Relationships between Social Spending and Childhood Obesity in OECD Countries: An Ecological Study

Atsushi Miyawaki*, Charlotte Elizabeth Louise Evans, Patricia J Lucas, Yasuki Kobayashi

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
20 Downloads (Pure)


Objectives: The burden of childhood obesity is clustered among children in low-socioeconomic groups. Social spending on children―public welfare expenditure on families and education―may curb childhood obesity by reducing socioeconomic disadvantages. The objective of this study was to examine the relationship between social spending on children and childhood obesity across the Organization for Economic Cooperation and Development (OECD) countries. Design: Ecological study. Setting: Data on social spending on children were obtained from the OECD Social Expenditure Database and the OECD educational finance indicators dataset during 2000−2015. Data on childhood obesity were obtained from the NCD Risk Factor Collaboration database. Participants: Aggregated statistics on obesity among children aged 5 to 19 years, estimated for OECD 35 countries based on the measured height and weight on 31.5 million children. Outcome Measures: Country-level prevalence of obesity among children aged 5 to 19 years. Results: In cross-sectional analyses in 2015, social spending on children was inversely associated with the prevalence of childhood obesity after adjusting for potential confounders (the gross domestic product per capita, unemployment rate, poverty rate, percentage of children aged < 20 years and prevalence of childhood obesity in 2000). In addition, when we focused on changes from 2000 to 2015, an average annual increase of 100 US dollars in social spending per child was associated with a decrease in childhood obesity by 0.6 percentage points for girls (p = 0.007) and 0.7 percentage points for boys (p = 0.04) between 2000 and 2015, after adjusting for the potential confounders. The dimensions of social spending that contributed to these associations between the changes in social spending on children and childhood obesity were early childhood education and care (ECEC) and school education for girls and ECEC for boys. Conclusion: Countries that increase social spending on children tend to experience smaller increases in childhood obesity.
Original languageEnglish
Article numbere044205
Number of pages11
JournalBMJ Open
Issue number2
Publication statusPublished - 23 Feb 2021

Structured keywords

  • SPS Centre for Research in Health and Social Care


Dive into the research topics of 'Relationships between Social Spending and Childhood Obesity in OECD Countries: An Ecological Study'. Together they form a unique fingerprint.

Cite this