Effects of social mobility from childhood to adolescence on BMI

Social mobility by parent education and childhood overweight and obesity: a prospective cohort study

BACKGROUND

The association of social mobility, measured by parent education and childhood overweight and obesity (OWOB) has been scarcely reported on. This study evaluated the associations between social mobility measured by parent education and childhood OWOB at child age 6 and 10 years.

METHODS

We analyzed data of 4030 children and parents participating in the Generation R study. We used generalized linear models controlling for potential confounders to determine if social mobility (upward mobility, static-low and static-high based on the change of parent education) was associated with age- and sex-specific standard deviation scores of body mass index (BMI-SDS) or OWOB (the cut-offs of International Obesity Task Force).

RESULTS

Mean BMI-SDS of the children was 0.23 ± 0.89 and 0.26 ± 1.03 at child age 6 and 10 years, respectively; the prevalence of OWOB increased from 15.2 to 17.4%. Compared with children from mothers in the upward mobility group, children from mothers in the static-high group had lower BMI-SDS and lower odds of OWOB at both ages (all P < 0.001). Compared with children from fathers in the upward mobility group, children from fathers in static-low group had higher BMI-SDS and higher odds of OWOB at both ages (all P < 0.05).

CONCLUSIONS

Our study contributes to the literature by showing that the behaviors of parents' obtaining a higher level of education after the child was born may be beneficial to attenuate the odds of the child developing overweight in late childhood.

Assessing the Impact of Changes in Household Socioeconomic Status on the Health of Children and Adolescents: A Systematic Review

Understanding how child and adolescent health is influenced by fluctuations in socioeconomic status has important public health and policy implications, as children are often subjected to both micro and macro-level socioeconomic events. This study provides the first systematic review to date on the relationship between changes in household or parental socioeconomic status and subsequent child and adolescent health outcomes. Eighty articles were identified for inclusion in this review, examining 85 different socioeconomic exposures in five categories: Income (n = 64), Employment (n = 14), Socioeconomic Mobility (n = 3), Education (n = 2), and Food Insecurity (n = 2). The health outcomes analyzed by these eighty articles were separated into eight discrete categories, with many articles examining outcomes in more than one category: Anthropometric Measurements (n = 21), Cognition and Development (n = 15), Dental Health (n = 3), Health Behaviours (n = 9), Mental Health (n = 12), Overall Parent/Guardian Assessed health (n = 6); Physical Health Outcomes (n = 11), and Socio-Emotional Behaviour (n = 30). Several consistent patterns emerged in the literature, such as a link between increased income and improved, or decreased income and deteriorating, cognition, dental health, and physical health. The results of this review suggest a need to replicate current studies in diverse geographies to expand generalizability and clarify regional patterns. There should also be an effort to go beyond income, and employment, to assess the relationship between less frequently studied socioeconomic exposures and child health outcomes.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-021-00151-8.

Statistical challenges in modelling the health consequences of social mobility: the need for diagonal reference models

Objectives

Various studies on the health consequences of socio-economic position address social mobility. They aim to uncover whether health outcomes are affected by: (1) social mobility, besides, (2) social origin, and (3) social destination. Conventional methods do not, however, estimate these three effects separately, which may produce invalid conclusions. We highlight that diagonal reference models (DRMs) overcome this problem, which we illustrate by focusing on overweight/obesity (OWOB).

Methods

Using conventional methods (logistic-regression analyses with dummy variables) and DRMs, we examine the effects of intergenerational educational mobility on OWOB (BMI ≥ 25 kg/m²) using survey data representative of the Dutch population aged 18–45 (1569 males, 1771 females).

Results

Conventional methods suggest that mobility effects on OWOB are present. Analyses with DRMs, however, indicate that no such effects exist.

Conclusions

Conventional analyses of the health consequences of social mobility may produce invalid results. We, therefore, recommend the use of DRMs. DRMs also validly estimate the health consequences of other types of social mobility (e.g. intra- and intergenerational occupational and income mobility) and status inconsistency (e.g. in educational or occupational attainment between partners).

Effects of socioeconomic position and social mobility on linear growth from early childhood until adolescence

OBJECTIVE

To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort.

METHODS

Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each child's family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used.

RESULTS

We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth.

CONCLUSION

Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.

Gender and social mobility modify the effect of birth weight on total and central obesity

BACKGROUND

Little is known about the interaction between gender and low birth weight (LBW) and lifelong social mobility as an explanation of the etiology of obesity. The aim of the present study was to evaluate total and central obesity according to gender, LBW and social mobility, within the context of the epidemiological transition in middle-income countries. We hypothesize that there are more pronounced metabolic consequences of social mobility for women born with LBW.

METHODS

We used data from a birth cohort study conducted in Ribeirão Preto, São Paulo, Brazil. Data regarding anthropometric measurements, schooling and smoking status were collected at 23-25 years of age. Social mobility was determined based on maternal and adult offspring schooling and categorized as Low-Low, Low-High and High-High. Analysis of covariance was performed to assess the association between social mobility and body mass index (BMI) or waist circumference (WC) in adulthood, stratified by LBW and gender.

RESULTS

Data on 6827 singleton pregnancies were collected at birth in 1978/79 and a sample was followed up in 2002/04. A total of 2063 subjects were included in the study. Mean age was 23.9 ± 0.7 years, 51.8% (n = 1068) were female and the LBW was 6.2% (n = 128). There was a triple interaction between social mobility, LBW and gender. Among women born without LBW, BMI and WC were higher in the Low-Low group compared to High-High schooling group. Among LBW women, BMI and WC were higher in the Low-Low group compared to the Low-High group.

CONCLUSIONS

Women born with LBW belonging to the low schooling group in early adulthood had high BMI and WC, compared to the Low-High social mobility group.