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Public health
Research
An exploratory spatial analysis of overweight and obesity among children and adolescents in Shandong, China
  1. Wenzhe Qin1,
  2. Lu Wang2,
  3. Lingzhong Xu1,
  4. Long Sun1,
  5. Jiajia Li1,
  6. Jiao Zhang1,
  7. Hui Shao3
  1. 1 School of Public Health, Shandong University, Jinan, China
  2. 2 Shandong Provincial Medical Examination Office, Shandong Province Health and Family Planning Commission, Jinan, China
  3. 3 Department of Global Health Systems and Development School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
  1. Correspondence to Dr Lingzhong Xu; lzxu{at}sdu.edu.cn

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.

  • child and adolescent
  • geographic location
  • obesity
  • overweight
  • spatial analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-028152

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    Footnotes

    • WQ and LW contributed equally.

    • Contributors WQ planned the study, conducted the analysis and wrote the paper while being supervised by LX; LW, JL, LS helped to plan the study, including the instrumentation and to revise the manuscript. JZ and HS accomplished the statistical analysis and contributed to revising the paper. All authors contributed to the discussion of the paper, read and approved the final manuscript.

    • Funding This project was funded by the National Natural Science Foundation of China (grant number 71673169 and 71673170).

    • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the Academic Research Ethics Committee of Shandong University.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.