Richer doesn’t always mean thinner for ethnic minority children

Public health initiatives could be much better designed and targeted if we can get to the bottom of what’s driving these inequalities.
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New research suggests that privilege doesn’t protect ethnic minority children from gaining weight in the same way as it does their White peers.

The study found that White children from less advantaged homes had a 13 per cent higher risk of being overweight or obese than White children who were more advantaged. However, this pattern did not hold for other ethnic groups.

In fact, the opposite was true for Black African and Caribbean children. Those from poorer homes had a 37 per cent lower risk of being overweight or obese than Black children from richer families.

Dr Alice Goisis, one of the study’s authors, said: “It might be easy to assume that obesity levels are higher among some ethnic minorities because they are relatively disadvantaged in the UK, and that those inequalities are driven by unhealthier behaviours, as they are among White groups."

Researchers analysed data on more than 11,000 7-year-olds born in the UK at the turn of the century, who are being followed by the Millennium Cohort Study. They compared the BMI, the weight and height of a person, of children from poorer and richer households, within four ethnic groups – White; Black African and Caribbean; Indian; and, Pakistani and Bangladeshi. The researchers took into account the fact that weight and body fat differ between boys and girls.

Among Indian children, there was no statistically significant difference between those of wealthier and poorer parents. This was also true of Pakistani and Bangladeshi children.

By mid-childhood, more than two fifths (42%) of Black African and Caribbean children from more advantaged homes were overweight or obese, compared to over a quarter (27%) of those from less well-off homes.

Among Pakistani and Bangladeshi children, more than a quarter (27%) of those from richer homes were overweight or obese compared to more than a fifth (21%) from poorer homes. Just under a quarter (24%) of wealthier Indian children were overweight or obese, compared to over a fifth (22%) of their less privileged counterparts.

Among White children, under a fifth (18%) of those from richer homes were overweight or obese, compared to just over a fifth (21%) of those from poorer homes.

The researchers examined what role healthy lifestyles played in the socioeconomic differences within these ethnic groups, as previous research has suggested that the increased risk of overweight and obesity among less advantaged children is driven by poorer diets and fewer opportunities to be physically active.

They considered 13 potential factors that could explain the relationship between family income and children’s weight, covering mothers’ health behaviours during pregnancy and a year after birth, as well as information on children’s diet and levels of exercise at age 7.

Once again, the findings confirmed previous evidence that among White families, lifestyle differences are an important driver of socioeconomic inequalities in overweight and obesity. On average, less advantaged White children had unhealthier diets, took less exercise, were less likely to have been breastfed, and were more likely to have a mother who smoked during pregnancy. These differences largely accounted for the disparities in weight between poorer and richer White children.

However, these patterns were less clear among ethnic minorities. Among all minority ethnic groups, socioeconomic differences in health habits were either much less stark, or in fact reversed. For example, among Pakistani, Bangladeshi, and Black African and Caribbean children, those from poorer homes were less likely than their wealthier peers to have sugary drinks between meals, and were more likely to eat breakfast every day.

Healthy lifestyles did not explain the socioeconomic differences in weight for any ethnic minority groups.

Dr Goisis said: "Our findings challenge these assumptions and point to the need for future research. Public health initiatives could be much better designed and targeted if we can get to the bottom of what’s driving these inequalities within ethnic minority groups, rather than assuming the underlying causes of obesity are the same across the board.”

The research teams came from the UCL Centre for Longitudinal Studies, London School of Economics and Political Science and the University of Washington.

Behind the article

When richer doesn’t mean thinner: ethnicity, socio-economic position and the risk of child obesity in the U.K. by Alice Goisis, Melissa Martinson and Wendy Sigle was published by Demographic Research on Thursday 5th September 2019.