Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Epidemiology and population health

The association between area-based deprivation and change in body-mass index over time in primary school children: a population-based cohort study in Hampshire, UK



Childhood obesity is a serious public health challenge. Cross-sectional evidence indicates that childhood obesity is strongly linked to area deprivation level, yet longitudinal research is scarce. We assessed the association of home-based and school-based deprivation indices with change in childhood body-mass index (BMI) z-score and BMI status over 6 years in Hampshire, England.


This longitudinal study linked the National Child Measurement Programme data for children aged 4–5 years (2007–08 to 2009–10) to 10–11 years. The dataset was stratified into two groups: 18,733 children for whom home deprivation quintiles, according to the Index of Multiple Deprivation (IMD), remained constant, and 6153 children who moved home deprivation quintiles between the two time points. The associations between IMD quintiles and change in BMI z-score and status were analysed.


63.7% of children remained a healthy weight, 3.1% remained overweight, 5.3% remained with obesity, 8.3% became overweight, and 10.3% developed obesity. Children living in the most deprived quintile increased their BMI z-score by 0.13 units more than those in the least deprived quintile (95% CI: 0.08–0.19). Home-based deprivation displayed associations with change in BMI status. (Relative risk for the most deprived quintile: become overweight 1.47, 1.21–1.78, remain obese 1.82, 1.34–2.40, become obese 2.07, 1.73–2.48.) School-based deprivation was not associated with change in BMI z-score or BMI status. Moving home to a more deprived quintile was associated with developing obesity (1.22, 1.04–1.43).


More children living in deprived areas developed obesity over time. Home-based deprivation level is more strongly associated with adverse change in childhood weight than school-based deprivation. Scholarly settings can provide opportunities for interventions, however obesity prevention interventions should tackle the obesogenic environment combining family and area-based measures.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others


  1. Public Health England. Childhood obesity: overview. 2016. Accessed 17 Sept 2016.

  2. The World Health Organisation. Obesity and overweight. 2016. Accessed 17 Sept 2016.

  3. The World Health Organisation. Why does childhood overweight and obesity matter? 2016. Accessed 17 Sept 2016.

  4. Centers for Disease Control and Prevention. The health effects of overweight and obesity. 2015. Accessed 12 Sept 2016.

  5. Public Health England. Health risks of childhood obesity. 2016. Accessed 17 Jan 2017.

  6. Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421–40.

    Article  Google Scholar 

  7. European Association for the Study of Obesity. Obesity facts and figures. 2015. Accessed 26 Jun 2016.

  8. NHS Digital. National child measurement programme—England, 2015–16: Tables. 2016. Accessed 15 Dec 2016.

  9. Government Office for Science. Foresight. Tackling obesities: future choices—report. 2nd ed. 2007×-tackling-obesities-future-choices-report.pdf. Accessed 12 Dec 2016.

  10. Public Health England. Health matters: obesity and the food environment. 2017. Accessed 31 Mar 2017.

  11. Whitehead M. The health divide. In: Townsend P, Davidson N, Whitehead W, editors. Inequalities in health. 1992 edition. Middlesex, England: Penguin books; 1992. p. 236.

  12. Ministry of Housing, Communities and Local Government. English indices of deprivation. 2015. Accessed 19 Nov 2016

  13. National Obesity Observatory. Child obesity and socioeconomic status. Accessed 18 Aug 2016.

  14. Bammann K, Gwozdz W, Pischke C, Eiben G, Fernandez-Alvira JM, Henauw SDe, et al. The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study. Int J Obes. 2017;41:54–60.

    Article  CAS  Google Scholar 

  15. Carter MA, Dubois L, Tremblay MS, Taljaard M. The influence of place on weight gain during early childhood: a population-based, longitudinal study. J Urban Health. 2013;90:224–39.

    Article  Google Scholar 

  16. Wheaton N, Millar L, Allender S, Nichols M. The stability of weight status through the early to middle childhood years in Australia: a longitudinal study. BMJ Open. 2015:5.

    Article  Google Scholar 

  17. Jansen PW, Mensah FK, Nicholson JM, Wake M. Family and neighbourhood socioeconomic inequalities in childhood trajectories of BMI and overweight: longitudinal study of Australian children. PLoS ONE. 2013:8.

  18. Gose M, Plachta-Danielzik S, Willie B, Johannsen M, Landsberg B, Muller MJ. Longitudinal influences of neighbourhood built and social environment on children’s weight status. Int J Environ Res Public Health. 2013;10:5083–96.

    Article  Google Scholar 

  19. Norman P, Boyle P, Rees P. Selective migration, health and deprivation: a longitudinal analysis. Soc Sci Med. 2005;12:2755–71.

