China's one-child policy (1979–2015) has affected Chinese parenting practices and children's health behaviors and also may have contributed to increased childhood obesity. However, very limited research has investigated the association between one-child policy and childhood obesity. We examined characteristics of single-child families and the influence of one-child policy (indicated by single-child status) on children's weight status and related health behaviors. Data from children aged 6–18 years old in the 2011 (n = 1580) and 2000 (n = 2317) China Health and Nutrition Survey were cross-sectionally analyzed with multilevel models. From 2000 to 2011, the rates about doubled for being a single-child (30.1% to 57.0%) and being overweight or obese (OWB, 6.6% to 16.5%) along with urbanization (27.5% to 37.1%). Single-child families had higher levels of parental education, household income and urban residence than families with ≥ two children (p < 0.05). Compared to the children with siblings, single children were more likely to be OWB; the association became stronger over time (OR = 4.5 (1.7–12.4) in 2011 and 1.7 (1.0–2.8) in 2000). Also, single children had less recreational screen time, but similar physical activity levels; however single urban children were more likely to have excess total energy intake (OR = 5.70 (1.58–20.60)) than those with siblings. Being single-child is about four times more likely to be overweight/obesity than those having siblings, and the association became stronger over time in China. China's one-child policy might have contributed to its rising childhood obesity rates. Obesity intervention programs may need to account for the influence of the one-child policy in China.
- Body mass index
- One child policy
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health