Social Determinants of Child Overweight and Obesity in Shanghai, China: Understanding Chinese Disparities
*Names in bold indicate Presenter
We use the 2014 Child Well-Being Study of Shanghai, China—a new study modeled on child cohort studies in the United States and several other countries. The sample of approximately 2,000 children are 7 years of age on average at the time of survey in 2014. We estimate odds ratios and adjusted proportions of overweight and obesity by income tercile, parental education, and hukou status (rural vs. urban). Results use the CDC overweight and obesity cutpoints for comparison to the United States, but we also conduct sensitivity analyses using other established international and Chinese overweight and obesity standards. All results are stratified by gender due to established gender differences in childhood obesity. We also include a number sociodemographic factors, health insurance status, and health behaviors in our models.
Preliminary results find a very high rate of childhood overweight and obesity (36% and 21%, respectively) in Shanghai, China. 42% of boys and 30% of girls in our sample are overweight or obese. Overall, childhood overweight and obesity is higher in Shanghai than it is in the United States (CDC, 2013). The analysis also indicates that like many developing countries, our sample has a reverse income and education gradient in childhood overweight and obesity—but only for girls. High income and high education are associated with higher rates of childhood overweight and obesity for girls, but no pattern by SES exists for boys. Girls from rural status families are also much less likely to be overweight or obese than girls from urban families. These results have important implications for social programs and health insurance reform in Shanghai, and how these new policies interact with gender differences and overall economic development in rapidly changing China.