School enrollment and obesity in Brazilian adolescents

School Enrollment Protects Brazilian Adolescents from Overweight and Obesity, Even for Siblings in the Same Household

Letícia J. Marteleto, Molly Dondero, Jennifer Van Hook, Luiz C. D. Gama, and Rachel Donnelly

Introduction

Brazilian children and adolescents are now among the heaviest in the world. Indeed, the proportion of children considered obese or overweight in Brazil grew from 3.7% in 1970 to 21.7% in 2009. Projections show that Brazil could surpass the United States in the proportion of overweight and obese children as early as next year.

Brazil is also one of the most unequal countries in the world, and obesity increasingly affects those with lower socioeconomic status. The country also continues to undergo the nutrition transition—a phenomenon present in most middle- and high-income countries—characterized by increases in the consumption of ultra-processed foods high in saturated fat, sodium, and sugar.

The role of an adolescent family’s socioeconomic status has been clearly linked to adolescent overweight and obesity. In contrast, researchers have paid less attention to the role of adolescents’ own emerging socioeconomic characteristics, measured by whether they are in school or working, on their weight status.

Adolescents’ schooling and work experiences are nascent indicators of their socioeconomic status and capture more than resources at the household level. They reflect the process through which adolescents acquire resources and status on their own. For example, through schooling, adolescents may gain a greater sense of personal control, which is associated with healthier lifestyles. School and work also connect adolescents to people, institutions, and experiences and provide routine and a sense of purpose at a formative stage in their lives. Importantly, a large proportion of adolescents work and do not complete high school in Brazil.

Using a nationally representative data set (Pesquisa de Orçamentos Familiares; Household Expenditure Survey) that includes anthropometric measures of the height and weight of all household members, the authors examine whether and how adolescents’ school and work experiences are associated with overweight and obesity in Brazil. They use an innovative approach by focusing on common markers of an adolescent’s own nascent socioeconomic status – school enrollment and work – instead of simply on measures of family socioeconomic status. This approach, along with sophisticated statistical techniques that approximate a natural experiment, allow them to measure overweight/obesity differences between adolescents within the same family.

Key Findings

• Brazilian adolescents who are enrolled in school are less likely to be overweight or obese than those who are not enrolled.
• School protects adolescents from obesity/overweight even when considering family factors shared by siblings. Accounting for these family factors indicates that adolescents who are enrolled in school—both those who work and those who do not—have the lowest probabilities of being overweight or obese (see Figure).
• Work status alone is not associated with either higher or lower likelihood of being overweight or obese.

Policy Implications

Trajectories of socioeconomic and health disadvantages established early in life and during adolescence are likely compounded in adulthood. Therefore, policy interventions that affect young people can have large payoffs. This study’s finding that school protects against adolescent overweight and obesity supports the need for robust policies in Brazil that promote school retention throughout childhood and adolescence. Such benefits go beyond education, extending to health benefits.

Moreover, adolescents who work while enrolled in school are not more likely to have an increased risk of overweight/obesity, potentially because combining school and work is a way for adolescents to gain skills that promote healthy eating habits. This finding points to the need for policies that encourage part-time work for adolescents enrolled in school.

Reference

Marteleto*, L.J., Dondero*, M., Van Hook, J., Gama, L.C.D. & Donnelly, R. (2021). Intersections of adolescent well-being: school, work, and weight status in Brazil. Journal of Health and Social Behavior 62(1): 69-84. *Marteleto and Dondero contributed equally to the article.

Suggested Citation

Marteleto, L.J., Dondero, M., Van Hook, J., Gama, L.C.D. & Donnelly, R. (2021). School enrollment protects Brazilian adolescents from overweight and obesity, even for siblings in the same household. PRC Research Brief6(5). DOI: 10.26153/tsw/12301.  

About the Authors

Letícia J. Marteleto (marteleto@prc.utexas.edu) is a faculty research associate at the Population Research Center and a professor of sociology, The University of Texas at Austin; Molly Dondero is an assistant professor of sociology at American University in Washington, DC; Jennifer Van Hook is Roy C. Buck Professor of Sociology and Demography at the Pennsylvania State University, and nonresident fellow at the Migration Policy Institute;  Luiz Carlos Day Gama is a professor in the Department of Economics at Ibmec-MG, Brazil; and Rachel Donnelly is an assistant professor of sociology at Vanderbilt University. Dondero, Van Hook, and Donnelly are former PRC graduate research trainees; Gama was a visiting researcher at the PRC.

Acknowledgements

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C HD042849), awarded to the Population Research Center at The University of Texas at Austin. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.