scholarly journals Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Davide Rasella ◽  
Lorenzo Richiardi ◽  
Nicolai Brachowicz ◽  
H. Xavier Jara ◽  
Mark Hanson ◽  
...  
Keyword(s):  
Child Health ◽  
Family Income ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Strong Impact ◽  
Baseline Scenario ◽  
Fiscal Policies ◽  
Childhood Health ◽  
Targeted Interventions ◽  
The Impact

Abstract Background We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy. Methods MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell’Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. Results Both universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children—in comparison with the baseline fiscal system—of 0.88 (95%CI 0.82–0.93) and 0.89 (95%CI 0.83–0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50–0.83) for the simulated BI and 0.64 (95%CI 0.44–0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones. Conclusions Our results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.

scholarly journals Growth and Weight Status in Chinese Children and Their Association with Family Environments

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 397
Author(s):  
Xu Tian ◽  
Hui Wang
Keyword(s):  
Weight Status ◽  
Family Income ◽  
Decomposition Analysis ◽  
Overweight And Obesity ◽  
Chinese Children ◽  
Nutrition Survey ◽  
Growth Status ◽  
Health And Nutrition ◽  
The Impact ◽  
Over Time

The growth status and weight status of Chinese children have experienced remarkable changes in the past decades. Using China Health and Nutrition Survey (CHNS) data, this paper examines the secular trends and disparity of the growth status and weight status in Chinese children and further investigates the impact of various family environments on children’s growth from 1991 to 2011. We found an increasing trend in standardized growth indicators (height, weight, and BMI), overweight, and obesity from 1991 to 2011. We also observed an increasing disparity in overweight and obesity over time. Family environments had a significant impact on children’s growth status and weight status. In particular, children that live in families with a small size, higher family income, better sanitary conditions, and with well-educated parents or overweight parents tended to be taller and heavier and have a higher BMI, lower risk of being underweight, and higher risk of exhibiting overweight and obesity. Further decomposition analysis showed that more than 70% of the disparity in standardized height, weight, and overweight and around 50% of the disparity in standardized BMI, underweight, and obesity could be attributed to heterogeneity in family environments. Moreover, the disparity associated with family environments tended to increase over time.

scholarly journals The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Gwinyai Masukume ◽  
Sinéad M. O’Neill ◽  
Philip N. Baker ◽  
Louise C. Kenny ◽  
Susan M. B. Morton ◽  
...  
Keyword(s):  
Cohort Study ◽  
Caesarean Section ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Childhood Overweight And Obesity ◽  
The Impact ◽  
New Evidence

scholarly journals Long work hours of mothers and fathers are linked to increased risk for overweight and obesity among preschool children: longitudinal evidence from Germany

2019 ◽  
Vol 73 (8) ◽  
pp. 723-729 ◽  
Author(s):  
Jianghong Li ◽  
Till Kaiser ◽  
Matthias Pollmann-Schult ◽  
Lyndall Strazdins
Keyword(s):  
Preschool Children ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
The Body ◽  
Work Hours ◽  
Employment Protection ◽  
Mothers And Fathers ◽  
Child Overweight ◽  
Long Work Hours ◽  
The Impact

BackgroundMost existing studies on maternal employment and childhood overweight/obesity are from the USA. They are predominantly cross-sectional and show a consistent linear association between the two. Less is known about the joint impact of fathers’ and mothers’ work hours on childhood overweight and obesity.ObjectivesTo examine the impact of maternal and paternal work hours on overweight/obesity among children aged 1–6 years in Germany using longitudinal data.MethodsChild body weight and height and their parents’ work hours were collected for 2413 children at ages 0–1, ages 2–3 and ages 5–6. Overweight and obesity was defined using the body mass index percentiles based on the Cole LMS-Method. Random effects model was conducted, adjusting for demographic, socioeconomic and health characteristics of parents and children.ResultsCompared with non-employment, when mothers worked 35 or more hours per week, the risk for child overweight and obesity increased among preschool children. When fathers worked 55 or more hours per week, this effect was strengthened and maternal part-time hours (24–34 per week) also became a risk for child overweight and obesity. The effect was mainly found in high-income families.ConclusionsBoth mothers’ and fathers’ long work hours matter to young children’s overweight status. Employment protection and work time regulation for both working parents during the first 6 years of the child’s life should be considered in future policy.

scholarly journals Social, economic and demographic correlates of overweight and obesity in primary-school children: preliminary data from the Healthy Growth Study

2010 ◽  
Vol 13 (10A) ◽  
pp. 1693-1700 ◽  
Author(s):  
George Moschonis ◽  
Sofia Tanagra ◽  
Anastasia Vandorou ◽  
Aikaterini E Kyriakou ◽  
Vasiliki Dede ◽  
...  
Keyword(s):  
Primary School ◽  
School Children ◽  
Family Income ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Primary Caregiver ◽  
Primary School Children ◽  
Urban Region ◽  
Annual Family Income ◽  
Childhood Overweight And Obesity

