Disentangling effects of socioeconomic status on obesity: A cross-sectional study of the Spanish adult population

Merino, María; Urbanos-Garrido, Rosa M.

doi:10.1016/j.ehb.2016.05.004

Cited by 34 publications

(27 citation statements)

References 33 publications

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“…According to the World Health Organization (WHO), in 2016 more than 1.9 billion adults worldwide (or 39% of the total adult population) were overweight, and over 650 million of these (or 13% of the population) were obese [3]. As in many countries belonging to the Organization for Economic Co-operation and Development (OECD) [6], this health problem is rapidly worsening in Spain [7, 8]. For instance, according to the Spanish National Health Survey (SNHS), the prevalence of adult obesity rose from about 7% in 1987 to approximately 15% in 2006 [9] and 17% in 2012 [10], while according to the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), which used direct anthropometric measurements [11], 23% of the Spanish adult population was categorized as obese in 2008–2010 [12].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

et al. 2018

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Many studies have demonstrated the existence of simple, unidimensional socioeconomic gradients in body mass index (BMI). However, in the present paper we move beyond such traditional analyses by simultaneously considering multiple demographic and socioeconomic dimensions. Using the Spanish National Health Survey 2011–2012, we apply intersectionality theory and multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to analyze 14,190 adults nested within 108 intersectional strata defined by combining categories of gender, age, income, educational achievement and living situation. We develop two multilevel models to obtain information on stratum-specific BMI averages and the degree of clustering of BMI within strata expressed by the intra-class correlation coefficient (ICC). The first model is a simple variance components analysis that provides a detailed mapping of the BMI disparities in the population and measures the accuracy of stratum membership to predict individual BMI. The second model includes the variables used to define the intersectional strata as a way to identify stratum-specific interactions. The first model suggests moderate but meaningful clustering of individual BMI within the intersectional strata (ICC = 12.4%). Compared with the population average (BMI = 26.07 Kg/m2), the stratum of cohabiting 18-35-year-old females with medium income and high education presents the lowest BMI (-3.7 Kg/m2), while cohabiting 36-64-year-old females with low income and low education show the highest BMI (+2.6 Kg/m2). In the second model, the ICC falls to 1.9%, suggesting the existence of only very small stratum specific interaction effects. We confirm the existence of a socioeconomic gradient in BMI. Compared with traditional analyses, the intersectional MAIHDA approach provides a better mapping of socioeconomic and demographic inequalities in BMI. Because of the moderate clustering, public health policies aiming to reduce BMI in Spain should not solely focus on the intersectional strata with the highest BMI, but should also consider whole population polices.

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Section: Introductionmentioning

confidence: 99%

Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

et al. 2018

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“…The association between SES and obesity has been studied extensively in HICs [ 4 , 8 , 10 ]. A cross-sectional study among adults aged 15 years and older in Spain showed that obesity was concentrated among the poor [ 10 ]. A recent prospective cohort study of people aged 50 years and older in England also showed that obesity was more prevalent among the poor [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach

Pujilestari

Nyström

Norberg

et al. 2017

Int J Equity Health

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BackgroundObesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities.MethodsWe utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity.ResultsAbdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%).ConclusionAbdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in abdominal obesity exists and concentrates more among the rich population in both sexes. The inequality gap is less prominent among women, indicating a trend towards obesity being more common in poor women. Policies to address social determinants of health need to be developed to address the socioeconomic inequality gaps in obesity, with particular focus on addressing the existing burden of obesity among the better-off population group, while preventing the imminent burden of obesity among the worst-off group, particularly among women.

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“…longterm unemployment, deprivation, and socioeconomic vulnerability). In particular, it is fundamental to find alternatives that are adequate to the material resources of these low-income groups; in addition, special measures to promote physical activity should be taken in populations at risk of poverty and unemployment (Merino Ventosa & Urbanos-Garrido, 2016). For example, promoting physical activity has proven to be an effective health strategy in reducing the risk of developing depression (Mammen & Faulkner, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…The initiative known as the “WHO Global Strategy on Diet, Physical Activity and Health” (WHO, ) fosters policies and actions aimed at promoting healthy diets and increasing physical activity in the entire population. The literature shows that promoting fruit/vegetable intake (You & Choo, ), physical activity and adequate sleep habits (Merino Ventosa & Urbanos‐Garrido, ; Mammen & Faulkner, ) for low‐SES groups should be prioritised as a health promotion strategy for preventing problems related to overweight and obesity. However, our results indicate that specific measures should also be tailored for populations living in adverse socioeconomic circumstances (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the influence of SES on obesity, some specific findings have been identified. Obesity has been found to be more prevalent among people who suffer poverty, and income disparities in people with obesity have also been reported (Merino Ventosa & Urbanos-Garrido, 2016). A recent study in Canada concludes that adverse macroeconomic conditions (i.e.…”

Section: The Influence Of Socioeconomic Status On Obesity and Depressionmentioning

confidence: 99%

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Socioeconomic Context as a Moderator in the Relationship between Body Mass Index and Depression in Europe

Álvarez‐Gálvez

Gómez-Baya

2017

Applied Psych Health & Well

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Disentangling effects of socioeconomic status on obesity: A cross-sectional study of the Spanish adult population

Cited by 34 publications

References 33 publications

Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach

Socioeconomic Context as a Moderator in the Relationship between Body Mass Index and Depression in Europe

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