Spatial-temporal analysis and spatial drivers of childhood obesity in China from 1985 to 2019.

Abstract

Objective: We characterized the spatial-temporal trends of obesity among Chinese children and adolescents from 1985 to 2019 and examined the impact of social determinants of health (SDOH) patterns.

Methods: Using data from the Chinese National Survey on Students' Constitution and Health (CNSSCH) conducted between 1985 and 2019, featuring seven cross-sectional surveys, we employed spatial-temporal analysis methods and collected 23 obesity-related variables to identify SDOH patterns. A general linear regression model investigated associations between SDOH patterns and obesity prevalence.

Results: Obesity prevalence rose from 0.1% to 8.1%. Northern regions formed a high-obesity cluster, whereas Southern regions were low-obesity clusters. The following four SDOH patterns emerged: Western Resource-Limited Frontier, Coastal-Central Development Belt, Inland Agricultural Heartland, and Metropolitan Resource-Rich Hubs. Prevalence was 5.7%, 5.8%, 10.2%, and 11.3% for Patterns 1 through 4, respectively. Compared with Pattern 2, Patterns 3 and 4 showed higher obesity risks.

Conclusions: Childhood obesity prevalence in China increased with regional disparities from 1985 to 2019, with higher prevalence in the North and lower prevalence in the South. SDOH patterns were linked to spatial clusters, suggesting that regions characterized by advanced urbanization, abundant resources (Pattern 4), and a dietary profile heavy in carbohydrates and low in protein (Pattern 3) potentially contributed to increased obesity risk.