Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China
Abstract
:1. Introduction
2. Methods
2.1. Sample
2.2. Measurements
2.2.1. Adolescent Overweight
2.2.2. Personal Characteristics
2.2.3. Factors Related to Early Infancy
2.2.4. Physical Activity and Diet
2.2.5. Family Socioeconomic Status
2.2.6. School Environment
2.3. Statistical Methods
2.4. Ethical Statement
3. Results
3.1. Participant Characteristics
3.2. A Comparison of the Characteristics of Overweight Adolescents in Public and Private Schools
3.3. Analysis of Differences in Adolescent Weight
4. Discussion
4.1. Rapid Immigration to Cities in China Proved Relevant the Increase in Adolescent Overweight
4.2. A Variety of Targeted Interventions Could Be Initiated for Students in the Two Types of Schools
4.3. Limitations
5. Conclusions
Availability of Data and Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable | Public School | Private School | Total | p Value | |
---|---|---|---|---|---|
452 (47.48%) | 500 (52.52%) | 952 (100%) | |||
Weight status | Not overweight | 406 (89.82) | 424 (84.80) | 830 (87.18) | 0.021 |
Overweight | 46 (10.18) | 76 (15.20) | 122 (12.82) | ||
Personal characteristics | |||||
Gender | Male | 242 (53.54) | 272 (54.40) | 514 (53.99) | 0.790 |
Female | 210 (46.46) | 228 (45.60) | 438 (46.01) | ||
Age, mean (SD) | 13.05 (0.92) | 13.09 (0.87) | 13.07 (0.89) | 0.517 | |
Factors related to early infancy | |||||
Overweight at birth | No | 417 (92.26) | 459 (91.80) | 876 (92.02) | 0.795 |
Yes | 35 (7.74) | 41 (8.20) | 76 (7.98) | ||
Gestational age ≥42 weeks | No | 340 (75.22) | 382 (76.40) | 722 (75.84) | 0.672 |
Yes | 112 (24.78) | 118 (23.60) | 230 (24.16) | ||
Breastfeeding | No | 49 10.84) | 77 (15.40) | 126 (13.24) | 0.038 |
Yes | 403 (89.16) | 423 (84.60) | 826 (86.76) | ||
Physical activity and diet | |||||
Weekly exercise | Not often | 229 (50.66) | 170 (34.00) | 399 (41.91) | <0.0001 |
Often | 223 (49.34) | 330 (66.00) | 553 (58.09) | ||
Time spent watching television or playing computer games, mean (SD) | 1.01 (1.39) | 1.06 (1.52) | 1.04 (1.46) | 0.651 | |
Number of snacks per day | Rarely | 144 (31.86) | 155 (31.00) | 299 (31.41) | 0.849 |
Sometimes | 144 (31.86) | 168 (33.60) | 312 (32.77) | ||
Often | 164 (36.28) | 177 (35.40) | 341 (35.82) | ||
Socioeconomic factors | |||||
Family monthly income (¥) | Below 6000 | 26 (5.75) | 76 (15.20) | 102 (10.71) | <0.0001 |
6001–12,000 | 157 (34.73) | 242 (48.40) | 399 (41.91) | ||
12,001–18,000 | 110 (24.34) | 89 (17.80) | 199 (20.90) | ||
Over 18,000 | 159 (35.18) | 93 (18.60) | 252 (26.47) | ||
Paternal education | High school degree or below | 83 (18.36) | 221 (44.20) | 304 (31.93) | <0.0001 |
Associate’s degree | 111 (24.56) | 160 (32.00) | 271 (28.47) | ||
Bachelor’s degree | 134 (29.65) | 85 (17.00) | 219 (23.00) | ||
Master’s degree or higher | 124 (27.43) | 34 (6.80) | 158 (16.60) | ||
Maternal education | High school degree or below | 100 (22.12) | 177 (35.40) | 277 (29.10) | <0.0001 |
Associate degree | 92 (20.35) | 196 (39.20) | 288 (30.25) | ||
Bachelor’s degree | 133 (29.42) | 84 (16.80) | 217 (22.79) | ||
Master’s degree or higher | 127 (28.10) | 43 (8.60) | 170 (17.86) | ||
Care from the parents, mean (SD) | 3.15 (0.87) | 3.12 (0.93) | 3.13 (0.90) | 0.632 | |
