MPIDR Working Paper

The role of childhood obesity in socioeconomic inequalities in young adolescents’ mental health: differential exposure or differential impact?

Gueltzow, M., Oude Groeniger, J., Bijlsma, M. J., Jansen, P. W., Houweling, T. A. J., van Lenthe, F. J.
MPIDR Working Paper WP-2023-016, 28 pages.
Rostock, Max Planck Institute for Demographic Research (April 2023)
Open Access


We investigated to what extent socioeconomic inequalities in young adolescents’ mental health are due to differential exposure to, or differential impact of obesity. We used data from 4,660 Generation R participants and defined mothers’ education and household income at child’s age 5 as a disparity measure. We estimated the contribution of differential exposure to, and differential impact of, body fat percentage at age 9 to the total disparity in internalizing and externalizing symptoms at age 13. This was done through a four-way decomposition with interventional analogues using marginal structural models with inverse probability of treatment weighting. The total disparity in internalizing symptoms was 0.98 points (95%CI 0.35, 1.63) and 1.68 points (95%CI 1.13, 2.19), comparing children from least- and most-educated mothers, and lowest and highest-income households, respectively. Of these total disparities in internalizing symptoms, 0.50 points (95%CI 0.15, 0.85) and 0.24 points (95%CI 0.09, 0.46) were due to differential exposure to obesity. We found no evidence for differential exposure or impact contributing to disparities in externalizing symptoms. Our results indicate that tackling the higher obesity prevalence in children from mothers with a low socioeconomic position may also reduce inequalities in internalizing symptoms in early adolescence. 

Keywords: Netherlands, adolescence, children, inequality, mental health, obesity
The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.