Socioeconomic determinants of childhood overweight and obesity in China: The long arm of institutional power

Abstract

Previous studies have widely reported that the association between socioeconomic status (SES) and childhood overweight and obesity in China is significant and positive, which lends little support to the fundamental-cause perspective. Using multiple waves (1997, 2000, 2004 and 2006) of the China Health and Nutrition Survey (CHNS) (N = 2,556, 2,063, 1,431 and 1,242, respectively) and continuous BMI cut-points obtained from a polynomial method, (mixed-effect) logistic regression analyses show that parental state-sector employment, an important, yet overlooked, indicator of political power during the market transformation has changed from a risk factor for childhood overweight/obesity in 1997 to a protective factor for childhood overweight/obesity in 2006. Results from quantile regression analyses generate the same conclusions and demonstrate that the protective effect of parental state sector employment at high percentiles of BMI is robust under different estimation strategies. By bridging the fundamental causes perspective and theories of market transformation, this research not only documents the effect of political power on childhood overweight/obesity but also calls for the use of multifaceted, culturally-relevant stratification measures in testing the fundamental cause perspective across time and space.