Associations of socioeconomic status, parenting style, and grit with health behaviors in children using data from the Panel Study on Korean Children (PSKC)

Article information

Child Health Nurs Res. 2021;27(4):309-316

Publication date (electronic) : 2021 October 31

doi : https://doi.org/10.4094/chnr.2021.27.4.309

Hwa-Mi Yang

Assistant Professor, Department of Nursing, Daejin University, Pocheon, Korea

Corresponding author Hwa-Mi Yang Department of Nursing, Daejin University, 1007 Hoguk-ro, Pocheon 11159, Korea TEL: +82-31-539-1878 FAX: +82-31-539-1870 E-MAIL: yhm2021@daejin.ac.kr

Received 2021 June 15; Revised 2021 July 9; Accepted 2021 August 3.

Abstract

INTRODUCTION

Childhood obesity is recognized as a major public health problem worldwide, particularly in the United States, wherein 1 out of 3 children is overweight or obese [1]. In Korea, the childhood obesity rate among elementary school students is also on the rise, from 21.9% in 2015 to 25.8% in 2019 [2]. Changes in health behaviors, such as healthy eating, increased physical activity, and reduced sedentary lifestyle, are essential to reduce obesity in children [3].

The links between low socioeconomic status, children's health behaviors, and poor health are well known among the general population [4]. Children's socioeconomic status and health behaviors are especially closely related. Adolescents with low socioeconomic status are reported to have low levels of health promotion behavior [5]. In addition, family-level behaviors, particularly parenting and constructing family health routines, affect children's health behaviors [6].

The social-ecological theory suggests that parenting may have an important role in children's health behavior, as the family is a child's most familiar social environment [7,8]. Parents play an influential role in shaping the behavior of their children [9]. Parenting styles include attitudes and behavioral patterns toward their children. Baumrind [10] categorized parenting styles as authoritative, authoritarian, and permissive according to parents' reactions to responses and demands. The authoritative style is characterized by parents providing positive reinforcement to their children to monitor and improve their children's health behavior [11]. Authoritative parenting styles tend to promote healthy behavior of children when compared with authoritarian parenting styles, which are characterized by parents forcing children to obey. Furthermore, permissive parenting styles are too generous and involve inconsistent principles [11]. Meanwhile, there may be differences between maternal and paternal parenting styles, with corresponding impacts on children's health behavior [12]. Maternal parenting styles are closely related to whether children consume a healthy diet, whereas paternal parenting styles are more related to their level of physical activity [12]. In Korea, research has focused mainly on the relationship between parenting behaviors and children's problem behaviors or depression [13,14], whereas few studies have investigated the relationship between the parenting styles of both parents and children's health behaviors.

From a positive psychological point of view, children form grit by experiencing a positive relationship with their parents. Grit consists of two facets: individual perseverance of effort and consistency in interest [15]. Grit is associated with reduced depression, emotional well-being, and sustainable behavior [16]. Specifically, grit is negatively predictive of depression, whereas it is positively predictive of psychological well-being and sustainable performance [16].

In Korea, previous research [17] has mainly focused on the relationship between grit and academic achievement; however, the relationship between grit and health behaviors is not well understood. Therefore, this study aimed to comprehensively explore the associations of socioeconomic status, parenting style, and grit with children's health behaviors.

METHODS

2. Data and Study Participants

This study targeted parents and their children using data from the 11th Panel Study on Korean Children (PSKC) in 2018. The PSKC collected a national representative sample of parents and children born between April and July 2008. The PSKC data are freely available for use by all researchers for academic purposes. The first survey began in 2008, and finally, the 11th survey was conducted in 2018 using self-administered questionnaires for the parents and their children's face-to-face interviews with trained interviewers. The 11th survey aimed to investigate the growth and developmental characteristics of children and the impacts of parenting, parenting support, and policy measures.

Data were provided on 2,150 participants in the 11th PSKC. Data regarding age, sex, and grit were not recorded for 742 participants, data on household income were not recorded for 113 participants, and information on parenting style was not recorded for 251 participants; these were all excluded from the analysis. In addition, four children with disabilities were also excluded. Finally, 1,040 parents and their children were included in the data analysis (Figure 1).

Figure 1.

Flow chart of participants. PSKC, Panel Study on Korean Children.

5. Statistical Analysis

All statistical analyses were conducted using SPSS for Windows version 23.0 (IBM, Armonk, NY, USA). In Table 2, the association of each variable with children's health behaviors, such as healthy eating and physical activity, was tested using linear regression analysis, while its association with sedentary behavior was tested using logistic regression analysis. In the final model in Table 3, children's age, sex, and subjective health status were adjusted, and the association between all major variables and children's health behaviors were analyzed using multiple linear or multiple logistic regression.

