Multilevel determinants of childhood obesity in the European region: An empirical analysis using the Social Ecological Model

¹ Health Education in Secondary Education, Cyprus Ministry of Education Sports and Youth, Cyprus
² Faculty of Tourism Management, Hospitality and Entrepreneurship, Cyprus University of Technology, Paphos, Cyprus
³ Heraclitus Research Centre, Cyprus University of Technology, Limassol, Cyprus

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Ensuring healthy lives and promoting well-being for all at all ages, as articulated in Sustainable Development Goal (SDG) 3: Good Health and Well-Being, requires urgent attention to the rising challenge of childhood obesity. This study explores the determinants of childhood obesity in a pan-European context, recognizing it as a complex public health issue with implications for future population health and equity. Guided by the Social Ecological Model (SEM), the analysis integrates data from the World Health Organization’s Childhood Obesity Surveillance Initiative (COSI) with socioeconomic indicators from multiple global indexes. Multiple Linear Regression (MLR) was employed to examine influences across micro- and macro-levels. At the individual and interpersonal levels, children’s dietary practices, levels of physical activity, and screen exposure emerged as significant predictors of obesity. At the broader societal level, factors such as poverty rates, GDP per capita, the Social Progress Index, and adult obesity prevalence were also found to contribute. The findings underscore the interplay between health behaviours and socioeconomic conditions in shaping obesity outcomes. Taking a pan-European perspective, this study provides a methodological framework and empirical evidence to support coordinated strategies and policies that advance progress toward SDG 3.