Examining the association between socioeconomic position and body mass index in 1978 and 2005 among Canadian working-age women and men
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Abstract
Objectives
We examined the association between socioeconomic position (SEP) and body mass index (BMI) among Canadian men and women in 1978 and 2005. We examined both the average SEP–BMI association, and variation in this association across the distribution of BMI.
Methods
We analysed data from two nationally representative surveys containing measured height and weight data: the Canada Health Survey (1978) and the Canadian Community Health Survey (2005). Ordinary least squares and quantile regression were used to examine average and distributional SEP–BMI associations, respectively, for each survey.
Results
Education was inversely associated with BMI for men and women at both time points, and there was no evidence of narrowing between 1978 and 2005. This association was stronger for women than men, and was particularly strong for heavier women. Education and income related differently to BMI.
Conclusions
The SEP–BMI association in Canada is complex, showing variation by gender, by aspect of SEP, across the BMI distribution, and at different time points. The association departs from the more consistent social gradient in health, thereby challenging our view of BMI as a typical health issue.
Keywords
Body mass index (BMI) Socioeconomic position (SEP) Canada Population trendsNotes
Acknowledgments
This work was supported by an Establishment Grant from the Alberta Heritage Foundation for Medical Research, and a Petro-Canada Young Innovator Award in Community Health, both awarded to Lindsay McLaren. Lindsay McLaren holds a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research. M. Christopher Auld holds a Health Scholar Award from the Alberta Heritage Foundation for Medical Research. Lise Gauvin holds a Canadian Institutes of Health Research/Centre de Recherche en Prévention de l’Obésité Applied Public Health Chair in Neighborhoods, Lifestyle, and Healthy Body Weight.
References
- Auld MC, Powell LM (2007) The economics of obesity: research and policy implications from a Canada-U.S. comparison. In: Beach C, Chaykowski R, Shortt S, St-Hilaire F, Sweetman A (eds) Health services restructuring: new evidence and new directions. McGill–Queen’s University Press, Kingston and Montreal, pp 305–332Google Scholar
- Auld MC, Powell LM (2009) Economics of food energy density and adolescent body weight. Economica 76:719–740Google Scholar
- Ball K, Crawford D (2005) Socioeconomic status and weight change in adults: a review. Soc Sci Med 60:1987–2010CrossRefPubMedGoogle Scholar
- Ball K, Mishra G, Crawford D (2002) Which aspects of socioeconomic status are related to obesity among men and women? Int J Obes 26:559–565CrossRefGoogle Scholar
- Bourdieu P (1984) Distinction: a social critique of the judgement of taste. Routledge, LondonGoogle Scholar
- Bowling A (2002) Research methods in health: investigating health and health services, 2nd edn. Open University Press, BerkshireGoogle Scholar
- Bryman A (2004) Social research methods, 2nd edn. Oxford University Press, OxfordGoogle Scholar
- Curry-Stevens A (2009) When economic growth doesn’t trickle down: the wage dimensions of income polarization. In: Raphael D (ed) Social determinants of health, 2nd edn. Canadian Scholars’ Press Inc, Toronto, pp 41–60Google Scholar
- Flegal KM, Troiano RP (2000) Changes in the distribution of body mass index of adults and children in the US population. Int J Obes 24:807–818CrossRefGoogle Scholar
- Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH (1993) Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 329:1008–1012CrossRefPubMedGoogle Scholar
- Gutiérrez-Fisac JL, Regidor E, Banegas Banegas JR, Rodríguez Artalejo F (2002) The size of obesity differences associated with educational level in Spain, 1987 and 1995/97. J Epidemiol Community Health 56:457–460CrossRefPubMedGoogle Scholar
