Impact of cuts to local government spending on Sure Start children's centres on childhood obesity in England: a longitudinal ecological study.
Impact of cuts to local government spending on Sure Start children's centres on childhood obesity in England: a longitudinal ecological study.
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DOI：
10.1136/jech-2020-216064
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发表时间：
2021-09
影响因子：
6.3
通讯作者：
Taylor-Robinson D
中科院分区：
文献类型：
--
作者：
Mason KE;Alexiou A;Bennett DL;Summerbell C;Barr B;Taylor-Robinson D
在英格兰的贫困地区，儿童肥胖症正在上升。扎实起步儿童中心为5岁以下儿童及其父母提供基于社区的服务，包括许多可以直接或间接支持健康体重的服务。自2010年以来，地方当局预算的紧缩导致扎实起步服务的公共支出大幅减少。我们评估了自2010年以来，在英格兰那些经历了更大幅度削减Sure Start支出的地区，儿童肥胖患病率是否增加了。这项纵向生态研究涵盖2010/2011-2017/2018年。我们的风险敞口是洛杉矶在“扎实起步”上的支出，使用的是教育部的数据。我们的主要结果是LA肥胖患病率在4-5岁，使用国家儿童测量计划的数据。我们使用固定效应面板回归来量化支出变化与儿童肥胖患病率变化之间的关联。在研究期间，扎实起步儿童中心的支出平均下降了53%，在更贫困的地方，削减幅度更大。每削减10%的开支，第二年肥胖患病率相对增加0.34%（95%CI 0.15%至0.53%）。我们估计，与保持资助水平的预期数字相比，肥胖儿童增加了4575人（95%CI 1751至7399），超重或肥胖儿童增加了9174人（95%CI 2689至15660）。削减“扎实起步”儿童中心的开支与儿童肥胖症的增加有关。随着贫困地区经历更大的开支削减，对这些服务的再投资可能会对儿童发展产生更广泛的好处，有助于减少儿童肥胖的不平等。
Childhood obesity is rising in disadvantaged areas in England. Sure Start children’s centres provide community-based services for children <5 years and their parents, including many services that can support healthy weight, directly or indirectly. Since 2010, austerity-driven cuts to local authority (LA) budgets have led to substantially reduced public expenditure on Sure Start services. We assessed whether childhood obesity prevalence has increased more since 2010 in those areas in England that experienced greater cuts to spending on Sure Start. This longitudinal ecological study covers the period 2010/2011–2017/2018. Our exposure was LA expenditure on Sure Start, using Department for Education data. Our main outcome was LA obesity prevalence at age 4–5 years, using National Child Measurement Programme data. We used fixed-effects panel regression to quantify the association between change in spending and change in the prevalence of childhood obesity. Spending on Sure Start children’s centres decreased on average 53% over the study period, with deeper cuts in more deprived LAs. Each 10% spending cut was associated with a 0.34% relative increase in obesity prevalence the following year (95% CI 0.15% to 0.53%). We estimated there were an additional 4575 children with obesity (95% CI 1751 to 7399) and 9174 overweight or obese (95% CI 2689 to 15 660) compared with expected numbers had funding levels been maintained. Cuts to spending on Sure Start children’s centres were associated with increased childhood obesity. With deprived areas experiencing bigger spending cuts, reinvesting in these services may, alongside wider benefits for child development, contribute to reducing inequalities in childhood obesity.
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DOI：
10.1097/ede.0b013e3181d61eeb
发表时间：
2010-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Lipsitch M;Tchetgen Tchetgen E;Cohen T
通讯作者：
Cohen T
影响因子：
1.9
作者：
Webb, Calum J. R.;Bywaters, Paul
通讯作者：
Bywaters, Paul
影响因子：
2.9
作者：
Bennett DL;Mason KE;Schlüter DK;Wickham S;Lai ET;Alexiou A;Barr B;Taylor-Robinson D
通讯作者：
Taylor-Robinson D
影响因子：
4.5
作者：
Burton, Wendy;Twiddy, Maureen;Bryant, Maria
通讯作者：
Bryant, Maria
影响因子：
168.9
作者：
Melhuish, Edward;Belsky, Jay;Barnes, Jacqueline
通讯作者：
Barnes, Jacqueline