School environment | |||||
Number of physical education classes per week | 0 | 28 (6.19) | 50 (10.00) | 78 (8.19) | 0.057 |
1–2 | 108 (23.89) | 115 (23.00) | 223 (23.42) | ||
3–4 | 159 (35.18) | 146 (29.20) | 305 (32.04) | ||
Over 4 | 157 (34.73) | 189 (37.80) | 346 (36.34) | ||
Number of classes per day, excluding physical education | Below 5 | 62 (13.72) | 33 (6.60) | 95 (9.98) | <0.0001 |
5–7 | 131 (28.98) | 100 (20.00) | 231 (24.26) | ||
8–10 | 259 (57.30) | 367 (73.40) | 626 (65.76) | ||
Often go to school stores that sell snacks | No | 26 (5.75) | 68 (13.60) | 94 (9.87) | <0.0001 |
Yes | 426 (94.25) | 432 (86.40) | 858 (90.13) | ||
Duration of lunch period (minutes) | 1–15 | 131 (28.98) | 146 (29.20) | 277 (29.10) | 0.824 |
16–30 | 172 (38.05) | 178 (35.60) | 350 (36.76) | ||
31–40 | 121 (26.77) | 146 (29.20) | 267 (28.05) | ||
Above 40 | 28 (6.20) | 30 (6.00) | 58 (6.09) |
Variable | Public School n = 452 | Private School n = 500 | Total n = 952 | ||||
---|---|---|---|---|---|---|---|
None | Overweight | None | Overweight | None | Overweight | ||
406 (89.82%) | 46 (10.18%) | 424 (84.80%) | 76 (15.20%) | 830 (87.18%) | 122 (12.82%) | ||
Personal characteristics | |||||||
Gender | Male | 206 (45.58) | 36 (7.96) | 223 (44.60) | 49 (9.80) | 429 (45.06) | 85 (8.93) |
Female | 200 (44.25) | 10 (2.21) | 201 (40.20) | 27 (5.40) | 401 (42.12) | 37 (3.89) | |
Age | Mean (SD) | 13.06 (0.92) | 13.05 (0.92) | 13.07 (0.88) | 13.22 (0.81) | 13.06 (0.90) | 13.16 (0.86) |
Factors related to early infancy | |||||||
Overweight at birth | No | 376 (83.19) | 41 (9.07) | 391 (78.20) | 68 (13.60) | 767 (80.57) | 109 (11.45) |
Yes | 30 (6.64) | 5 (1.11) | 33 (6.60) | 8 (1.60) | 63 (6.62) | 13 (1.37) | |
Gestational age ≥ 42 weeks | No | 311 (68.81) | 29 (6.42) | 337 (67.40) | 45 (9.00) | 648 (68.07) | 74 (7.77) |
Yes | 95 (21.02) | 17 (3.76) | 87 (17.40) | 31 (6.20) | 182 (19.12) | 48 (5.04) | |
Breastfeeding | No | 35 (7.74) | 14 (3.10) | 48 (9.60) | 29 (5.80) | 83 (8.72) | 43 (4.52) |
Yes | 371 (82.08) | 32 (7.08) | 376 (75.20) | 47 (9.40) | 747 (78.47) | 79 (8.30) | |
Physical activity and diet | |||||||
Weekly exercise | Not often | 197 (43.58) | 32 (7.08) | 137 (27.40) | 33 (6.60) | 334 (35.08) | 65 (6.83) |
Often | 209 (46.24) | 14 (3.10) | 287 (57.40) | 43 (8.60) | 496 (52.10) | 57 (5.99) | |
Time spent watching television or playing computer games, mean (SD) | Mean (SD) | 1.00 (1.40) | 1.18 (1.28) | 1.02 (1.56) | 1.24 (1.25) | 1.01 (1.49) | 1.22 (1.26) |
Frequency of snacks per day | Rarely | 129 (28.54) | 15 (3.32) | 137 (27.40) | 18 (3.60) | 266 (27.94) | 33 (3.47) |
Sometimes | 138 (30.53) | 6 (1.33) | 156 (31.20) | 12 (2.40) | 294 (30.88) | 18 (1.89) | |
Often | 139 (30.75) | 25 (5.53) | 131 (26.20) | 46 (9.20) | 270 (28.36) | 71 (7.46) | |
Socioeconomic factors | |||||||
Family monthly income (¥) | Below 6000 | 20 (4.42) | 6 (1.33) | 69 (13.80) | 7 (1.40) | 89 (9.35) | 13 (1.37) |
6001–12,000 | 139 (30.75) | 18 (3.98) | 192 (38.40) | 50 (10.00) | 331 (34.77) | 68 (7.14) | |
12,001–18,000 | 101 (22.35) | 9 (1.99) | 81 (16.20) | 8 (1.60) | 182 (19.12) | 17 (1.79) | |
Over 18,000 | 146 (32.30) | 13 (2.88) | 82 (16.40) | 11 (2.20) | 228 (23.95) | 24 (2.52) | |
