Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

Biomedical Sciences Department Faculty of Sport and Physical Education University of Novi Sad Novi Sad Serbia

Center for Health Ecology Institute of Public Health Podgorica Montenegro

College of Health and Agricultural Sciences University College Dublin Dublin Ireland

Croatian Institute of Public Health Zagreb Croatia

Department Food and Nutrition National Centre of Public Health and Analyses Sofia Bulgaria

Department of Cardiology Institute of Mother and Child Warsaw Poland

Department of Health and Inequality Division of Mental and Physical Health Norwegian Institute of Public Health Oslo Norway

Department of Living Conditions and Lifestyle Public Health Agency of Sweden Solna Sweden

Department of Non Communicable Diseases and Traumatisms Santé publique France the French Public Health Agency Saint Maurice France

Department of Nutrition Research National Institute for Health Development Tallinn Estonia

Department of Pediatrics Paracelsus Medical University Salzburg Austria

Department of Preventive Medicine Lithuanian University of Health Sciences Kaunas Lithuania

Department of Research and Health Statistics Centre for Disease and Prevention Control Riga Latvia

Department of Science and Professional Development National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan Almaty Kazakhstan

Department of Social and Policy Sciences University of Bath Bath UK

Division of Noncommunicable Diseases and Promoting Health through the Life Course WHO Country Office for Tajikistan Dushanbe Tajikistan

Faculty of Medicine Department of Public Health and Management University of Medicine and Pharmacy Carol Davila Bucharest Bucharest Romania

Faculty of Medicine Hacettepe University Ankara Turkey

Faculty of Medicine Ss Cyril and Methodius University Skopje North Macedonia

Faculty of Midwifery and Nursing Discipline of Public Health and Health Management University of Medicine and Pharmacy Carol Davila Bucharest Bucharest Romania

Health Authority Ministry of Health San Marino San Marino

Health Promotion and Inequality Danish Health Authority Copenhagen Denmark

Institute of Child and Adolescent Health Arabkir Medical Centre Institute of Child and Adolescent Health Yerevan Armenia

Institute of Paediatric Endocrinology National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation Moscow Russian Federation

Institute of Public Health Skopje North Macedonia

Institute of Statistics Faculty of Mathematics and Computer Science University of Bremen Bremen Germany

Kazakhstan School of Public Health Kazakhstan's Medical University Almaty Kazakhstan

Leibniz Institute for Prevention Research and Epidemiology BIPS Bremen Germany

Maternal Child and Reproductive Health National Center for Disease Control and Public Health Tbilisi Georgia

National Centre for Disease Prevention and Health Promotion Italian National Institute of Health Rome Italy

National Centre of Health Promotion and Health Evaluation National Institute of Public Health Bucharest Romania

National Institute of Public Health University of Southern Denmark Odense Denmark

Nutrition and Food Safety Sector Institute of Public Health Tirana Albania

Nutritional Surveillance and Epidemiology Team University Sorbonne Paris Nord Bobigny France

Obesity Management Centre Institute of Endocrinology Prague Czech Republic

Primary Child Health Unit Primary Health Care Floriana Malta

Public Health and Welfare Finnish Institute for Health and Welfare Helsinki Finland

Republican Center for Health Promotion and Mass Communication Ministry of Health of the Kyrgyz Republic Bishkek Kyrgyzstan

School of Medicine University of Zagreb Zagreb Croatia

Scientific Research Institute of Maternal and Child Health Ashgabat Turkmenistan

Spanish Agency for Food Safety and Nutrition Ministry of Consumer Affairs Madrid Spain

WHO Europe Collaborating Center for Nutrition and Childhood Obesity Food and Nutrition Department National Institute of Health Dr Ricardo Jorge Lisbon Portugal

World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases Division of Country Health Programmes WHO Regional Office for Europe Moscow Russian Federation

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