Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents2

https://doi.org/10.1093/ajcn/83.1.139Get rights and content
Under an Elsevier user license
open archive

ABSTRACT

Background: Low socioeconomic status (SES) is a risk factor for obesity. However, few studies have used a multilevel analysis to determine the influence of both individual- and area-level determinants of SES on obesity, and these studies have been limited to adults.

Objective: The primary objective was to examine associations between individual- and area-level measures of SES and obesity among adolescents by using a multilevel analytic approach. A secondary objective was to examine associations between individual- and area-level measures of SES with unhealthy eating and physical inactivity.

Design: The study sample consisted of 6684 youth in grades 6–10 from 169 schools across Canada. Individual-level SES exposures included material wealth and perceived family wealth. Area-level SES exposures included unemployment rate, percentage of adult residents with less than a high school education, and average employment income from head of household. Associations between SES and the outcome measures were examined by using multilevel logistic regression procedures that modeled students (individual level) nested within schools (area level).

Results: Both individual-level and all 3 area-level SES measures were inversely associated with obesity. The odds for unhealthy eating were increased for those living in an area with a low percentage of residents with a high school education. The odds of being physically inactive increased with decreasing levels of material wealth and perception of family wealth.

Conclusions: Individual- and area-level SES measures were independently related to obesity, which suggests that both individual and environmental approaches may be required to curtail adolescent obesity.

Keywords:

Health surveys
social class
body mass index
food habits
motor activity

Cited by (0)

2

Supported by Health Canada, which funds the Canadian version of the World Health Organization-Health Behaviour in School-Aged Children Survey (WHO-HBSC). The WHO-HBSC is a WHO/Euro collaborative study. International Coordinator of the 2001–2002 study: Candace Currie, University of Edinburgh, Scotland; Data Bank Manager: Oddrun Samdal, University of Bergen, Norway. This publication reports data solely from Canada (Principal Investigator: William Boyce) and was funded in part through a grant from the Canadian Population Health Initiative (CPHI). CPHI is a program of the Canadian Institutes of Health Information (CIHI). The CIHI supports research advancing knowledge of the determinants of the health of the Canadian population and develops policy options to improve population health and reduce health inequalities. CIHI is a national, not-for-profit organization responsible for developing and maintaining Canada’s comprehensive health information system.