To what extent do unhealthy behaviour indicators explain the neighbourhood deprivation gradient in overweight among 11-year-old English children?

AIMS

This study examined associations between neighbourhood deprivation, school commuting behaviour, a range of unhealthy behaviour indicators and overweight/obesity among 11-year-old English children.

METHODS

Data are from wave five of the UK Millennium Cohort Study, collected in 2012. Subjects consisted of 7262 (3637 boys) 11-year-old English children. Children were classified as normal weight or overweight/obese. School commute mode (active/passive) and health behaviour indicators were parent-reported. Health behaviour indicator scores below the mean of the lower half of the distribution were classified as unhealthy on this indicator. Neighbourhood deprivation was defined using the 2004 English Indices of Multiple Deprivation. Odds ratios (ORs) for being overweight/obese according to neighbourhood deprivation were estimated. A range of unhealthy behaviour indicators were explored to assess the extent to which they attenuated associations between neighbourhood deprivation and overweight/obesity.

RESULTS

Children living in the most deprived neighbourhoods in England were more likely to be overweight/obese, commute to and from school actively and participate in all unhealthy behaviour indicators compared to children living in the least deprived neighbourhoods. Adjusting for confounders and significant unhealthy behaviour indicators reduced the OR for overweight/obese from 1.81 (95% CI 1.54 to 2.13) to 1.56 (95% CI 1.30 to 1.88) in the highest neighbourhood deprivation group compared to the lowest.

CONCLUSION

Active school commuting alone is unlikely to be enough to prevent and reduce the prevalence of overweight/obesity in the most deprived English neighbourhoods. Childhood overweight/obesity-related interventions should focus on promoting participation in a range of health behaviours.