Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences

Purpose: Childhood overweight and obesity is on the rise in China and in Chinese cities in particular. The aim of this study is to explore the extent of income differences in childhood overweight in Shanghai, China, and examine demographic, social, and behavioral explanations for these differences. Methods: Using the 2014 Child Well-Being Study of Shanghai, China—a survey that included extensive contextual information on children and their families in China’s most populous city, prevalence rates and adjusted odds ratios of child overweight and obesity at age 7 were calculated by income tercile controlling for a wide variety of sociodemographic variables. Results: District aggregate income increases the odds of child overweight/obesity, but only for boys. In contrast, rural hukou status was associated with lower odds of overweight/obesity for girls. Conclusions: Boys at age 7 are more likely to be overweight and obese than girls. District income further increases this likelihood for boys, while rural hukou status decreases this likelihood for girls, suggesting that preferences for boys and thinness ideals for girls may play a role in the income patterning of childhood overweight and obesity.