Marte K R Kjøllesdal, Sara M B Shah, Angela S Labberton, Ingunn H Bergh, Samera Qureshi, Pål Surén
{"title":"Obesity diagnoses in children and adolescents in Norway by immigrant background.","authors":"Marte K R Kjøllesdal, Sara M B Shah, Angela S Labberton, Ingunn H Bergh, Samera Qureshi, Pål Surén","doi":"10.1177/14034948231157951","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Relatively few obese children and adolescents receive specialist treatment. Our aim was to assess associations between risk of receiving an obesity diagnosis in secondary/tertiary health services by socio-economic position and immigrant background in order ultimately to improve equity in health services.</p><p><strong>Methods: </strong>The study population comprised Norwegian-born children aged 2-18 years between 2008 and 2018 (<i>N</i>=1,414,623), identified via the Medical Birth Registry. Cox regressions were used to calculate hazard ratios (HR) of an obesity diagnosis from secondary/tertiary health services (Norwegian Patient Registry) by parental education and household income and by immigrant background.</p><p><strong>Results: </strong>Higher parental education and household income were associated with a lower hazard of obesity diagnosis regardless of Norwegian versus immigrant background. Compared to having a Norwegian background, having a Latin American (HR=4.12; 95% confidence interval (CI) 3.18-5.34), African (HR=1.54; 95% CI 1.34-1.76) and Asian (HR=1.60; 95% CI 1.48-1.74) background was associated with higher hazard of obesity diagnosis. Adjusted for parental education and household income, corresponding HRs were 3.28 (95% CI 2.95-3.65) for Latin America, 0.95 (95% CI 0.90-1.01) for Africa and 1.08 (95% CI 1.04-1.11) for Asia. Within Asia, those with a background from Pakistan, Turkey, Iraq and Iran had higher hazards than those with a Norwegian background, while those with a background from Vietnam had lower hazards, even after adjusting for parental education and household income.</p><p><strong>Conclusions: </strong>\n <b>To ensure more equitable treatment, more knowledge is warranted about health-service access and referral patterns, and underlying population prevalence rates, for obese children and adolescents with different immigrant backgrounds.</b>\n </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/14034948231157951","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: Relatively few obese children and adolescents receive specialist treatment. Our aim was to assess associations between risk of receiving an obesity diagnosis in secondary/tertiary health services by socio-economic position and immigrant background in order ultimately to improve equity in health services.
Methods: The study population comprised Norwegian-born children aged 2-18 years between 2008 and 2018 (N=1,414,623), identified via the Medical Birth Registry. Cox regressions were used to calculate hazard ratios (HR) of an obesity diagnosis from secondary/tertiary health services (Norwegian Patient Registry) by parental education and household income and by immigrant background.
Results: Higher parental education and household income were associated with a lower hazard of obesity diagnosis regardless of Norwegian versus immigrant background. Compared to having a Norwegian background, having a Latin American (HR=4.12; 95% confidence interval (CI) 3.18-5.34), African (HR=1.54; 95% CI 1.34-1.76) and Asian (HR=1.60; 95% CI 1.48-1.74) background was associated with higher hazard of obesity diagnosis. Adjusted for parental education and household income, corresponding HRs were 3.28 (95% CI 2.95-3.65) for Latin America, 0.95 (95% CI 0.90-1.01) for Africa and 1.08 (95% CI 1.04-1.11) for Asia. Within Asia, those with a background from Pakistan, Turkey, Iraq and Iran had higher hazards than those with a Norwegian background, while those with a background from Vietnam had lower hazards, even after adjusting for parental education and household income.
Conclusions: To ensure more equitable treatment, more knowledge is warranted about health-service access and referral patterns, and underlying population prevalence rates, for obese children and adolescents with different immigrant backgrounds.
目的:接受专科治疗的肥胖儿童和青少年相对较少。我们的目的是评估在二级/三级医疗服务机构接受肥胖诊断的风险与社会经济地位和移民背景之间的关联,以最终改善医疗服务的公平性:研究对象包括2008年至2018年期间出生的挪威籍2-18岁儿童(N=1,414,623),这些儿童是通过出生医学登记处确认的。根据父母教育程度、家庭收入和移民背景,采用Cox回归法计算二级/三级医疗服务机构(挪威患者登记处)诊断出肥胖症的危险比(HR):无论挪威背景还是移民背景,父母受教育程度和家庭收入越高,被诊断出肥胖症的风险就越低。与挪威人背景相比,拉美人(HR=4.12;95%置信区间(CI)3.18-5.34)、非洲人(HR=1.54;95%置信区间(CI)1.34-1.76)和亚洲人(HR=1.60;95%置信区间(CI)1.48-1.74)背景与较高的肥胖诊断风险有关。调整父母教育程度和家庭收入后,拉丁美洲的相应HR值为3.28(95% CI 2.95-3.65),非洲为0.95(95% CI 0.90-1.01),亚洲为1.08(95% CI 1.04-1.11)。在亚洲,具有巴基斯坦、土耳其、伊拉克和伊朗背景者的危险度高于具有挪威背景者,而具有越南背景者的危险度较低,即使在调整了父母教育和家庭收入之后也是如此: 结论:为了确保更公平的治疗,需要更多地了解不同移民背景的肥胖儿童和青少年获得医疗服务和转诊的模式,以及潜在的人口患病率。
期刊介绍:
The Scandinavian Journal of Public Health is an international peer-reviewed journal which has a vision to: publish public health research of good quality; contribute to the conceptual and methodological development of public health; contribute to global health issues; contribute to news and overviews of public health developments and health policy developments in the Nordic countries; reflect the multidisciplinarity of public health.