Abstract To identify multidomain health profiles in schoolchildren in Madrid during and after the COVID-19 pandemic, and examine their associations with socioeconomic status (SES), school type, sex, age and study wave. Cross-sectional study of 8–12-year-old children from public, semiprivate and private schools in Madrid (2020–2023), selected through stratified multistage sampling. Anthropometry, fitness, lifestyle, emotional well-being and parental behaviours were assessed with standardised protocols and validated questionnaires. K-means clustering derived multidimensional health profiles; multinomial logistic regression examined sociodemographic associations. Five distinct profiles emerged: a compensated profile (Cluster 0) with high BMI, low strength and good diet quality; a favourable lifestyle profile (Cluster 1) with very high MVPA and good emotional well-being; a healthiest profile (Cluster 2) with optimal BMI, diet, strength and low screen exposure; a least favourable profile (Cluster 3) with low emotional well-being and very high screen time; and a mixed-risk profile (Cluster 4) with low diet quality and elevated screen exposure. Children in higher SES groups were much more likely to belong to the healthiest profile and less likely to appear in least favourable or mixed-risk profiles. Public-school children had lower odds of belonging to the favourable lifestyle profile than those in private schools. The healthiest profile became more frequent in 2022–2023 than in 2020–2021, but high-risk profiles persisted in disadvantaged groups. Multidimensional profiles reveal cumulative lifestyle and social risks across the COVID-19 period and support equity-oriented interventions targeting physical, emotional and family environments.
Portals-Riomao et al. (2026) studied this question.