Overweight and obesity by school socioeconomic composition and adolescent socioeconomic status: a school-based study

Abstract

Background The main objective of this study was to investigate the interaction effect of school socioeconomic composition (SEC) and adolescent socioeconomic status (SES) in the prevalence of overweight and obesity among a representative sample of French adolescents of the third most populous département of France. Methods 1038 adolescents agreed to participate (response rate: 91.4%). They self-reported anthropomorphic variables, SES, school lunch and physical activity. The body mass index was divided into six categories according to the Center for Disease Control. Multivariable binary logistic regressions analysis without and with interaction term were performed on overweight or obesity. Models fit was compared using the Aikaike Information Criterion. Odds-ratios (OR) and their 95% accelerated-bootstrap confidence interval (95%BCa CI) were computed to estimate overweight or obesity risk. Results 8.9% of the adolescents were overweight. 3.4% were obese. No school-SEC effect was observed among low-SES adolescents. Medium-SES adolescents were at greater risk in low-SEC (OR = 10.75, 95%BCa CI = 2.67–64.57) and medium-SEC (OR = 5.08, 95%BCa CI = 1.55–24.84) compared with high-SEC schools. High-SES adolescents in low-SEC schools were at greater risk compared with those in medium-SEC (OR = 5.94, 95%BCa CI = 1.94–17.29) and high-SEC schools (OR = 4.99, 95%BCa CI = 1.71–13.14). A social gradient was observed in medium-SEC (ORlow/high = 2.79, 95%BCa CI = 1.22–7.41) and high-SEC (ORlow/medium = 6.86, 95%BCa CI = 1.06–5.22*106) schools. Conclusions Physical activity and lunch at and outside school help to understand these differences. Implications for obesity prevention initiatives are discussed.

The Relationship of Social Economic Status and Obesity Among Adolescents

“…The interaction effect also can be found in the developed country and developing country, Low SES is risk factor for obesity in the developed country but is protective factor in developing country [8]. The studies above have proven that the living environments (like community and school) are crucial for the relationship between obesity and objective social economic status [4,[7][8]. The same results may be found in other living environments for teens.…”

“…OSES is usually assessed by the indicators like educational level, occupation and income. Obesity has been found to be negatively correlated with objective social economic status in a number of studies [4]. In a same school, teenagers with low-SES were more likely to be obese than those with high-SES.…”

“…Subjects below the 5th percentile were considered underweight, normal weight was below the 85th percentile, overweight was between the 85th and 95th percentiles, and obesity was above the 95th percentile. Therefore, subjects who are overweight and obese should be above the 85th percentile [4].…”

“…Individual with high-SES living in high-end residential areas, they are less likely to be obese than those with lower incomes in the same region [7]. Another research shows that high-SES students have greater risk in low-SES school [4]. The interaction effect also can be found in the developed country and developing country, Low SES is risk factor for obesity in the developed country but is protective factor in developing country [8].…”

The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index: A comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States

“…Future studies might also examine mesolevel mechanisms, such as neighborhood differences in built environments across countries (Gordon-Larsen et al, 2006) and differences in school policies regarding diet and activity. Furthermore, recent studies conducted in Europe (Luiggi et al, 2021) and the US (Kim et al, 2020) have shown interaction effects between meso-and individual/family-level SES and overweight and obesity among children and adolescents. For example, Kim et al (2020) showed that, in the US, living in a high SES neighborhood is protective against obesity among higher-income children, but not among low-income children.…”