Association Between Sub-National Regional Socioeconomic Status and Childhood Obesity in Five South-East European Countries: The WHO European Childhood Obesity Surveillance Initiative—COSI (2019)

Musić Milanović, Sanja; Križan, Helena; Šlaus, Nika; Brađašević, Emanuel; Lang Morović, Maja; Djordjic, Visnja; Kujundžić, Enisa; Ostojic, Sergej M.; Spiroski, Igor; Starc, Gregor

doi:10.3390/children13020267

Association Between Sub-National Regional Socioeconomic Status and Childhood Obesity in Five South-East European Countries: The WHO European Childhood Obesity Surveillance Initiative—COSI (2019)

Journal

Children

Date Issued

2026-02-13

Author(s)

Musić Milanović, Sanja

Križan, Helena

Šlaus, Nika

Brađašević, Emanuel

Lang Morović, Maja

Djordjic, Visnja

Kujundžić, Enisa

Ostojic, Sergej M.

Starc, Gregor

DOI

10.3390/children13020267

Abstract

Background/Objectives: This study focused on the sub-national regional heterogeneity in childhood obesity prevalence across five countries in south-east Europe and the correlation between this heterogeneity and socioeconomic differences. Previous studies have mainly observed national or cross-national data but this study used a sub-national regional approach that may be beneficial in the further investigation of childhood obesity. Methods: Nationally representative samples of children from Croatia, Montenegro, North Macedonia, Serbia and Slovenia were selected using the COSI methodology and used to estimate regional childhood obesity prevalence values. The Sub-national Human Development Database provided data on the Sub-national Human Development Index (SHDI). The spatial autocorrelation analysis of childhood obesity prevalence in sub-national regions was performed and its association with sub-national human development was tested with an ordinary least squares regression model. Results: This study found statistically significant differences in childhood obesity prevalence across sub-national regions in Croatia, Slovenia and Serbia, while no such differences were observed in North Macedonia and Montenegro. There was moderate clustering in childhood obesity rates (Moran’s I = 0.337). The results indicated a significant negative association between SHDI and childhood obesity prevalence across the 48 regions (β = −66.63, p < 0.001). Conclusions: Future public health efforts should take into consideration regional differences in childhood obesity prevalence, and more targeted research is essential for understanding the mechanisms of resilience and vulnerability on a sub-national level.

Subjects

childhood obesity

sub-national

regional

socioeconomic

south-east Europe

File(s)

Name

Trud_objaven.pdf

Size

633.1 KB

Format

Adobe PDF

Checksum

(MD5):5b9acb2449bde2341fca27d35b53f1ec