An exploratory spatial analysis of overweight and obesity among children and adolescents in Shandong, China

BMJ Open. 2019 Aug 22;9(8):e028152. doi: 10.1136/bmjopen-2018-028152.

Abstract

Objective: Identifying the spatial patterns of childhood overweight/obesity (OW/OB) can help to guide resource allocation for preventive intervention in China. This study aims to estimate rates of childhood OW/OB across counties within Shandong Province, using geographic techniques to identify sex-specific spatial patterns of childhood OW/OB as well as the presence of spatial clusters.

Design: Cross-sectional study.

Setting: Shandong Province in China.

Participants and methods: Data on 6 216 076 children and adolescents aged 7-18 years from the Primary and Secondary Schoolchildren Physical Examination Database for Shandong Province were used in this study. Spatial patterns of sex-specific prevalence of childhood OW/OB were mapped. Global autocorrelation statistic (Moran's I) and the Local Indicator of Spatial Association (LISA) were applied to assess the degree of spatial autocorrelation.

Results: The overall prevalence of childhood OW/OB in Shandong province were 15.05% and 9.23%, respectively. Maps of the sex-specific prevalence of OW/OB demonstrate a marked geographical variation of childhood OW/OB in different regions. Prevalence of childhood OW/OB had a significant positive spatial autocorrelation among both boys and girls. LISA analysis identified significant clusters (or 'hot spots') of childhood OW/OB in the eastern coastal region, central region and southwestern region.

Conclusions: The prevalence of childhood OW/OB is highly spatially clustered. Geographically focused appropriate intervention should be introduced in current childhood OW/OB prevention and control strategy.

Keywords: child and adolescent; geographic location; obesity; overweight; spatial analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Overweight / epidemiology*
  • Pediatric Obesity / epidemiology*
  • Prevalence
  • Spatial Analysis