Child overweight and undernutrition in Thailand: is there an urban effect?

Area of Science:

• Global Health
• Child Nutrition
• Urban Health Disparities

Background:

• Urban areas often show lower child undernutrition but higher obesity rates compared to rural areas in developing nations.
• Disparities in child undernutrition and obesity may stem from socioeconomic concentrations or urban environmental factors.

Purpose of the Study:

• To investigate if urban-rural disparities in child undernutrition and obesity are driven by socioeconomic factors or urban environmental aspects.
• To analyze the roles of child socioeconomic status and community environment in urban-rural health differences.

Main Methods:

• Utilized data from 4610 children (ages 2-10) in Thailand's Kanchanaburi Demographic Surveillance System (2004).
• Employed multi-level logistic regression to model odds of short stature, underweight, and obesity across 102 communities.
• Tested the influence of child socioeconomic conditions versus social and physical environment on urban-rural disparities, adjusting for child characteristics.

Main Results:

• 27.8% of children were underweight, 19.9% had short stature, and 8.3% were obese.
• Urban residence was linked to lower undernutrition risk but higher obesity risk.
• Urban-rural disparities in short stature and underweight were explained by child socioeconomic status.
• Urban residence remained a risk factor for obesity, independent of child characteristics.
• Community wealth, TV access, and sanitation were associated with increased obesity risk.
• Undernutrition correlated with poverty; obesity correlated with affluence and urban environmental factors.

Conclusions:

• Child socioeconomic status explains urban-rural differences in undernutrition.
• Urban environments are independently associated with increased childhood obesity risk.
• Household affluence and urban environmental characteristics are key factors in childhood obesity in developing countries.