Cross-national comparison of socioeconomic inequalities in obesity in the United States and Canada

Siddiqi, Arjumand; Brown, Rashida; Nguyen, Quynh C.; Loopstra, Rachel; Kawachi, Ichiro

doi:10.1186/s12939-015-0251-2

Cited by 20 publications

(22 citation statements)

References 42 publications

(39 reference statements)

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“…In a recent analysis of data from 169 countries, income inequality was shown to be a greater predictor of average height than absolute national income 34. Our findings also provide further evidence in support of previous studies showing better health among people at all points in the social hierarchy in more equal countries 11–16…”

Section: Discussionsupporting

confidence: 89%

“…One previous ecological study using aggregated mortality data for rich and poor counties within US states found that mortality rates for some causes of death were lower for everyone in more equal US states, but for causes of death with no social gradient, there was no inequality effect 10. Several studies have used individual data to compare social gradients in health in different countries 11–17. When they are interpreted in relation to income inequality, they provide some indication that health is better among people at all points in the social hierarchy in more equal countries.…”

Section: Introductionmentioning

confidence: 99%

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Income inequality and social gradients in children’s height: a comparison of cohort studies from five high-income countries

Bird

Pickett

Graham

et al. 2019

bmjpo

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BackgroundHealth and well-being are better, on average, in countries that are more equal, but less is known about how this benefit is distributed across society. Height is a widely used, objective indicator of child health and predictor of lifelong well-being. We compared the level and slope of social gradients in children’s height in high-income countries with different levels of income inequality, in order to investigate whether children growing up in all socioeconomic circumstances are healthier in more equal countries.MethodsWe conducted a coordinated analysis of data from five cohort studies from countries selected to represent different levels of income inequality (the USA, UK, Australia, the Netherlands and Sweden). We used standardised methods to compare social gradients in children’s height at age 4–6 years, by parent education status and household income. We used linear regression models and predicted height for children with the same age, sex and socioeconomic circumstances in each cohort.ResultsThe total analytic sample was 37 063 children aged 4–6 years. Gradients by parent education and household income varied between cohorts and outcomes. After adjusting for differences in age and sex, children in more equal countries (Sweden, the Netherlands) were taller at all levels of parent education and household income than children in less equal countries (USA, UK and Australia), with the greatest between-country differences among children with less educated parents and lowest household incomes.ConclusionsThe study provides preliminary evidence that children across society do better in more equal countries, with greatest benefit among children from the most disadvantaged socioeconomic groups.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Income inequality and social gradients in children’s height: a comparison of cohort studies from five high-income countries

Bird

Pickett

Graham

et al. 2019

bmjpo

View full text Add to dashboard Cite

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“…Socioeconomic gradients in MetS components like obesity are less steep in Canada, when compared to countries that are culturally similar like the United States (43). It is possible that in societies with less pronounced health disparities, adverse experiences need to occur during sensitive or vulnerable periods for these effects to become manifest, but more cross-national research will be needed to test this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Early-Life Socioeconomic Disadvantage and Metabolic Health Disparities

et al. 2017

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Objective A quarter of the world’s population suffers from metabolic syndrome (MetS). MetS prevalence stratifies by socioeconomic status (SES), such that low SES is associated with higher MetS risk. The present study examined the relative roles of early-life SES and current SES in explaining MetS risk. Methods Participants (N = 354, ages 15–55, M = 36.5 years, SD = 10.7; 55% female; 72.9% White, 16.9% Asian, 10.2% other) were evaluated for SES and MetS. All were in good health, defined as free of chronic medical illness and acute infectious disease. Using occupational status as a proxy for SES, we recruited roughly equal numbers of participants with low-low, low-high, high-low and high-high combinations of early-life and current SES. We used the International Diabetes Federation definition for MetS using race- and sex-specific cut-offs for waist circumference, triglyceride levels, HDL cholesterol, blood pressure, and HbA1c levels. Results Analyses revealed a main effect of low early-life SES on increased MetS risk according to three separate definitions. They included the traditional MetS diagnosis (OR=1.53, CI=1.01–2.33, p=.044), the number of MetS components for which diagnostic thresholds were met (OR=1.61, CI=1.10–2.38, p=.015), and a continuous indicator of metabolic risk based on factor analysis, F(1,350)=6.71, p=.010, partial η2=.019. There was also a significant interaction of early-life SES and current SES in predicting MetS diagnosis (OR=1.54, CI=1.02–2.34). Main effects of current SES were non-significant in all analyses. Conclusions These findings suggest MetS health disparities originate in childhood, which may be an opportune period for interventions.

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“…That is, we are still unaware of these patterns at local levels. As states and locations may vary in the resources and how resources can operate (67)(68)(69), it is important to conduct local research on whether or not educational attainment, income, and employment generate similar or different health gain for non-Hispanic Blacks than non-Hispanic Whites. The results derived from such studies can potentially inform local policy on the most effective interventions that can equalize health across racial groups, particularly non-Hispanic Blacks and non-Hispanic Whites.…”

Section: Due To Multiple Societal Mechanisms Ses Indicators May Genementioning

confidence: 99%

Education and Income Better Boost the Health of Non-Hispanic White than Black Americans

Assari

Bazargan

2020

Preprint

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Background. Socioeconomic status (SES) indicators such as education and income influence population health including but not limited to self-rated health (SRH). Based on Minorities' Diminished Returns (MDRs), however, we observe weaker health effects SES indicators for non-Hispanic Blacks compared to non-Hispanic Whites. While such diminished returns of SES resources are shown in nationally representative data and Michigan data, there is still a need to replicate these findings in other settings. This is particularly relevant because the effects of social SES indicators are not universal but vary across geographic locations. This cross-sectional study tested racial differences in the effects of high educational attainment and income on SRH among Californian adults. Methods. Survey of California Adults on Serious Illness and End-of-Life is a representative survey of Californian adults conducted for the California Health Care Foundation. The independent variables were educational attainment and income. The main outcome was poor/fair SRH. Age, gender, marital status, and employment were control variables (confounders). Racial group membership was the effect modifier. Linear regression model was utilized to analyze the data. Results. Overall, higher education and income were associated with better SRH. Race showed significant statistical interactions with education and income on SRH, indicating weaker boosting effects of high education and income on SRH of non-Hispanic Blacks than non-Hispanic Whites. At least some of the diminished return of education on health for non-Hispanic Blacks than non-Hispanic Whites was due to income. Conclusions. While high education and income improve SRH of Californians, these effects are unequal between non-Hispanic Blacks and non-Hispanic Whites with education and income showing diminished health returns for non-Hispanic Blacks than non-Hispanic Whites. More than the availability of education and income, what populations can do with their education and income may be important. Under segregation, racism, and discrimination, education and income have weaker effects on changing the living condition of the historically oppressed racial group. To close the existing racial gap in health, we need much more than equalizing access to education and income. Education quality of urban public schools should be improved. Types of occupations that are available in Black communities should be improved. Meanwhile, non-Hispanic Black middle class should be helped so they can better leverage their SES resources and turn to outcomes. Such changes need a through change to the living conditions of non-Hispanic Blacks across all SES levels.

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Cross-national comparison of socioeconomic inequalities in obesity in the United States and Canada

Cited by 20 publications

References 42 publications

Income inequality and social gradients in children’s height: a comparison of cohort studies from five high-income countries

Income inequality and social gradients in children’s height: a comparison of cohort studies from five high-income countries

Early-Life Socioeconomic Disadvantage and Metabolic Health Disparities

Education and Income Better Boost the Health of Non-Hispanic White than Black Americans

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