Paternal education | High school degree or below | 72 (15.93) | 11 (2.43) | 185 (37.00) | 36 (7.20) | 257 (27.00) | 47 (4.94) |
Associate degree | 101 (22.35) | 10 (2.21) | 141 (28.20) | 19 (3.80) | 242 (25.42) | 29 (3.05) | |
Bachelor’s degree | 122 (26.99) | 12 (2.65) | 69 (13.80) | 16 (3.20) | 191 (20.06) | 28 (2.94) | |
Master’s degree or higher | 111 (24.56) | 13 (2.88) | 29 (5.80) | 5 (1.00) | 140 (14.71) | 18 (1.89) | |
Maternal education | High school degree or below | 89 (19.69) | 11 (2.43) | 147 (29.40) | 30 (6.00) | 236 (24.79) | 41 (4.31) |
Associate degree | 78 (17.26) | 14 (3.10) | 172 (34.40) | 24 (4.80) | 250 (26.26) | 38 (3.99) | |
Bachelor’s degree | 126 (27.88) | 7 (1.55) | 70 (14.00) | 14 (2.80) | 196 (20.59) | 21 (2.21) | |
Master’s degree or higher | 113 (25.00) | 14 (3.10) | 35 (7.00) | 8 (1.60) | 148 (15.55) | 22 (2.31) | |
Parental care, mean (SD) | 3.24 (0.83) | 2.30 (0.81) | 3.26 (0.88) | 2.30 (0.77) | 3.25 (0.85) | 2.30 (0.78) | |
School environment | |||||||
Number of physical education classes per week | 0 | 26 (5.75) | 2 (0.44) | 38 (7.60) | 12 (2.40) | 64 (6.72) | 14 (1.47) |
1–2 | 96 (21.24) | 12 (2.65) | 100 (20.00) | 15 (3.00) | 196 (20.59) | 27 (2.84) | |
3–4 | 147 (32.52) | 12 (2.65) | 124 (24.80) | 22 (4.40) | 271 (28.47) | 34 (3.57) | |
Over 4 | 137 (30.31) | 20 (4.42) | 162 (32.40) | 27 (5.40) | 299 (31.41) | 47 (4.94) | |
Number of classes per day, excluding physical education | Below 5 | 59 (13.05) | 3 (0.66) | 29 (5.80) | 4 (0.80) | 88 (9.24) | 7 (0.74) |
5–7 | 116 (25.66) | 15 (3.32) | 85 (17.00) | 15 (3.00) | 201 (21.11) | 30 (3.15) | |
8–10 | 231 (51.11) | 28 (6.19) | 310 (62.00) | 57 (11.40) | 541 (56.83) | 85 (8.93) | |
Often go to school stores selling snacks | No | 19 (4.20) | 7 (1.55) | 60 (12.00) | 8 (1.60) | 79 (8.30) | 15 (1.58) |
Yes | 387 (85.62) | 39 (8.63) | 364 (72.80) | 68 (13.60) | 751 (78.89) | 107 (11.24) | |
Duration of lunch period (min) | 1–15 | 115 (25.44) | 16 (3.54) | 125 (25.00) | 21 (4.20) | 240 (25.21) | 37 (3.89) |
16–30 | 158 (34.96) | 14 (3.10) | 146 (29.20) | 32 (6.40) | 304 (31.93) | 46 (4.83) | |
31–40 | 106 (23.45) | 15 (3.32) | 127 (25.40) | 19 (3.80) | 233 (24.47) | 34 (3.57) | |
Over 40 | 27 (5.97) | 1 (0.22) | 26 (5.20) | 4 (0.80) | 53 (5.57) | 5 (0.53) |
Variable | Public School # | Private School § | |||||
---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | ||
Personal characteristics | |||||||
Gender | Male | 1.00 | Reference | 1.00 | Reference | ||
Female | 0.13 | 0.04–0.37 | 0.0002 | 0.44 | 0.20–0.98 | 0.045 | |
Age | 1.11 | 0.64–1.92 | 0.708 | 1.06 | 0.70–1.59 | 0.790 | |
Factors related to early infancy | |||||||
Overweight at birth | No | 1.00 | Reference | 1.00 | Reference | ||
Yes | 0.95 | 0.19–4.75 | 0.950 | 1.04 | 0.34–3.16 | 0.952 | |
Gestational age ≥ 42 weeks | No | 1.00 | Reference | 1.00 | Reference | ||
Yes | 2.62 | 0.95–7.28 | 0.064 | 4.50 | 2.14–9.45 | <0.0001 | |
Breastfeeding | No | 1.00 | Reference | 1.00 | Reference | ||
Yes | 0.27 | 0.09–0.82 | 0.021 | 0.18 | 0.09–0.39 | <0.0001 | |
Physical activity and diet | |||||||
Exercise per week | No | 1.00 | Reference | 1.00 | Reference | ||
Yes | 0.40 | 0.15–1.03 | 0.059 | 0.52 | 0.23–1.15 | 0.105 | |
