Health inequalities: obesity significantly higher in south of Malta

In an indication linking social class inequality to health problems, children in the southern region are more likely to be obese than those hailing from the north of Malta.

In a study focusing on the geographical distribution of the prevalence of childhood overweight and obesity in Malta published in the Malta Medical Journal, a higher propensity towards obesity was revealed in the south.

One-third of boys attending primary schools in the southern harbour region which includes Cottonera, Valletta, Zabbar, Tarxien and Paola are obese, compared to a quarter in the northern (which includes Naxxar and St Paul’s Bay) and the north harbour districts (which includes Sliema, St Julian’s, Birkirkara and Qormi). 

Gozo and the south-eastern region, which includes Birzebbugia, Zejtun, Zurrieq and Marsaxlokk, also showed higher than average rates of obesity.

The authors of the study link this disparity to income inequality, noting that on average, persons living in the north were also found to live in larger residences, have better literacy levels, have a higher chance of owning their home – rather than renting – and have lower levels of unemployment when compared to the South.

This emerges from a study a national study carried out in 2015 to measure the body mass index (BMI) of all 41,343 children attending school in Malta thereby covering ages 5 to 15. The study found that 40% of school-aged children in Malta were overweight or obese. The study found that most overweight children were also obese.

On the other hand, less than 3% of children were underweight. The highest rate of underweight children (4.2%) was found among males in Gozitan secondary schools.

Boys hailing from the south were the most prone to weight problems. Only 51% of males in primary school in the two southern regions had a normal weight (neither underweight nor overweight) compared to over 58% in the two northern regions.

Among girls in the same age bracket, the difference was less pronounced, with 57% to 59% having a normal weight in the south, compared to 63% in the north.

Results show significant differences in BMI (Body Mass Index) between children living in northern and southern regions of Malta.

Obesity rates in Gozo and southern regions are also significantly higher among females attending secondary schools, peaking at 28% in the south harbour region compared to 21% in the north harbour region.

The study shows a significant difference in BMI between children living in the northern regions and those living in the southern parts of the island, with the authors noting that the difference is notable because of “the small size of the country.”

These trends demonstrate a relationship between socioeconomic status and obesity, reinforcing studies done in other countries.

For example, American datasets over the years have shown that higher levels of childhood overweight and obesity were present in families with parents having a lower level of education, those living below the poverty level and those living in low-income neighbourhoods.

Despite the north-south differences, all regions show a high prevalence of overweight and obesity.

The authors of this study call on government to provide the “necessary leadership” to tackle this major issue for our islands.

It also calls on the State to consider the taxation of the unhealthy food options.

The experts said a regular repetition of the study was needed to determine trends of childhood overweight and obesity in Malta and monitor the effect of any prevention and intervention programmes being implemented. They also called for further research into socioeconomic determinants of local overweight and obesity to determine how best to address the problem.

The study is authored by paediatricians Samuel Aquilina and Victor Grech, educator Erin Camilleri, research coordinator Karl Spiteri, Maria Louisa Busuttil (Fund manager, Ministry for Social Dialogue), Victoria Farrugia Sant-Angelo (Medical Co-ordinator Child Health Services, Primary Health Care), Neville Calleja (Director of Health Information and Research, Primary Health Care).