation of the relationship of SES and obesity in children are complicated by the complexity of SES and lack of common definition. A number of SES-related interventional targets have been identified. Intervention research should ensure they are addressing SES-associated issues in the study population.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Pratt CA, Loria CM, Arteaga SS, Nicastro HL, Lopez-Class M, de Jesus JM, et al. A systematic review of obesity disparities research. Am J Prev Med. 2017;53(1):113–22.
Trust for America’s Health. The state of obesity: better policies for a healthier America. [Internet]. 2019. Available from: https://www.tfah.org/wp-content/uploads/2019/09/2019ObesityReportFINAL-1.pdf
UNICEF. The state of the world’s children 2019. Children, food and nutrition: growing well in a changing world. [Internet]. New York: UNICEF; 2019. Available from: https://www.unicef.org/reports/state-of-worlds-children-2019
Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31(1):219–30.
Finkelstein EA, Graham WKC, Malhotra R. Lifetime direct medical costs of childhood obesity. Pediatr. 2014;133(5):854–62.
Hamilton D, Dee A, Perry IJ. The lifetime costs of overweight and obesity in childhood and adolescence: a systemic review. Obes Rev. 2018;19(4):452–63.
Sonntag D, Ali S, De Bock F. Lifetime indirect costs of childhood overweight and obesity: a decision analytic model. Obesity. 2016;24(1):200–6.
Gebremariam M, Lien N, Nianogo R, Arah O. Review of mediators of socioeconomic differences in adiposity among youth: a systematic review. Obes Rev. 2017;18(8):880–98.
Vallgarda S. Childhood obesity policies - mighty concerns, meek reactions. Obes Rev. 2018;19(3):295–301.
The World Bank. World bank country and lending groups. [Internet]. 2019. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
Safron M, Cislak A, Gaspar T, Luszczynska A. Effects of school-based interventions targeting obesity-related behaviors and body weight change: a systematic umbrella review. J Behav Med. 2011;37(1):15–25.
Cislak A, Safron M, Pratt M, Gaspar T, Luszczynska A. Family-related predictors of body weight and weight-related behaviours among children and adolescents: a systematic umbrella review. Child Care Health Dev. 2012;38(3):321–31.
Rajjo T, Mohammed K, Alsawas M, Ahmed AT, Farah W, Asi N, et al. Treatment of pediatric obesity: an umbrella systematic review. J Clin Endocrinol Metab. 2017;102(3):763–75.
Kobes A, Kretschmer T, Timmerman G, Schreuder P. Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis. Obes Rev. 2018;19(8):1065–79.
Ells LJ, Rees K, Brown T, Mead E, Al-Khudairy L, Azevedo L, et al. Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. Int J Obes. 2018;42(11):1823–33.
Jang M, Chao A, Whittemore R. Evaluating intervention programs targeting parents to manage childhood overweight and obesity: a systematic review using the re-aim framework. J Pediatr Nurs. 2015;30(6):877–87.
Ash T, Agaronov A, Young T, Aftosmes-Tobio A, Davison KK. Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis. Int J Behav Nutr Phys Act. 2017;14(1):113.
Ling J, Robbins L, Wen F, Zhang N. Lifestyle interventions in preschool children: a meta-analysis of effectiveness. Am J Prev Med. 2017;53(1):102–12.
•• Brown T, Moore T, Hooper L, Gao Y, Zayegh A, Ijaz S, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2019;7:CD001871 Most recent (at time of publication) systematic review of interventions that reports SES differences.
Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev Psychiatry. 2012;24(3):176–88.
Schroeder K, Kulage KM, Lucero R. Beyond positivism: understanding and addressing childhood obesity disparities through a critical theory perspective. J Spec Pediatr Nurs. 2015;20(4):259–70.
Grant-Guimaraes J, Feinstein R, Laber E, Kosoy J. Childhood overweight and obesity. Gastroenterol Clin N Am. 2016;45(4):715–28.
Sobal J, Stunkard A. Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989;105:260–75.
Wu S, Ding Y, Wu F, Li R, Hu Y, Hou J, et al. Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis. Sci Rep. 2015;5(1):11354.
Shrewsbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity. 2008;16(2):275–84.
El-Sayed AM, Scarborough P, Galea S. Socioeconomic inequalities in childhood obesity in the United Kingdom: a systematic review of the literature. Obes Facts. 2012;5:671–92.
Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr. 2015;15.
Stamatakis E, Wardle J, Cole TJ. Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities. Int J Obes. 2010;34(1):41–7.
