The associations of SES, obesity, sport activity, and perceived neighborhood environments: is there a model of environmental injustice penalizing Portuguese children?

Objectives: This study analyses the associations between children's obesity, sports activity (SA), and perceived environmental characteristics with the children's SES.

Methods: A sample of 1,885 Portuguese children, aged 3-10 years, living in Coimbra, Portugal, was observed. Weight and height were measured and obesity was defined by age-and sex-specific, BMI cut-off points. Questionnaires included variables on SA levels, SES and parental neighborhood perceptions were done. A CATPCA was performed and two neighborhood dimensions were achieved. The independent associations of SES with obesity, SA and perceived neighborhood dimensions was analyzed using ordered logistic regressions.

Results: Children of low [odds ratio (OR) = 1.76; confidence interval (CI) = 1.25-1.99] and medium SES (OR = 1.57; CI = 1.34-2.33) were more likely to be obese than their high-SES peers, less likely to participate in SA (low SES OR = 0.177; CI = 0.12-0.26; medium SES OR = 0.357; CI = 0.24-0.53), and their parents were less likely to have positive perceptions of their built environment (low SES OR = 0.516; CI = 0.38-0.70; medium SES OR = 0.565; CI = 0.37-0.86).

Conclusions: Obesity increases and SA decreases among children with the lowest SES and these living in neighborhoods with higher perceived risk. This finding suggests a model of environmental injustice, whereby differential access to the neighborhood's resources overlaps with familial socioeconomic disadvantage.