Socio-economic accounting of inequalities in excess weight: a population-based analysis

Abstract

Background The prevalence of excess weight has been increasing globally in the last decades, affecting disproportionally adults from low socio-economic backgrounds and putting undue pressure on health systems and societal resources. In England, tackling unfair and unjust health inequalities is at the heart of national public health policy, and a prerequisite for enabling these decision makers to set policy priorities is an understanding of the prevalence and determinants of excess weight inequalities in their local population. Methods We conducted both pooled (England) and regional-level (nine regions: North-East, North-West, Yorkshire and Humber, East Midlands, West Midlands, East of England, London, South East and South West) analyses of individual level data from a nationally representative sample of adults (N = 6,387). We used the Corrected Concentration Index (CCI) to measure absolute inequalities in excess weight across three dimensions of socio-economic deprivation: neighbourhood-level deprivation, occupational status and educational qualification. We used a Shapley decomposition method to evaluate their relative contribution to inequality. Results At a national level, all three dimensions of socio-economic deprivation were found to be positively associated with excess weight across the adult population, as measured by the CCI, with educational qualification ranking first [CCI: -0.090, p < 0.01], closely followed by neighbourhood-level deprivation [CCI: -0.050, p < 0.01]. Large variation was found between regions and genders, with inequality being either considerably higher or exclusively patterned among women. The strongest independent factor contributing to excess weight inequalities was having a long-lasting limiting illness, especially among women and towards the right tail of the excess weight spectrum. Heterogeneous patterns of contribution across the excess weight spectrum were found, however age played a dominant role toward the left tail of the distribution. Conclusions While socio-economic inequalities in excess weight exist in the English adult population, our findings underscore the importance of considering multiple dimensions of deprivation and the unique needs of different populations when developing policies to address overweight and obesity. Targeted interventions for adults with overweight and obesity with long-lasting illnesses and women can generate both short-term and long-term economic benefits, by reducing healthcare costs and increasing workforce productivity.

The Prognostic Value of Arterial Stiffness According to Socioeconomic Status

“…Increasing evidence highlights the disparities in cardiovascular health outcomes based on SES, with individuals of lower SES presenting worse cardiovascular risk profiles and prognoses [6,7]. This disparity is likely due to a myriad of factors, including limited access to healthcare, poorer lifestyle habits, higher stress levels, and the greater prevalence of other comorbidities [8,9]. In alignment with this, our results also showed that individuals from the MAB group had more cardiovascular risk factors and higher arterial stiffness levels than those from the NHIB group.…”

“…This elevated risk can be attributed to several factors, including increased exposure to detrimental health practices such as poor dietary habits, sedentary lifestyles, tobacco consumption, and excessive alcohol intake. Further exacerbating the situation, those in the lower SES often encounter barriers to accessing quality healthcare, hindering early detection and intervention [8,9]. Additionally, the stress associated with financial insecurity and inadequate living conditions can contribute to hypertension and other heart-related conditions [10].…”