Time spent watching television or playing computer games | 1.09 | 0.85–1.40 | 0.489 | 0.97 | 0.80–1.17 | 0.740 | |
Number of snacks per day | Rarely | 2.12 | 0.72–6.27 | 0.174 | 0.30 | 0.12–0.73 | 0.113 |
Sometimes | 0.64 | 0.17–2.41 | 0.512 | 0.53 | 0.24–1.16 | 0.008 | |
Often | 1.00 | Reference | 1.00 | Reference | |||
Socioeconomic factors | |||||||
Family monthly income (¥) | Below 6000 | 1.00 | Reference | 1.00 | Reference | ||
6001–12,000 | 1.63 | 0.28–9.45 | 0.587 | 3.27 | 1.04–10.30 | 0.043 | |
12,001–18,000 | 0.47 | 0.06–3.54 | 0.460 | 1.06 | 0.25–4.63 | 0.934 | |
Over 18,000 | 1.17 | 0.16–8.41 | 0.877 | 1.26 | 0.32–4.99 | 0.746 | |
Paternal education | High school degree or below | 0.85 | 0.13–5.80 | 0.872 | 0.61 | 0.15–2.44 | 0.480 |
Associate’s degree | 0.89 | 0.23–3.44 | 0.868 | 0.52 | 0.13–2.14 | 0.369 | |
Bachelor’s degree | 0.87 | 0.23–3.32 | 0.834 | 1.43 | 0.34–6.13 | 0.627 | |
Master’s degree or over | 1.00 | Reference | 1.00 | Reference | |||
Maternal education | High school degree or below | 0.85 | 0.14–5.23 | 0.859 | 0.72 | 0.19–2.73 | 0.624 |
Associate’s degree | 1.27 | 0.39–4.13 | 0.692 | 0.99 | 0.28–3.49 | 0.983 | |
Bachelor’s degree | 0.25 | 0.06–1.02 | 0.053 | 1.47 | 0.38–5.64 | 0.575 | |
Master’s degree or over | 1.00 | Reference | 1.00 | Reference | |||
Parental care | 0.09 | 0.05–0.19 | <0.0001 | 0.18 | 0.11–0.28 | <0.0001 | |
School environment | |||||||
Number of physical education classes per week | 0 | 1.00 | Reference | 1.00 | Reference | ||
1–2 | 1.72 | 0.22–13.73 | 0.607 | 1.24 | 0.34–4.46 | 0.746 | |
3–4 | 1.29 | 0.16–10.20 | 0.808 | 2.00 | 0.60–6.68 | 0.257 | |
Over 4 | 5.00 | 0.60–41.61 | 0.137 | 2.09 | 0.63–6.94 | 0.229 | |
Number of classes per day, excluding physical education | Below 5 | 0.02 | 0.002–0.11 | <0.0001 | 0.16 | 0.04–0.70 | 0.015 |
5–7 | 0.44 | 0.14–1.36 | 0.153 | 0.43 | 0.18–1.05 | 0.064 | |
8–10 | 1.00 | Reference | 1.00 | Reference | |||
Often go to school stores selling snacks | No | 1.00 | Reference | 1.00 | Reference | ||
Yes | 0.37 | 0.07–1.95 | 0.241 | 1.45 | 0.51–4.13 | 0.483 | |
Duration of lunch period (min) | 1–15 | 1.00 | Reference | 1.00 | Reference | ||
16–30 | 0.30 | 0.09–0.98 | 0.047 | 0.66 | 0.28–1.55 | 0.341 | |
31–40 | 0.49 | 0.15–1.59 | 0.233 | 0.40 | 0.15–1.04 | 0.060 | |
Over 40 | 0.05 | 0.003–0.82 | 0.036 | 0.36 | 0.08–1.72 | 0.202 |
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Share and Cite
Shi, J.; Tan, D.; Xie, H.; Yang, B.; Liu, R.; Yu, D.; Lu, Y.; Mei, B.; Wang, Z. Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China. Int. J. Environ. Res. Public Health 2017, 14, 252. https://doi.org/10.3390/ijerph14030252
Shi J, Tan D, Xie H, Yang B, Liu R, Yu D, Lu Y, Mei B, Wang Z. Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China. International Journal of Environmental Research and Public Health. 2017; 14(3):252. https://doi.org/10.3390/ijerph14030252
Chicago/Turabian StyleShi, Jianwei, Duxun Tan, Huilin Xie, Beilei Yang, Rui Liu, Dehua Yu, Yuan Lu, Bing Mei, and Zhaoxin Wang. 2017. "Unequal Distribution of Overweight Adolescents in Immigrant-Rich Areas: Analysis of Disparities among Public and Private School Students in Shanghai, China" International Journal of Environmental Research and Public Health 14, no. 3: 252. https://doi.org/10.3390/ijerph14030252