The role of energy balance related behaviors in socioeconomic inequalities in childhood body mass index : a comparative analysis of Germany, the Netherlands, the United Kingdom, and the United States

Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries—Germany, the Netherlands, the United Kingdom (UK), and the United States (US)—to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors—physical activity, screen time, and breakfast consumption—in explaining these inequalities. Children were aged 5–7 at our first timepoint and were followed up at age 8–11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families

International differences in gradients in early childhood overweight and obesity: the role of maternal employment and formal childcare attendance

Socio-economic differences in BMI/overweight can already be observed from early childhood. There are important cross-country differences in such gradients in later childhood and adulthood, but few studies have assessed whether such international variation is already evident from early childhood. To explain gradients in childhood BMI/overweight, most research has focused on parental behaviours and characteristics, while ignoring other important spheres of a child’s early environment such as their mode of childcare. Access to childcare often varies by socio-economic background, and formal collective childcare appears to be positive for some, but not all, child outcomes; we know less about its role in children’s physical well-being, and especially BMI/overweight. The role of childcare in explaining BMI/overweight gaps might vary widely across countries, given differences in access, quality of care, heterogeneity in quality across groups, etc. In this paper, we explore the variation in gaps in children’s BMI and overweight by parental education across six high income countries, at 3 years old; and assess whether differential attendance to childcare in early life accounts for some of these gaps Preliminary results for France suggest that only the most disadvantaged groups (as measured by the parents’ combined educational level) have an increased risk of overweight at age 3, compared to the most advantaged. Socio-demographic household characteristics (income, family structure, nativity, mother’s age), parental behaviour (smoking during pregnancy, ever breastfed), and child characteristics (birthweight, prematurity) decrease coefficients by about a quarter, while remaining statistically significant. For France, childcare attendance and intensity do not appear to explain observed gaps in BMI/overweight. Substantive results were similar whether a linear BMI variable or a dummy for overweight/obesity is used. Harmonized analyses from the UK, Netherlands, Germany, US, and Japan will assess to what extent these results are generalizable across rich countries

National context and socioeconomic inequalities in educational achievement

Empirical research repeatedly shows cross-country differences in the extent and distribution of socioeconomic inequalities in educational achievement. This observation is the starting point for the comparative DICE-project (Development of Inequalities in Child Educational Achievement: A Six-Country Study). It aims to improve the understanding of child development by socioeconomic status, operationalised in terms of parental education in six countries: France, Germany, Japan, the Netherlands, the United Kingdom, and the United States. The project moves beyond cross-sectional and single country snapshots and examines the development of inequalities from 3 years of age up to the end of lower secondary schooling. In this contribution, we introduce the six countries. First, by synthesizing data from a range of international databases we provide a rich and multidimensional characterisation of macrostructural conditions in each country. Linking the contextual situation in the DICE-countries to general theoretical assumptions about the effects of macrostructural conditions, we highlight the implications for cross-national differences in inequalities in educational achievement. Second, we analyse PISA data providing information about achievement test scores at age 15. We study how the different packages of macrostructural characteristics described in the contextual section are reflected in terms of educational inequalities by the end of lower secondary schooling in each country