University of Oxford, British Heart Foundation Health Promotion Research Group, Oxford, England.
Int J Obes (Lond). 2012 Jan;36(1):45-52. doi: 10.1038/ijo.2011.191. Epub 2011 Oct 18.
Evidence suggests that area-level deprivation is associated with obesity independently of individual socioeconomic status; however, although the school may also have an impact on child health, few studies have investigated the association between school-level deprivation and the body mass index (BMI) of students. The aim of this study was to assess the relationship between the BMI for children of different ages and area-level and school-level deprivation.
BMI measurements were collected through the National Child Measurement Programme (NCMP) that samples from two school years: 396,171 reception year pupils (4-5-year olds) and 392,344 year 6 pupils (10-11-year olds) from 14,054 primary schools in England.
Cross-classified multilevel models with four levels: individual (n=788,525), lower super output areas corresponding to area of residence (n=29,606), schools (n=14,054) and primary care trusts (PCTs, n=143), which coordinate the collection of data within a large area, were used to study the relationship between measures of deprivation at an area and school level, and childhood BMI within England.
A positive association was found between the area and school measures of deprivation, and student BMI. Both the measures of deprivation explained a greater proportion of variance in BMI z-scores for year 6 students than for the reception year students, with a greater difference between the year groups found with the school-level measure of socioeconomic status than for the the area-level measure.
Deprivation explains a greater proportion of the variance in BMI for older compared with younger children, perhaps reflecting the impact of deprivation as children age, highlighting the widening of health inequalities through childhood. The association with school-level deprivation illustrates the impact of the school on BMI status throughout the primary school years.
有证据表明，区域贫困程度与个体社会经济地位无关，但与肥胖有关；然而，尽管学校也可能对儿童健康产生影响，但很少有研究调查学校贫困程度与学生体重指数（BMI）之间的关系。本研究旨在评估不同年龄段儿童 BMI 与区域和学校贫困程度之间的关系。
通过全国儿童测量计划（NCMP）收集 BMI 测量数据，该计划从两个学年中抽取样本：14054 所英国小学的 396171 名幼儿园（4-5 岁）和 392344 名六年级学生（10-11 岁）。
采用交叉分类多水平模型，有四个层次：个体（n=788525）、居住区域对应的下层超级输出区（n=29606）、学校（n=14054）和初级保健信托（PCT，n=143），用于研究英格兰儿童 BMI 与区域和学校贫困程度之间的关系。
发现区域和学校贫困程度与学生 BMI 呈正相关。两种贫困程度都解释了六年级学生 BMI z 分数方差的更大比例，与幼儿园学生相比，这一比例差异更大，而与学校社会经济地位的衡量标准相比，这一差异在年级群体中更为明显。
与较年轻的儿童相比，贫困程度解释了 BMI 方差的更大比例，这可能反映了随着儿童年龄的增长，贫困程度的影响，突出了通过童年时期健康不平等的扩大。与学校贫困程度的关联说明了学校对整个小学阶段 BMI 状况的影响。
