Spatial analysis of food insecurity and obesity by area-level deprivation in children in early years settings in England

Backgroundwe assessed manager perceptions of food security and obesity in young children attending nurseries across England, assessing spatial differences by area-level deprivation.Methodswe conducted an adjusted multinomial logistic regression and an adjusted geographically weighted logistic regression examining the odds of a manager perceiving obesity, food insecurity, or both as a problem among children in care measured via a mailed survey.Results851 (54.3%) managers returned the survey. A nursery being in the highest tertile of area-level deprivation was associated with a 1.89 (95% CI 1.00, 3.57) greater odds of perceiving obesity as a problem, a 3.06 (95% CI 1.94, 4.84) greater odds of perceiving food insecurity as a problem, and a 8.39 (95% CI 4.36, 16.15) greater odds of perceiving both as a problem, compared with the lowest tertile.Conclusionswe observed differences in manager perception by area-level deprivation, but the relationship was especially pronounced for food insecurity.