Epidemiologic Reviews Advance Access originally published online on July 31, 2009
Epidemiologic Reviews 2009 31(1):21-51; doi:10.1093/epirev/mxp006
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Associations Between Childhood Socioeconomic Position and Adulthood Obesity
Correspondence to Dr. Eric B. Loucks, Center for Population Health and Clinical Epidemiology, Department of Community Health, Epidemiology Section, Brown University, 121 South Main Street, Box G-S121-2, Providence, RI (e-mail: eric.loucks{at}brown.edu).
accepted for publication May 8, 2009.
Childhood socioeconomic position (SEP) is inversely associated with cardiovascular disease and all-cause mortality. Obesity in adulthood may be a biologic mechanism. Objectives were to systematically review literature published between 1998 and 2008 that examined associations of childhood SEP with adulthood obesity. Five databases (Cochrane Library, MEDLINE, EMBASE, PsycINFO, Web of Science) were searched for studies from any country, in any language. Forty-eight publications based on 30 studies were identified. In age-adjusted analyses, inverse associations were found between childhood SEP and adulthood obesity in 70% (14 of 20) of studies in females and 27% (4 of 15) in males. In studies of females showing inverse associations between childhood SEP and adulthood obesity, typical effect sizes in age-adjusted analyses for the difference in body mass index between the highest and lowest SEP were 1.0–2.0 kg/m2; for males, effect sizes were typically 0.2–0.5 kg/m2. Analyses adjusted for age and adult SEP showed inverse associations in 47% (8 of 17) of studies in females and 14% (2 of 14) of studies in males. When other covariates were additionally adjusted for, inverse associations were found in 4 of 12 studies in females and 2 of 8 studies in males; effect sizes were typically reduced compared with analyses adjusted for age only. In summary, the findings suggest that childhood SEP is inversely related to adulthood obesity in females and not associated in males after adjustment for age. Adulthood SEP and other obesity risk factors may be the mechanisms responsible for the observed associations between childhood SEP and adulthood obesity.
adult • child • health status disparities • obesity • review • social class • socioeconomic factors
CI, confidence interval • SEP, socioeconomic position
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