背景與目的：已知西方國家中兒童肥胖與社經位置多為負相關，即低社經位置兒童肥胖情形較高社經位置兒童高；回顧國內少數相關研究，卻發現國內兒童肥胖與社經位置關係的結果無一致相關性。又鑒於台灣近年來除經濟發展，亦面臨著飲食日漸西化，速食、外食及含糖飲料攝取頻率增加，活動也趨於靜態的轉變。在這般環境轉變下，是否會影響了我國兒童肥胖與社經位置的關係，也進而導致不易確定兩者間的相關性?因此本研究欲透過2001年、2005年與2009年國民健康訪問及2012年國民營養健康狀況變遷調查共四個國家型橫斷性調查資料，探討國內近12年來兒童肥胖不平等嚴重程度、變化趨勢及當中肥胖危險因子對肥胖不平等的影響。
方法：以6至11歲兒童為研究對象，以家戶所得為主要社經位置指標，使用集中指數(concentration index, C)將兒童肥胖不平等程度予以量化，以了解兒童肥胖不平等嚴重程度與變化。此外藉由分解分析(decomposition analysis)將各調查所得兒童肥胖集中指數進行解構，以了解各類肥胖危險因子對肥胖不平等的影響。
結果：本研究樣本數依資料庫年代先後排序分別是2057人、2276人、2069人及955人。12年來兒童肥胖率維持在12%左右，並無明顯變化。然而從集中指數發現兒童肥胖自2001年即存在著偏貧(pro-poor)不平等現象，整體肥胖偏貧不平等呈現持平後轉趨嚴重的變化，男女童肥胖不平等程度的變化模式並不同。而從分解分析結果，發現各調查中各類因子對於肥胖不平等的貢獻程度變化情形不同，男女童間亦有差異。但整體可看出父母教育程度是構成兒童肥胖偏貧不平等主要的因子，其貢獻程度有增長的趨勢；其次因子是居住地區及靜態活動；至於家戶所得本身是趨緩肥胖偏貧的主要因子。兒童本身的飲食行為對於肥胖不平等僅佔少部分的影響。
結論: 我國兒童肥胖具有偏貧不平等的情形，且嚴重程度整體上在近12年呈現持平後轉趨嚴重的變化。經由分解分析，發現父母教育程度、居住地區、靜態活動和家戶所得是影響兒童肥胖不平等的主要因子。因此建議未來在改善兒童肥胖不平等問題上，可針對所得較低的家庭及高中職教育程度的父母進行衛教，以預防其兒童肥胖的機會；此外加強營造東部兒童肥胖防治的友善環境，以及鼓勵兒童從事動態活動以減少打電腦、上網或打電動等靜態活動的時間。

The negative association between socioeconomic position (SEP) and childhood obesity is noticed in Western developed countries. However, such studies in Taiwan are sparse, in spite of the fact that Western food culture, eating-out lifestyle and sweetened beverages have been adapted into our rapidly developing society. Therefore, this study is aimed for providing a comprehensive analysis of socioeconomic-related inequalities in obesity risk among Taiwanese 6- to 11-year-old children over the past decade using 2001, 2005, 2009 National Health Interview Survey (NHIS) and 2012 Nutrition and Health Survey in Taiwan (NAHSIT). We employed the concentration indices (C) to quantify the socioeconomic inequalities in obesity risk in each survey period. A decomposition analysis of each concentration index is performed to examine factors that lie behind income-related inequality in obesity risk. Although overall obesity rate has remained at about 12%, there exists worsening income-related inequality in childhood obesity risk in recent years, while the changing patterns are different by gender. The decomposition analysis suggests that parental education level, residential area and sedentary lifestyles are key factors explaining pro-poor inequality in childhood obesity risk. Conversely, household income makes the opposite contribution. Children’s dietary habits contribute relatively little to be observed inequality. In conclusion, poorer family, parents with high-school educated level, Eastern Taiwan and sedentary lifestyles are the parts which should be focused on to combat the increasing trend of inequality in childhood obesity.

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