Table 2.

Crude Associations of Socioeconomic Status, Parenting Styles, and Grit with Children's Health Behaviors (N=1,040)

Table 3.

Associations of Socioeconomic Status, Parenting Styles, and Grit with Children's Health Behavior (N=1,040)

RESULTS

1. General Characteristics of Participants

The average age of children was 10.3 years; 51.5% were boys, and 48.5% were girls, and their overall health status was good (4.2 points). The average monthly household income was 5.71 million KRW, and the socioeconomic status perceived by children was 7.2 points. Children's happiness score averaged 19.9 points out of 24, and their average grit score was 27.4 points out of 40. The average scores for maternal authoritative, authoritarian, and permissive parenting styles were 3.80, 2.43, and 2.35 points, respectively, whereas those for paternal parenting styles were 3.68, 2.35, and 2.44 points, respectively. The average score for healthy eating was 13.7 points out of 18, and the number of days with physical activity was 3.3 days per week. The sedentary behavior rate of children as operationalized by having more than 2 hours of screen time on weekdays was 43.7% (Table 1).

Table 1.

General Characteristics of Study Participants (N=1,040)

DISCUSSION

This study examined the relationships of socioeconomic status, parenting style, and grit with children's health behaviors. Higher levels of household income and maternal authoritative parenting were associated with higher levels of children's healthy eating behavior. These results are similar to the findings of Eo and Kim's study [23], in which the family's socioeconomic status was positively associated with children's health behaviors, and parental attention had a moderating effect on this relationship. Therefore, the association of socioeconomic status with children's health behavior may also be related to parental factors.

An authoritarian parenting style, in which parents exert excessive pressure or limitations on their children regarding eating, is associated with adverse outcomes in children's healthy behaviors [24]. In contrast, an authoritative parenting style was associated with children's healthy eating habits, such as the consumption of fruit and vegetables [25]. Similarly, Collins et al. [26] found that parents with authoritative styles focused more on their children's eating behavior than parents with permissive styles. Our study showed that only a maternal authoritative style was significantly related to children's healthy eating behaviors. According to a study by Shek and Dou [27], mothers have been reported to have better parenting quality in parent-child relationships than fathers. In Korea, the mother's contribution to raising children, managing household affairs, and creating a healthy environment may be relatively more influential than the father's [28]. This association might be due to differences in socio-cultural backgrounds, and only a maternal authoritative parenting style is considered to be related to children's healthy eating behaviors.

A higher level of grit was related to a higher number of physical activity days per week among children. Our results are similar to those of a study by Allee et al. [29], in which a higher level of grit among children was associated with a higher level of physical activity. According to a previous study [7], family culture and parental policies on physical activity can substantially promote healthy physical activity in children and adolescents. Therefore, strategies to improve grit, which can be changed by individual will and efforts, and improvements to policies and culture within the family that promote physical activity are important for increasing children's physical activity.

In this study, higher grit was associated with children engaging in sedentary behavior for less than 2 hours on weekdays. Moreover, a permissive parenting style among mothers was associated with sedentary behavior for more than 2 hours on weekdays. These results are similar to those of a previous study [30] in which children of mothers with a permissive parenting style had a 5.2 times more likely to watch television for 4 hours or more per day than children of mothers with an authoritative parenting style. According to Lloyd et al. [12], a maternal parenting style that involves limiting children's screen time or providing reinforcement was associated with low levels of sedentary behaviors in children. Little is known about the direct association between grit and sedentary behavior; however, grit is known to be related to sustainable behavior [16]. Our study suggests that children's grit is important for reducing sedentary behavior. Moreover, ongoing efforts that enable children to set their own goals and persistently develop healthy habits in difficult situations are important. In addition, to improve children's sedentary behavior, it is necessary for parents to limit their children's screen time or provide recognition for reducing sedentary behavior, and to avoid practicing a permissive parenting style.

This study has limitations as it only included Korean parents and their children, and careful consideration would be needed to interpret and generalize the findings to other socio-cultural populations. Moreover, the cross-sectional nature of the study limits causal inferences.

CONCLUSION

A maternal authoritative parenting style and high levels of grit in children were found to be associated with healthy behaviors. Parenting style and grit of children are both factors that are modifiable to improve children's behaviors and foster healthy living. The significance of this study is that parenting style and grit can be important strategies to improve health behaviors in children. Therefore, family-based education interventions and strategies that discourage a maternal permissive parenting style, encourage an authoritative parenting style, and promote grit in children would be beneficial to increase children's healthy behaviors, especially in socio-economically vulnerable groups. In practice, a family-based approach could have tangible impacts on the prevention of obesity in children by improving children's health behaviors.

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