title: A cross-sectional study examining the pattern of childhood obesity in Leeds: affluence is not protective.
abstract: BACKGROUND
  The aim of this paper was to investigate variations in childhood obesity globally and spatially at the micro-level across Leeds.
  
  
  METHODS
  Body mass index data from three sources were used. Children were aged 3-13 years. Obesity was defined as above the 98th centile (British reference dataset). The data were analysed by age group and gender, then tested for significant micro-level hot spots of childhood obesity using a spatial scan statistic and a two-level multilevel model.
  
  
  RESULTS
  Older children (13 years) were 2.5 times (95% CI 2.1 to 3.1) more likely to be obese than younger children (3 years). Childhood obesity was significantly associated with deprived and affluent areas. 'Blue collar communities,' 'Constrained by circumstances' and 'Multicultural' had significantly higher (relative risk (RR): 1.1, 1.2, 1.2; 95% CI 1.0 to 1.2, 1.1 to 1.2, 1.1 to 1.3, respectively) obesity levels, and 'Typical traits' and 'Prospering suburbs' had significantly lower (RR: 0.9, 0.8; 95% CI 0.8 to 1.0, 0.7 to 0.9, respectively) obesity levels. In the unadjusted model, obesity 'hot spots' were found in deprived (RR 1.5) and affluent (RR 6.1) areas. After adjusting for demographic covariates, hot spots were found only in affluent areas (RR 1.6 to 1.9), and cold spots in affluent (RR 1.3 to 4.4) and deprived (RR up to 1.1) areas.
  
  
  CONCLUSIONS
  These results suggest there is either a spread of obesity across socio-economic groups and/or something special about the high-/low-prevalence areas that affects the likelihood of obesity. The microlevel spatial analyses displayed the variations in obesity across Leeds thoroughly, identifying high-risk populations.
authors: Centre of Epidemiology and Biostatistics, Room 8.49, Worsley Building, University of Leeds, Leeds LS2 9JT, UK. k.l.edwards@leeds.ac.uk
authors: K L
authors: KL
authors: Edwards
authors: J E
authors: JE
authors: Cade
authors: J K
authors: JK
authors: Ransley
authors: G P
authors: GP
authors: Clarke
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D011204:Poverty Areas; D012307:Risk Factors; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data