London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Int J Environ Res Public Health. 2012 Apr;9(4):1472-89. doi: 10.3390/ijerph9041472. Epub 2012 Apr 16.
There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations.
越来越多的证据表明,欧洲儿童超重存在社会差异。本文研究了欧洲国家社会经济不平等与儿童超重流行之间是否存在关联,以及儿童超重的社会经济差异是否在增加。我们分析了欧洲国家间家庭不平等和儿童超重流行率的跨国比较,并综述了文献中关于按社会群体划分的儿童超重随时间的变化。来自 22 个欧洲国家的数据表明,家庭收入不平等程度越大,自我报告和测量的儿童超重流行率就越高。此外,四个国家的七项研究报告了社会经济因素对儿童超重分布随时间变化的影响。在七项研究中有四项报告了儿童超重的社会差距扩大,有一项研究发现小部分群体中存在统计学上显著的差异,一项研究发现非统计学上显著的差异,最后一项研究则报告说没有社会梯度。在儿童超重的社会梯度扩大的地方,涉及超重流行的生活方式和饮食习惯的变化,对社会经济地位较低的群体的影响可能不如对其他人群的影响那么有利。为了阻止当前和未来几代人儿童超重的社会梯度不断增加,需要更深入的基于全民社会和环境干预的结构性变革。