Olds T, Maher C, Zumin S, Peneau S, Lioret S, Castetbon K, et al. Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int J Pediatr Obes. 2011;6(5–6):342–60.
Frederick CB, Snellman K, Putnam RD. Increasing socioeconomic disparities in adolescent obesity. Proc Natl Acad Sci U S A. 2014;111(4):1338–42.
Robert Wood Johnson Foundation. Declining childhood obesity rates - where are we seeing signs of progress? [Internet]. Health Policy Snapshot - Childhood Obesity. 2013; Available from: https://www.issuelab.org/resources/15536/15536.pdf.
Ogden CL, Carroll MD, Lawman HG, Fryar C, Kruszon-Moran D, Kit B, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA. 2016;315(21):2292–9.
Chung A, Backholer K, Wong E, Palermo C, Keating C, Peeters A. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obes Rev. 2016;17(3):276–95.
Dinsa GD, Goryakin Y, Fumagalli E, Suhrcke M. Obesity and socioeconomic status in developing countries: a systematic review. Obes Rev. 2012;13(11):1067–79.
Byrne M, Schwartz O, Simmons J, Sheeber L, Whittle S, Allen N. Duration of breastfeeding and subsequent adolescent obesity: effects of maternal behavior and socioeconomic status. J Adolesc Health. 2018;62(4):471–9.
Mech P, Hooley M, Skouteris H, Williams J. Review of parent-related mechanisms underlying the social gradient of childhood overweight and obesity: a systematic review. Child Care Health Dev. 2016;42(5):603–24.
• Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M, et al. Socioeconomic status in health research one size does not fit all. JAMA. 2005;294(22):2879–88 Critical analysis of the problems with measuring socioeconomic status and suggested improvements that are reiterated in the current review.
Hillier-Brown FC, Bambra CL, Cairns J, Kasim A, Moore HJ, Summerbell CD. A systematic review of the effectiveness of individual, community and societal level interventions at reducing socioeconomic inequalities in obesity amongst children. BMC Public Health. 2014;14(1):834.
Silventoinen K, Huppertz C, van Beijsterveldt C, Bartels M, Willemsen G, Boomsma D. The genetic architecture of body mass index from infancy to adulthood modified by parental education. Obesity. 2016;24(9):2004–11.
Shackleton N. Is there a link between low parental income and childhood obesity? J Early Child Res. 2017;15(3):238–55.
Powell LM, Wada R, Krauss RC, Wang Y. Ethnic disparities in adolescent body mass index in the United States: the role of parental socioeconomic status and economic contextual factors. Soc Sci Med. 2012;75(3):469–76.
Laws R, Campbell KJ, van der Pligt P, Russell G, Ball K, Lynch J, et al. The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review. BMC Public Health. 2014;14(1):779.
Morgan EH, Schoonees A, Sriram U, Faure M, Seguin-Fowler RA. Caregiver involvement in interventions for improving children’s dietary intake and physical activity behaviors. Cochrane Database of Syst Rev. 2020;1:CD012547.
Gibbs B, Forste R. Socioeconomic status, infant feeding practices and early childhood obesity. Pediatr Obes. 2014;9(2):135–46.
Chatham RE, Mixer SJ. Cultural influences on childhood obesity in ethnic minorities: a qualitative systematic review. J Transcult Nurs. 2019;31(1):87–99.
Yan J, Liu L, Zhu Y, Huang G, Wang P. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health. 2014;14(1):1267.
Kaur J, Lamb M, Ogden C. The association between food insecurity and obesity in children - the National Health and Nutrition Examination Survey. J Acad Nutr Diet 2015:115(5):751–758.
Jones KM, Power ML, Queenan JT, Schulkin J. Racial and ethnic disparities in breastfeeding. Breastfeed Med. 2015;10(4):186–96.
Tremblay MS, Gray CE, Akinroye K, Harrington DM, Katzmarzyk PT, Lambert EV, et al. Physical activity of children: a global matrix of grades comparing 15 countries. J Phys Act Health. 2014;11(suppl 1):S113–25.
Brown T, Smith S, Bhopal R, Kasim A, Summerbell C, Brown T. Diet and physical activity interventions to prevent or treat obesity in South Asian children and adults: a systematic review and meta-analysis. Int J Environ Res Public Health. 2015;12(1):566–94.
Andrea S, Hooker E, Messer L, Tandy T, Boone-Heinonen J. Does the association between early life growth and later obesity differ by race/ethnicity or socioeconomic status? A systematic review. Ann Epidemiol. 2017;27(9):583–92.
Whitaker R, Wright J, Pepe M, Seidel K, Dietz W. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337(13):869–73.
