Socio-spatial differences in overweight and obesity among preschoolers: An overview using data from the school entry examination.

Background: School entry examinations (SEE) conducted by the federal states provide measurement data on the height and weight of preschool-aged children. Prevalence rates for overweight and obesity are available for Health Reporting and can be linked to other factors at the aggregate level. This article describes the prevalence of overweight and obesity among preschool children based on aggregated data from SEE, differentiated by two socio-spatial indicators. Method: In the AdiRaum 2.0 project, aggregated SEE data on overweight and obesity from the 2006 - 2024 school entry years were compiled from 13 federal states (where available). As an example, the prevalence of overweight and obesity among children starting school in 2019 was linked to the degree of urbanisation and socioeconomic deprivation. Results: Data from 4,269,299 children aged 4 to 7 years were collected. Between 2006 - 2024, the prevalence of overweight (including obesity) ranged from 8.6 % to 13.4 %, and the prevalence of obesity ranged from 3.7 % to 5.9 %. In 2019, children from districts with high socioeconomic deprivation were more frequently affected by obesity than children from other districts. Conclusions: The analyses confirm that high socioeconomic deprivation is a key risk factor for overweight and obesity already in childhood. Aggregated SEE data on preschool-aged children are suitable for this analysis. Prevention efforts should address and reduce health inequalities in childhood at the environmental level.