title: In urban South Africa, 16 year old adolescents experience greater health equality than children.
abstract: Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n=346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9-10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9-10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.
authors.affiliation: Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, UK; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: P.griffiths@lboro.ac.uk.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Griffiths
authors.forename: William
authors.initials: W
authors.lastname: Johnson
authors.forename: Noël
authors.initials: N
authors.lastname: Cameron
authors.forename: John M
authors.initials: JM
authors.lastname: Pettifor
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000886:Anthropometry; D044383:Black People / Q000706:statistics & numerical data*; D001823:Body Composition; D002648:Child; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population
keywords: Adolescence; Body composition; Health inequalities; Neighbourhood; South Africa