Rising socioeconomic disparities in childhood overweight in Belgium

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2. Rising socioeconomic disparities in childhood overweight in Belgium

Childhood overweight significantly affects a child’s quality of life. In the short term, it is associated with increased metabolic and cardiovascular risk factors. Additionally, children with overweight often face social biases, including stigmatisation, bullying, and social exclusion, which can contribute to low self-esteem and mental health problems such as depression. Over the long term, excess weight in childhood strongly predicts overweight in adulthood, which raises the risk of chronic diseases. Therefore, addressing childhood overweight with early interventions is crucial.

Poor eating habits and a lack of physical activity are major risk factors for weight gain. Excessive consumption of free sugars, particularly in sugar-sweetened beverages, is strongly associated with overweight in children and adolescents. Young people are also becoming less active because screen time increases. These problems are made worse by an obesogenic environment where cheap, energy-dense, nutrient-poor food is readily available and heavily marketed, and opportunities for active transport are decreasing. Children from lower socio-economic backgrounds are more likely to be at risk of food insecurity and have poorer eating habits. They also tend to be less active. Unhealthy food environments are often located near schools in deprived neighbourhoods, which also tend to have fewer sports facilities and green spaces. 

This study uses data from the Belgian Health Interview Survey (HIS), conducted in 1997, 2001, 2004, 2008, 2013 and 2018. The HIS is a cross-sectional survey of Belgian households, with around 10,000 respondents in each wave. The analyses focus on children aged 2-17 years. The Body Mass Index (BMI, kg/m²) was calculated from self-reported data and proxy reports for children under 15. Overweight was determined using age- and sex-specific cut-off points. Socio-economic status (SES) was approximated by the highest level of parental education. Both absolute and relative differences (prevalence difference versus odds ratio) were assessed. 

Widening socio-economic gap in childhood overweight rates

In Belgium, childhood overweight increased significantly from 13.6% in 1997 to 18.9% in 2018. The absolute socio-economic gap also widened, growing from 8.0 percentage points in 1997 to 14.9 percentage points in 2018. This rise is mainly due to the increase in overweight among children and adolescents of parents with lower educational levels, which went up from 16.8% in 1997 to 27.8% in 2018. However, relative socio-economic disparities in overweight remained fairly stable over this period.

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Definitions

Overweight

Overweight was defined based on the body mass index (BMI), which was calculated using self-reported height and weight information. In children and adolescents, the cut-off points to define BMI categories are age and sex-specific and are based on the cut-off values of the International Obesity Taskforce (IOTF).

Educational level

Educational level is based on self-reported information and is further categorised into different groups. Low education includes primary education and low secondary education, high education includes post-secondary non-tertiary education, short-cycle tertiary education, bachelor’s or equivalent level, master’s or equivalent level and doctoral or equivalent.

Please cite this page as: Sciensano. Factsheets: Rising socioeconomic disparities in childhood overweight in Belgium, Health Status Report, 28 Oct 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/factsheets/ad-hoc-surveillance-of-covid-19-2020-2022