    Article  Google Scholar 

  20. Heritage T, Mcmanus J. Hertfordshire’s public health strategy. In: Hertfordshire assembly meeting. Hertfordshire County Council. Hertfordshire, 2013.

  21. NHS Digital. National child measurement programme. 2016. Accessed 17 June 2016.

  22. Public Health England. National child measurement programme operational guidance. 2016. Accessed 15 June 2016.

  23. Inokuchi M, Matsuo N, Takayama JI, Hasegawa T. BMI z-score is the optimal measure of annual adiposity change in elementary school children. Ann Hum Biol. 2011;38:747–51.

    Article  Google Scholar 

  24. Cole TJ, Faith MS, Pietrobelli A, Heo M. What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score or BMI centile? Eur J Clin Nutr. 2005;59:419–25.

    Article  CAS  Google Scholar 

  25. Must A, Anderson SE. Body mass index in children and adolescents: considerations for population-based application. Int J Obes. 2006;30:590–94.

    Article  CAS  Google Scholar 

  26. National Obesity Observatory. A simple guide to classifying body mass index in children. 2011. Accessed 10 Dec 2016.

  27. Department for Communities and Local Government. The English indices of deprivation: technical report. 2015. Accessed 18 July 2016.

  28. Little E. Association of deprivation with overweight and obesity among primary school children in England: an ecological cross-sectional study. The Lancet. 2017:390. S59

  29. Ministry of Housing, Communities and Local Government. English Indices of Deprivation 2015 area look up. 2015. Accessed 19 Nov 2016.

  30. Department for Communities and Local Government. The English Indices of Deprivation: Technical Report. 2015.

  31. Moore DB, Howell PB, Treiber FA. Changes in overweight in youth over a period of 7 years: impact of ethnicity, gender and socioeconomic status. Ethnic Dis. 2002;12:83–6.

    Google Scholar 

  32. Ofsted. School inspection handbook. Ofsted. Report number 150066; 2016.

  33. Ofsted. State funded schools statistics. 2014. Accessed Nov 2016.

  34. Office for National Statistics. Rural urban classification (2011) of lower layer super output areas in England and Wales. 2013. Accessed 12 Oct 2016.

  35. Stata. Stata for Windows. 2016. Accessed 21 Nov 2016.

  36. NHS Digital. Data quality statement. 2015. Accessed 6 Dec 2016.

  37. Semmler C, Ashcroft J, Van Jaarsveld CHM, Carnell S, Wardle J. Development of overweight in children in relation to parental weight and socioeconomic status. Obesity. 2009;17:814–20.

    Article  Google Scholar 

  38. Oliver LN, Hayes MV. Effects of neighbourhood income on reported body mass index: an eight year longitudinal study of Canadian Children. BMC Public Health. 2008;8. 16

  39. Valerio G, D'Amico O, Adinolfi M, Munciguerra A, D'Amico R, Franzese A. Determinants of weight gain in children from 7 to 10 years. Nutr Metab Cardiovasc Dis. 2006;16:272–8.

    Article  Google Scholar 

  40. O’Dea JA, Chiang H, Peralta LR. Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6-year longitudinal cohort of Australian school children from 2007 to 2012. BMC Public Health. 2014;14:222 Accessed 17 June 2016.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Kinra S, Nelder RP, Lewendon GJ. Deprivation and childhood obesity: a cross sectional study of 20 973 children in Plymouth, United Kingdom. J Epidemiol Community Health. 2000;54:456–60.

    Article  CAS  Google Scholar 

  42. Parkes A, Sweeting H, Young, R, Wight D. Does parenting help to explain socioeconomic inequalities in children’s body mass index trajectories? Longitudinal analysis using the Growing Up in Scotland study. J Epidemiol Community Health. 2016;70. 868–73

    Article  Google Scholar 

  43. O’Dea JA, Dibley MJ, Rankin NM. Low sleep and low socioeconomic status predict high body mass index: a 4year longitudinal study of Australian school children. Pediatr Obes. 2012;4:295–303.

    Article  Google Scholar 

  44. Norman P, Rees P, Boyle P. Achieving data compatibility over space and time: creating consistent geographical zones. Popul Space Place. 2003;9:365–86.

    Google Scholar 

Download references


We would like to acknowledge Hampshire County Council’s Director of Public Health for facilitating the use of the data in this research and the University of Southampton M.Sc. Public Health Team for their support. This research was conducted as an M.Sc. Public Health dissertation project. AT was supported by Health Education England-Wessex to complete the M.Sc. Programme.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Abbie Twaits.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Twaits, A., Alwan, N.A. The association between area-based deprivation and change in body-mass index over time in primary school children: a population-based cohort study in Hampshire, UK. Int J Obes 44, 628–636 (2020).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links