- Hao L, Naiman DQ (2007) Quantile regression. Sage, LondonGoogle Scholar
- Health and Welfare Canada, Statistics Canada (1981) The health of Canadians: report of the Canada health survey. Minister of Supply and Services Canada, OttawaGoogle Scholar
- Kamhon K, Wei-Der T (2004) Obesity and risk knowledge. J Health Econ 23:907–934CrossRefGoogle Scholar
- Katzmarzyk PT (2002) The Canadian obesity epidemic: an historical perspective. Obes Res 10:666–674CrossRefPubMedGoogle Scholar
- Koenker R, Hallock KF (2001) Quantile regression. J Econ Perspect 15:143–156CrossRefGoogle Scholar
- Kuhle S, Veugelers PJ (2008) Why does the social gradient in health not apply to overweight? Health Rep 19:7–15PubMedGoogle Scholar
- Mackenbach JP, Stirbu I, Roskam AJR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358:2468–2481CrossRefPubMedGoogle Scholar
- McLaren L (2007) Socioeconomic status and obesity. Epidemiol Rev 29:29–48CrossRefPubMedGoogle Scholar
- McLaren L, Godley J (2009) Social class and body mass index among Canadian adults: a focus on occupational prestige. Obesity 17:290–299PubMedGoogle Scholar
- McLaren L, Kuh D (2004) Women’s body dissatisfaction, social class, and social mobility. Soc Sci Med 58:1575–1584CrossRefPubMedGoogle Scholar
- McLaren L, Godley J, MacNairn IAS (2009) Social class, gender, and time use: implications for the social determinants of body weight. Health Rep (Statistics Canada, Catalogue 82–003) 20(4)Google Scholar
- Mikolajczyk RF, Richter M (2008) Associations of behavioural, psychosocial, and socioeconomic factors with over- and underweight among German adolescents. Int J Public Health 53:214–220CrossRefPubMedGoogle Scholar
- Millar WJ, Stephens T (1993) Social status and health risks in Canadian adults: 1985 and 1991. Health Rep 5:143–156PubMedGoogle Scholar
- Quintana-Domeque C (2005) The income gradient in body mass index. Working Paper, Department of Economics. Princeton University, Princeton, NJGoogle Scholar
- Raphael D (2009) Social determinants of health, 2nd edn. Canadian Scholars’ Press Inc, TorontoGoogle Scholar
- Sargent JD, Blanchflower DG (1994) Obesity and stature in adolescence and earnings in young adulthood. Analysis of a British birth cohort. Arch Pediatr Adolesc Med 148:681–687PubMedGoogle Scholar
- Shaw M, Galobardes B, Lawlor DA, Lynch J, Wheeler B, Davey Smith G (2008) The handbook of inequality and socioeconomic position: concepts and measures. The Policy Press, BristolGoogle Scholar
- Shields M (2006) Overweight and obesity among children and youth. Health Rep 17:27–42PubMedGoogle Scholar
- Shields M, Tjepkema M (2006) Trends in adult obesity. Health Rep 17:53–59PubMedGoogle Scholar
- Shields M, Connor Gorber S, Tremblay MS (2008) Estimates of obesity based on self-report versus direct measures. Health Rep 19:1–16Google Scholar
- Shilling C (2005) The body and social theory, 2nd edn. Sage, LondonGoogle Scholar
- StataCorp (2007) Stata statistical software: release 10. StataCorp LP, College StationGoogle Scholar
- Tjepkema M (2006) Adult obesity. Health Rep 17:9–25PubMedGoogle Scholar
- Torrance GM, Hooper MD, Reeder BA (2002) Trends in overweight and obesity among adults in Canada (1970–1992): evidence from national surveys using measured height and weight. Int J Obes 26:797–804CrossRefGoogle Scholar
- Wardle J, Boniface D (2008) Changes in the distributions of body mass index and waist circumference in English adults, 1993/1994 to 2002/2003. Int J Obes 32:527–532CrossRefGoogle Scholar
- Wolff H, Delhumeau C, Beer-Borst S, Golay A, Costanza MC, Morabia A (2006) Converging prevalences of obesity across educational groups in Switzerland. Obesity 14:2080–2088CrossRefPubMedGoogle Scholar
- Zhang Q, Wang Y (2004) Trends in the association between obesity and socioeconomic status in U.S. adults: 1971 to 2000. Obes Res 12:1622–1632CrossRefPubMedGoogle Scholar