Table 4.
Association between socioeconomic factors, BMI, MVPA and (in)direct costs (generalized linear mixed model)
| Parameter | Direct costs | Indirect costs | ||||
|---|---|---|---|---|---|---|
| Total | Physician | Therapist | Hospital | Inpatient rehabilitation | Parental work absence | |
| Exp(Est) [95% CI] | Exp(Est) [95% CI] | Exp(Est) [95% CI] | Exp(Est) [95% CI] | Exp(Est) [95% CI] | Exp(Est) [95% CI] | |
| Age | 1.63 [1.28-2.08]*** | 0.99 [0.87-1.13] | 0.73 [0.51-1.04] | 1.46 [0.86-2.48] | 2.62 [0.75-9.16] | 1.03 [0.83-1.29] |
| Gender, Ref: Girls | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Boys | 1.13 [1.01-1.27]* | 1.06 [0.99-1.13] | 1.23 [1.04-1.45]* | 1.02 [0.76-1.36] | 1.31 [0.64-2.70] | 1.06 [0.96-1.17] |
| BMI categories 1 , Ref: Normal weight (P10 to P90) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Severely underweight (< P3) | 1.59 [1.13-2.24]** | 1.14 [0.94-1.37] | 0.84 [0.51-1.36] | 1.14 [0.57-2.26] | 0.56 [0.08-3.68] | 1.33 [0.95-1.85] |
| Underweight (P3 to < P10) | 1.62 [1.29-2.05]*** | 1.16 [1.03-1.32]* | 1.06 [0.76-1.46] | 1.64 [1.00-2.67]* | 0.48 [0.04-5.25] | 1.15 [0.94-1.40] |
| Overweight, not obese (> P90 to P97) | 1.42 [1.12-1.80]** | 1.31 [1.14-1.49]*** | 0.85 [0.612-1.17] | 1.55 [0.94-2.55] | 1.16 [0.25-5.48] | 1.19 [0.93-1.50] |
| Obese (> P97) | 1.89 [1.27-2.82]** | 1.16 [0.93-1.45] | 1.20 [0.64-2.23] | 1.29 [0.58-2.90]* | 1.06 [0.37-3.08] | 1.18 [0.83-1.69] |
| Missing | 1.55 [1.14-2.12]** | 0.88 [0.74-1.04] | 0.70 [0.42-1.19] | 2.34 [1.16-4.74] | 0.37 [0.08-1.75] | 0.86 [0.66-1.12] |
| Education level of parents 2 , Ref: High (>10 years) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Low (<10 years) | 1.81 [1.36-2.40]*** | 1.03 [0.89-1.19] | 1.11 [0.72-1.73] | 2.39 [1.29-4.44]** | 0.62 [0.15-2.65] | 1.43 [1.02-1.99]* |
| Medium (=10 years) | 1.11 [0.97-1.28] | 1.12 [1.04-1.20]** | 1.08 [0.88-1.33] | 0.96 [0.68-1.34] | 0.74 [0.36-1.53] | 1.16 [1.03-1.32]* |
| Relative income position 3 , Ref: > 100% of median income | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| ≤60% of median income | 1.43 [1.208-1.72]*** | 1.02 [0.93-1.13] | 1.87 [1.42-2.46]*** | 1.12 [0.74-1.68] | 1.48 [0.55-3.97] | 1.07 [0.88-1.29] |
| >60% and ≤ 100% of median income | 1.18 [1.03-1.34]* | 1.00 [0.93-1.07] | 1.21 [1.01-1.46]* | 1.13 [0.80-1.60] | 1.31 [0.57-3.01] | 1.00 [0.89-1.13] |
| Single parenthood, Ref: No | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Yes | 0.82 [0.67-0.99]* | 0.89 [0.80-0.99]* | 0.97 [0.74-1.28] | 0.92 [0.55-1.54] | 1.82 [0.32-10.38] | 1.10 [0.91-1.32] |
| Missing | 0.90 [0.59-1.38] | 1.16 [0.91-1.47] | 1.30 [0.69-2.42] | 0.65 [0.19-2.23] | 1.00 [1.00-1.00] | 1.09 [0.77-1.52] |
| Study region, Ref: Munich | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Leipzig | 1.54 [1.27-1.86]*** | 1.07 [0.96-1.18] | 0.84 [0.64-1.10] | 1.63 [1.09-2.44]* | 1.41 [0.57-3.49] | 1.67 [1.45-1.91]*** |
| Bad Honnef | 0.78 [0.61-0.99]* | 0.98 [0.85-1.12] | 0.75 [0.51-1.11] | 0.82 [0.45-1.51] | 0.67 [0.12-3.61] | 1.09 [0.86-1.39] |
| Wesel | 0.67 [0.58-0.76]*** | 0.93 [0.86-0.99]* | 0.72 [0.58-0.89]** | 0.89 [0.62-1.28] | 0.60 [0.27-1.33] | 0.98 [0.84-1.14] |
| MVPA activity time 4 , Ref: < 7 h/week MVPA 5 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| ≥7 h/week MVPA6 | 0.99 [0.88-1.12] | 0.96 [0.90-1.03] | 1.11 [0.93-1.32] | 0.79 [0.57-1.09] | 0.91 [0.42-1.98] | 1.06 [0.95-1.18] |
Abbreviations: BMI: body mass index; CI: confidence interval; Exp(Est): exponential function of the l’beta estimate; h: hours; %: percentage; Ref: reference category.
1BMI categories according to Kromeyer-Hauschild et al. 2001 [28].
2Maximum completed school years of either of the parents.
3Categorized relatively to the median equivalence income of the year 2007 (1521 EUR/month) [24].
4MVPA: moderate-to-vigorous physical activity (year average, dichotomized according to WHO recommendations ≥ 60 min/day MVPA) [2].
5WHO recommendations not met.
6WHO recommendations met.
***/**/*, values nominally significant at the 0.1%/1%/5% level (without adjustment for multiple testing).
Number of observations: 3356.
Model information: dependent variables: Exp(Estimate) for costs (total direct, physician, therapist, hospital, inpatient rehabilitation, parental work absence); assumptions: gamma distribution of the error terms, log-link function.