AbstractObjectiveTo record the prevalence of overweight and obesity in urban primary-school children in relation to several socio-economic and demographic factors.DesignCross-sectional.Setting/subjectsA representative sample of 729 schoolchildren (379 male and 350 female), aged 9–13 years, stratified by parental educational level, was examined in the urban region of Athens. Weight and height were measured using standard procedures. The International Obesity Task Force thresholds were used for the definition of overweight and obesity. Several socio-economic and demographic data and the child’s ‘popularity’ score were also recorded with specifically designed standardized questionnaires.ResultsThe prevalence of overweight and obesity was 29·6 % and 11·1 %, respectively. Annual family income of €12 000–20 000 (OR = 1·58), residence ownership (OR = 1·63) and the grandmother as the child’s primary caregiver (OR = 1·38) were significantly associated with higher odds of childhood overweight and obesity. Non-Greek parental nationality (OR = 0·72) and higher ‘popularity’ scores of children (OR = 0·42) were significantly associated with lower odds of overweight and obesity. The grandmother as the child’s primary caregiver and an annual family income of €12 000–20 000 remained significantly associated with childhood overweight and obesity after adding all significant correlates of childhood overweight and obesity observed at the bivariate level in a multivariate regression model (OR = 1·51 and 1·61, respectively).ConclusionsAmong family income, residence ownership, child’s primary caregiver, parental nationality and popularity scores that were identified as significant correlates of childhood overweight and obesity at the bivariate level, lower family income and grandmother as the child’s primary caregiver were the only factors that remained significantly associated with childhood overweight and obesity at a multivariate level.

scholarly journals Determinants of takeaway and fast food consumption: a narrative review

2017 ◽  
Vol 31 (1) ◽  
pp. 16-34 ◽  
Author(s):  
Hayley G. Janssen ◽  
Ian G. Davies ◽  
Lucinda D. Richardson ◽  
Leonard Stevenson
Keyword(s):  
Public Health ◽  
Food Consumption ◽  
Fast Food ◽  
Dietary Habits ◽  
Developing Economies ◽  
Overweight And Obesity ◽  
Narrative Review ◽  
Targeted Interventions ◽  
Home Food ◽  
The Impact

AbstractOut-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.

scholarly journals Planting a seed - child health care nurses’ perceptions of speaking to parents about overweight and obesity: a qualitative study within the STOP project

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
My Sjunnestrand ◽  
Karin Nordin ◽  
Karin Eli ◽  
Paulina Nowicka ◽  
Anna Ek
Keyword(s):  
Health Care ◽  
Childhood Obesity ◽  
Child Health ◽  
Communication Skills ◽  
Organizational Factors ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Child Health Care ◽  
Stockholm County ◽  
Nurses Perceptions

Abstract Background Nurses in child health care (CHC) centers in Sweden play a key role in the early detection and management of childhood overweight/obesity, through meeting families early, regularly and over many years. However, research focusing on CHC nurses’ perceptions of their role in childhood overweight/obesity management is scarce. As part of the EU-funded project “Science and Technology in childhood Obesity Policy” (STOP), this study examines CHC nurses’ perceptions of speaking to parents about children’s overweight/obesity and of their role in referring children to treatment for overweight/obesity. Methods All registered CHC nurses in Stockholm County (n = 442) received an email invitation letter explaining the study. Individual face-to-face visits (n = 15) in selected centers, and phone calls (n = 24) to nurses working in these centres were also conducted. In total, 17 CHC nurses (all female, average work experience 6.7 years (SD ± 4.9 years)) from 10 municipalities (including four of the top five municipalities with the highest prevalence of overweight and obesity) in Stockholm County were interviewed. The interviews were conducted by phone, transcribed and analyzed using thematic analysis. Results Two main themes were developed through the analysis: 1) The relationship between the nurse and the parent and 2) Glitch in the system. Under the first theme, nurses reported that weight-related discussions were facilitated by building and maintaining trust with parents. However, nurses also said they were reluctant to address children’s weights if this could compromise parents’ trust. Under the second theme, nurses highlighted several organizational barriers to addressing a child’s weight with parents, including insufficient cooperation with other healthcare providers and limited time for visits. Nurses also identified lack of sufficient knowledge about what to offer the family and lack of confidence in their communication skills as additional barriers. Conclusions We found that pediatric nurses perceive relational and organizational factors as barriers to address childhood obesity with parents. To improve care, it is necessary to provide nurses with continuing education about obesity and communication skills and organizational support to improve communication within the healthcare system. Trial registration ClinicalTrials.gov NCT03800823; 11 Jan 2019, prospectively registered.

