Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region

Sanja Musić Milanović, Marta Buoncristiano, Helena Križan, Giulia Rathmes, Julianne Williams, Jolanda Hyska, Vesselka Duleva, Hana Zamrazilová, Tatjana Hejgaard, Maja Bæksgaard Jørgensen, Benoît Salanave, Lela Shengelia, Cecily C. Kelleher, Angela Spinelli, Paola Nardone, Shynar Abdrakhmanova, Zhamilya Usupova, Iveta Pudule, Ausra Petrauskiene, Victoria Farrugia Sant'AngeloEnisa Kujundžić, Anna Fijałkowska, Ana Isabel Rito, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Andrea Gualtieri, Marta García-Solano, Enrique Gutiérrez-González, Khadichamo Boymatova, Mahmut S. Yardim, Maya Tanrygulyyeva, Marina Melkumova, Daniel Weghuber, Eha Nurk, Päivi Mäki, Ingunn Holden Bergh, Sergej M. Ostojic, Kenisha Russell Jonsson, Igor Spiroski, Harry Rutter, Wolfgang Ahrens, Ivo Rakovac, Stephen Whiting, João Breda

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Abstract

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94–2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of “less healthy” behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

Original languageEnglish
Article numbere13209
JournalObesity Reviews
Volume22
Issue numberS6
Early online date7 Jul 2021
DOIs
Publication statusPublished - 30 Nov 2021

Bibliographical note

Funding Information:
The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from: Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe. Albania: World Health Organization (WHO) Country Office Albania and the WHO Regional Office for Europe. Bulgaria: WHO Regional Office for Europe. Czech Republic: Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17‐31670 A and MZČR–RVO EÚ 00023761. Denmark: The Danish Ministry of Health. France: Santé publique France, the French Agency for Public Health. Georgia: WHO. Ireland: Health Service Executive. Italy: Italian Ministry of Health; Italian National Institute of Health (Istituto Superiore di Sanità). Kazakhstan: the Ministry of Health of the Republic of Kazakhstan within the scientific and technical program. Kyrgyzstan: World Health Organization. Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry. Spain: the Spanish Agency for Food Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria.

Funding Information:
The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from: Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe. Albania: World Health Organization (WHO) Country Office Albania and the WHO Regional Office for Europe. Bulgaria: WHO Regional Office for Europe. Czech Republic: Ministry of Health of the Czech Republic, grant nr. AZV MZ?R 17-31670 A and MZ?R?RVO E? 00023761. Denmark: The Danish Ministry of Health. France: Sant? publique France, the French Agency for Public Health. Georgia: WHO. Ireland: Health Service Executive. Italy: Italian Ministry of Health; Italian National Institute of Health (Istituto Superiore di Sanit?). Kazakhstan: the Ministry of Health of the Republic of Kazakhstan within the scientific and technical program. Kyrgyzstan: World Health Organization. Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry. Spain: the Spanish Agency for Food Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. We gratefully acknowledge support from Liza Villas and Gerben Rienk for making the COSI project possible.

Funding Information:
We gratefully acknowledge support from Liza Villas and Gerben Rienk for making the COSI project possible.

Funding

The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from: Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe. Albania: World Health Organization (WHO) Country Office Albania and the WHO Regional Office for Europe. Bulgaria: WHO Regional Office for Europe. Czech Republic: Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17‐31670 A and MZČR–RVO EÚ 00023761. Denmark: The Danish Ministry of Health. France: Santé publique France, the French Agency for Public Health. Georgia: WHO. Ireland: Health Service Executive. Italy: Italian Ministry of Health; Italian National Institute of Health (Istituto Superiore di Sanità). Kazakhstan: the Ministry of Health of the Republic of Kazakhstan within the scientific and technical program. Kyrgyzstan: World Health Organization. Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry. Spain: the Spanish Agency for Food Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. We gratefully acknowledge support from Liza Villas and Gerben Rienk for making the COSI project possible.

Keywords

  • physical activity
  • sedentary behavior
  • sleep hygiene
  • social inequalities

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Public Health, Environmental and Occupational Health

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