Neighborhood contributions in influencing overweight and obesity among Chinese children and adolescents: Temporal, geographical and gender variations

Objective

The precise extent to which neighborhood influences childhood overweight and obesity (O/O) remains unknown. We investigated the magnitudes of neighborhood contributions to childhood O/O and explored potential temporal, geographical and gender variations.

Study design

This was a pooled analysis using secondary survey data from six China Family Panel Studies from 2010 to 2020.

Methods

26 262 children and adolescents aged 6–16 years residing in the low, medium and high O/O prevalence areas were included. Multilevel logistic analyses with random slopes were utilized to regress O/O on various individual and neighborhood covariates. Intraclass Correlation Coefficients were applied to quantify neighborhood contributions and 80 % Interval Odds Ratio and Proportions of Opposed Odds Ratios were used to evaluate between-neighborhood discrepancies in specific neighborhood factors.

Results

Overall, neighborhood accounted for 2%–8% of O/O variations. Temporally, neighborhood contributions declined from 2010 to 2016 but increased thereafter. Geographically, they were higher in medium/low prevalence areas than high prevalence areas (4%–10 % vs. 2%–6%). Compared to males, they were greater among females (3%–9% vs. 1%–7%). Neighborhood contributions in high prevalence areas have rapidly increased recently with those among males growing faster. Besides O/O prevalence areas, residence (OR: 1.12, CIs: 1.01–1.23)) and percentage of households with minimum living allowance (1.01, 1.00–1.01) were significant neighborhood factors with the effects of residence exhibited lower between-neighborhood variations (32%–43 % vs. 48%–50 %).

Conclusion

This study empirically suggests the importance of neighborhood and supports the potential of governmental policies aiming at curbing childhood overweight/obesity through tailored neighborhood-based interventions.