Parental consumption of ultra-processed, high-fat products has no association with childhood overweight/obesity: an epidemiological study among 10–12-years-old children in Greece

2020 ◽  
Author(s):  
Aikaterini Kanellopoulou ◽  
Eleni Antoniou ◽  
Venetia Notara ◽  
George Antonogeorgos ◽  
Andrea-Paola Rojas-Gil ◽  
...  
Keyword(s):  
Public Health ◽  
Data Analysis ◽  
Weight Status ◽  
Family Income ◽  
Dietary Habits ◽  
Task Force ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Processed Food ◽  
High Fat

Abstract Background Overweight and obesity during childhood consist two of the most important public health issues in the 21st century. Consumption of high-fat processed food has been increased alarmingly. Objective To examine the association between parental ultra-processed, high-fat products’ consumption and childhood overweight/obesity. Methods A cross-sectional survey, conducted among 422 children, aged 10–12 years, and their parents, during school years 2014–16. Parental and child data were collected through self-administered, anonymous and validated questionnaires. Among others, high-fat ultra-processed food consumption was also recorded. Children’s weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index (BMI) cut-offs. Results The prevalence of obesity in the reference population was 2.9%, whereas the prevalence of overweight was 19.3%. A strong correlation was observed between children’s and their parents’ BMI status (P < 0.001). Multi-adjusted data analysis revealed no association between parental intake of ultra-processed, high-fat products and children overweight/obesity. Similarly, when the data analysis accounted for family income and physical activity status of the children, the aforementioned results remained insignificant. Conclusion Despite the fact that parents’ specific dietary habits seem not to affect their children’s weight status, public health programs should consider parental nutrition education and mobilization as a preventive measure for childhood overweight/obesity.

scholarly journals Early feeding practices and family structure: associations with overweight in children

2013 ◽  
Vol 73 (1) ◽  
pp. 132-136 ◽  
Author(s):  
Monica Hunsberger
Keyword(s):  
Family Structure ◽  
Future Development ◽  
Exclusive Breastfeeding ◽  
Feeding Practices ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Early Feeding ◽  
Increased Risk ◽  
Two Factors ◽  
The Impact

The aim of this review is to examine two factors that may be associated with development of childhood overweight: early feeding, namely exclusive breastfeeding practices; family structure. Findings from the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study are presented in the context of the literature. IDEFICS is a multi-centre European study exploring the risks for overweight and obesity in children, which recruited 16 224 children aged 2–9 years from September 2007 to June 2008 at survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Among the IDEFICS sample, after controlling for confounders, exclusive breastfeeding for 4–6 months was protective of overweight (including obesity) when compared with children never exclusively breastfed (OR 0·73, 95 % CI 0·63, 0·85). Family structure and number of siblings may also be associated with overweight. IDEFICS children without siblings were more likely (OR 1·52, 95 % CI 1·34, 1·72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight such as country, parental education, parental weight, maternal age, child's age, birth weight and gender. Both early feeding practices and family structure play a role in the future development of obesity. The impact of breastfeeding on future development of overweight is dependent upon the dose. Exclusive breastfeeding for the recommended 6 months appears to be protective of overweight. Family structure is also an important component and emerging research suggests only children are at increased risk for overweight in comparison with those with siblings. In European countries, approximately 22 million children are overweight. Early dietary exposures, genetic, environmental and social factors have all been proposed as potential causal factors. Two such factors include exclusive breastfeeding and the impact of being an only child. We have investigated these two factors for associations with overweight; our studies, in the context of previous findings, are the focus of this review.

scholarly journals Environmental, Socioeconomic, Maternal, and Breastfeeding Factors Associated with Childhood Overweight and Obesity in Ceará, Brazil: A Population-Based Study

2020 ◽  
Vol 17 (5) ◽  
pp. 1557
Author(s):  
Sabrina G. M. O. Rocha ◽  
Hermano A. L. Rocha ◽  
Álvaro J. M. Leite ◽  
Márcia M. T. Machado ◽  
Ana C. Lindsay ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Family Income ◽  
Childhood Overweight ◽  
Population Based ◽  
Overweight And Obesity ◽  
P Value ◽  
Cross Sectional ◽  
Nutritional Factors ◽  
Childhood Overweight And Obesity ◽  
The Relationship

Childhood obesity is now an epidemic in many countries worldwide and is known to be a multifactorial condition. We aimed to examine the relationship of environmental, socioeconomic, and nutritional factors with childhood overweight and obesity. We conducted a population-based cross-sectional study of children from 2 to 6 years of age in Ceará, Brazil. Children’s nutritional status was assessed by body mass index (BMI) Z scores categorized as overweight and obesity. Ordinal logistic regression models were used to assess the relationship between the factors with overweight and obesity. A total of 2059 children participated, of which 50.4% were male. The mean age was 46 ± 17 months, with a prevalence of overweight and obesity of 12.0% (95% CI 10.7–13.6) and 8.0% (6.7–9.5), respectively. In multivariate analysis, the probability of childhood obesity increased as family income increased (adjusted hazard ratio (aHR) 0.6 (95% CI 0.37–0.95), p-value = 0.03). Moreover, families with fewer children had more than 30% fewer overweight children (aHR 0.68; 95% CI 0.48–0.96). Environmental, socioeconomic, and child nutritional factors were associated with overweight and obesity. The results provided could be used to design integrated interventions spanning from conception, or earlier, through the first years of life and may improve child nutritional outcomes.

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