Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study

Abstract

Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16–0.48), severe obesity (OR = 0.20; 95% CI: 0.05–0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23–0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.

The Dimensionality, Consistency, and Structural Validity of an Instrument Used to Measure Obesogenic Attitudes in Parents from Southern Spain (The PRELSA Scale)

“…In addition, the measurement invariance for three socio-economic variables relevant to the family environment, such as education, income, and marital status, was confirmed. It was shown that these three variables influence the way parents act with respect to the problem of childhood obesity [ 62 , 63 ], and this invariance allows for comparisons of scores on this scale between these groups of parents to be made in subsequent analyses. Also, to ensure gender invariance, it will be necessary to reach a larger group of fathers, which, in view of the low level of interest shown in this first field test, will require specific sampling (probably face-to-face sampling).…”

A análise de fatores para o desenvolvimento da obesidade infantil como uma medida para a sua prevenção

“…Crianças e adolescentes cujos pais tinham nível superior escolar apresentaram uma probabilidade menor de 34% de desenvolverem obesidade grave, quando comparados aos que tinham pais com uma escolaridade menor. Logo, entender a associação entre a desigualdade socioeconômica e obesidade infantil é crucial, para combater o crescente aumento dessa doença (Homs et al, 2023).…”

“…A OMS pontuou a urgência de reduzir as desigualdades socioeconômicas, como uma forma de prevenção para a obesidade infantil. Em alguns países, foram implementados impostos sobre bebidas açucaradas e o regimento da publicidade em alimentos e bebidas não saudáveis, para crianças com menos de 16 anos (Homs et al, 2023).…”