Reinehr T, Kleber M, Lass N, Toschke A. Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success. Am J Clin Nutr. 2010;91(5):1165–71.
Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–88.
Fakhouri T, Hughes J, Brody D, Kit B, Ogden C. Physical activity and screen-time viewing among elementary school-aged children in the United States from 2009 to 2010. JAMA Pediatr. 2013;167(3):1–7.
Mcgoron L, Hvizdos E, Bocknek E, Montgomery E, Ondersma S. Feasibility of internet-based parent training for low-income parents of young children. Child Youth Serv Rev. 2018;84:198–205.
de Niet J, Timman R, Jongejan M, Passchier J, van den Akker E. Predictors of participant dropout at various stages of a pediatric lifestyle program. Pediatrics. 2011;127(1):e164–70.
Cui Z, Seburg E, Sherwood N, Faith M, Ward D. Recruitment and retention in obesity prevention and treatment trials targeting minority or low-income children: a review of the clinical trials registration database. Trials. 2015;16(1):564.
Shabbir S, Kwan D, Wang MC, Shih M, Simon PA. Asians and Pacific Islanders and the growing childhood obesity epidemic. Ethn Dis. 2010;20(2):129–35.
Bullock A, Sheff K, Moore K, Manson S. Obesity and overweight in American Indian and Alaska Native children, 2006-2015. Am J Public Health. 2017;107(9):1502–7.
Ligthart KAM, Buitendijk L, Koes BW, van Middelkoop M. The association between ethnicity, socioeconomic status and compliance to pediatric weight-management interventions - a systematic review. Obes Res Clin Pract. 2017;11(5 Suppl 1):1–51.
Barkin SL, Gesell SB, Po’e EK, Escarfuller J, Tempesti T. Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschool-aged children. Pediatrics. 2012;130(3):445–56.
Perez LG, Arredondo EM, Elder JP, Barquera S, Nagle B, Holub CK. Evidence-based obesity treatment interventions for Latino adults in the US: a systematic review. Am J Prev Med. 2013;44(5):550–60.
Gassman-Pines A, Skinner AT. Psychological acculturation and parenting behaviors in Mexican-immigrant families. J Fam Issues. 2018;39(5):1139–64.
Peeters A, Backholer K. Prioritising and tackling socio-economic inequalities in obesity. BMC Obesity. 2014;1.
Lin B, Smith T, Lee J, Hall K. Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax. Econ Hum Biol. 2011;9(4):329–41.
Briggs A, Mytton O, Kehlbacher A, Tiffin R, Rayner M, Scarborough P. Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study. BMJ. 2013;347.
Ruff RR, Zhen C. Estimating the effects of a calorie-based sugar-sweetened beverage tax on weight and obesity in New York city adults using dynamic loss models. Ann Epidemiol. 2015;25(5):350–7.
• Nakhimovsky SS, Feigl AB, Avila C, O’Sullivan G, Macgregor-Skinner E, Spranca M. Taxes on sugar-sweetened beverages to reduce overweight and obesity in middle-income countries: a systematic review. PLoS ONE. 2016;11(9):e0163358 This recent systematic review, based on mostly estimates, suggests taxing SSBs will reduce net energy intake by enough to prevent further growth in obesity prevalence, but not to reduce population weight permanently.
Nakamura R, Mirelman A, Cuadrado C, Silva-Illanes N, Dunstan J, Suhrcke M. Evaluating the 2014 sugar-sweetened beverage tax in Chile: an observational study in urban areas. PLoS Med. 2018;15(7):e1002596.
Gortmaker S, Wang Y, Long M, Giles C, Ward Z, Barrett J, et al. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Aff. 2015;34(11):1932–9.
• Jones A. Race, socioeconomic status, and health during childhood: a longitudinal examination of racial/ethnic differences in parental socioeconomic timing and child obesity risk. Int J Environ Res Public Health. 2018;15(4) Strong recent study suggesting SES, particularly mother’s employment and father’s education, is linked to weight gain differently for White, Black, and Hispanic children at specific ages.
CONSORT. Transparent Reporting of Trials. [Internet]. 2020. Available from: http://www.consort-statement.org/
Hoffmann T, Glasziou P, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
No conflicts of interest are declared for study authors.
Human and Animal Rights
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Etiology of Obesity
Rights and permissions
About this article
Cite this article
Vazquez, C.E., Cubbin, C. Socioeconomic Status and Childhood Obesity: a Review of Literature from the Past Decade to Inform Intervention Research. Curr Obes Rep 9, 562–570 (2020). https://doi.org/10.1007/s13679-020-00400-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13679-020-00400-2