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Age differences in the association of childhood obesity with area-level and school-level deprivation: cross-classified multilevel analysis of cross-sectional data

International Journal of Obesity volume 36, pages 45–52 (2012)Cite this article

Abstract

Objective:

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.

Subjects:

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.

Design:

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.

Results:

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.

Conclusions:

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.

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Acknowledgements

NOO acknowledge the NHS Information Centre (IC) in providing the NCMP data. Core funding for the study was provided by the National Obesity Observatory (NOO). This work was undertaken by the Oxford University and NOO. NOO received funding from the Department of Health; the views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

Author contributions

NT was responsible for statistical analysis and writing the manuscript; he is the guarantor. HR and CF contributed to the development of the study and provided critical review of the manuscript.

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Authors and Affiliations

  1. University of Oxford, British Heart Foundation Health Promotion Research Group, Oxford, England

    N Townsend & C Foster

  2. National Obesity Observatory, Oxford, England

    N Townsend & H Rutter

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  1. N Townsend
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  3. C Foster
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Correspondence to N Townsend.

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Townsend, N., Rutter, H. & Foster, C. Age differences in the association of childhood obesity with area-level and school-level deprivation: cross-classified multilevel analysis of cross-sectional data. Int J Obes 36, 45–52 (2012). https://doi.org/10.1038/ijo.2011.191

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