Differences in socioeconomic conditions are a major driver of unequal obesity rates among Māori, Pacific and European children, a new study shows.

The study – the first of its kind in Aotearoa New Zealand – found that the difference in numbers of four-year-old children affected by obesity between Māori and European would halve if Māori children experienced the same family and neighbourhood conditions as Europeans. If Pacific children experienced the same conditions as European children, differences in obesity rates would reduce by about one third.

Researchers for A Better Start E Tipu e Rea National Science Challenge gathered data from 253,260 four year olds who underwent a B4 School Check between 2010 and 2016, and who were resident in New Zealand when the 2013 census was completed. They cross-checked this with other data about the children’s parents, family, neighbourhood and region to find any patterns.

“While ethnic and socioeconomic differences in child obesity rates are well documented, we know little about how to reduce these differences, or the extent to which ethnic differences reflect the unequal distribution of resources across ethnic groups,” says lead author, Senior Research Fellow Dr Nichola Shackleton, from the University of Auckland’s quantitative social science centre COMPASS.

Overall, 15.2 per cent of the children in the study were affected by obesity, according to their BMI measure. Eleven per cent of European, 20 per cent of Māori, and 33 per cent of Pacific children were affected by obesity. There was no evidence those disparities were reducing or growing.

The children’s family and neighbourhood conditions – including family make-up, levels of deprivation, rural versus urban and region – accounted for half of the differences in obesity rates between Māori and European children, and a third of the disparity between Pacific and European children.

The study is published in a Nature journal, the International Journal of Obesity.

Director of A Better Start, Liggins Institute Professor Wayne Cutfield, was a senior author on the study. “The findings suggest that tackling socio-economic disadvantage could significantly reduce disparities in obesity rates, as well as disparities for many related health issues,” says Professor

“This study provides useful information on why ethnic differences in childhood obesity rates persist in New Zealand,” says Dr Shackleton. “To many people, it will be no surprise that differences in socioeconomic position are a main driver of these differences in obesity. Our findings highlight the potential health impact of redressing wider inequities in society, and reinforce the need to move beyond individualistic framing of obesity and take a more holistic view,” she says.

Dr Shackleton says the health status of Māori needs to be considered alongside Aotearoa New Zealand’s colonial history. “Power and resources were taken from Māori, who were marginalized by new social systems, based on European norms and values,” she says.

“Increased health needs among Māori and their increased experience of deprivation may be a consequence of the repression of indigenous peoples, the confiscation of land and political power, and the breaching of their rights. A loss of traditional food gathering places and practices following colonisation, alongside the introduction of new foods such as wheat, negatively impacted food  security for Māori and resulted in a loss of traditional knowledge about food practices.”

The researchers say further analysis using a richer data source, such as Growing up in New Zealand – a longitudinal study based at the University of Auckland – is needed to gain a more detailed understanding of these differences.

International Journal of Obesity: Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers

Note: The B4 School Check is a nationwide programme offering a free health and development check for 4-year olds, which aims to identify and address any health, social, developmental or behavioural concerns which could impact on a child’s ability to get the most from school, such as a communication or hearing problem.

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