Journal of Public Health

, Volume 16, Issue 6, pp 403–411 | Cite as

Income-related inequality in the distribution of obesity among Europeans

  • Agelike NikolaouEmail author
  • Dimitrios Nikolaou
Original Article



The current study concentrates on the issue of income related inequality in obesity for the case of European Union, an association, which has not been thoroughly examined in the literature.

Subjects and methods

Ten European countries for a period of 4 consecutive years (1998–2001) are under consideration, with the information deriving from the “European Community Household Panel” (ECHP) dataset. In order to elaborate on the above association, the concentration index was selected as a means for measuring quantitatively the degree of inequality. Furthermore, an alternative method was introduced, known as the “indirect standardization method,” so as to examine if the observed level of inequality was over-reported.


Treating the European Union as a whole, income inequality in obesity appears to be a burden for the less affluent. Investigation of each country separately reveals that inequality is of most importance for the female population, and especially for the middle-aged one, while no clear association was found for the males. Furthermore, negligence to adjust the models for the education level and the employment status could lead to an over-estimation of the inequality in obesity.


Our primary results attest to the existing literature, showing that a BMI with a value greater than 30 is most likely to be an encumbrance for those of low socioeconomic profiles. However, the extent of inequality in the European Union is found to be low. Effective preventive policies should address the low socioeconomic status female population in Europe, and special attention should be given to the middle-aged.


Income inequality Obesity Socioeconomic status Concentration index Indirect estimation method 




Conflict of interest statement

The authors confirm that there are no relevant associations that might pose a conflict of interest.


  1. Costa-Font J (2005) Are there socioeconomic inequalities in obesity in Spain? FEDEA 216:1–26Google Scholar
  2. Daly MC, Duncan GJ, Kaplan GA, Lynch JW (1998) Macro to micro links in the relation between income inequality and mortality. Milbank Quart 76:315–339CrossRefGoogle Scholar
  3. Gordon-Larsen P, Adair LS, Popkin BM (2003) The relationship of ethnicity, socioeconomic factors, and overweight in U.S. adolescents. Obes Res 11:121–129Google Scholar
  4. Jenkins S (1988) Calculating income distribution indices from micro data. National Tax J 41:139–142Google Scholar
  5. Kakwani N, Wagstaff A, van Doorslaer E (1997) Socioeconomic inequalities in health: measurement, computation, and statistical inference. J Econometrics 77:87–103CrossRefGoogle Scholar
  6. Kaplan GA, Pamuk ER, Lynch JW, Cohen RD, Balfour JL (1996) Inequality in income and mortality in he United States: analysis of mortality and potential pathways. Brit Med J 312:999–1003PubMedGoogle Scholar
  7. Kautto M, Fritzell J, Hvinden B, Kvist J, Uusitalo H, Nordic Welfare States in the European Context. Routlege, NY; 2001Google Scholar
  8. Kawachi I, Kennedy BP (1997) The relationship of income inequality to mortality: does the choice of indicator matter? Soc Sci Med 45:1121–1127PubMedCrossRefGoogle Scholar
  9. Kennedy BP, Kawachi I, Glass R, Stith DP (1998) Income distribution, socioeconomic status and self-rated health in the United States: multilevel analysis. Brit Med J 317:917–921PubMedGoogle Scholar
  10. Kinra S, Nelder R, Lewendon G (2000) Deprivation and childhood obesity: a cross-sectional study of 20,973 children in Plymouth, United Kingdom. J Epidemiol Commun Health 54:456–460CrossRefGoogle Scholar
  11. Lerman RI, Yitzaki S (1989) Improving the accuracy of estimates of Gini coefficients. J Econometrics 42(1):43–47CrossRefGoogle Scholar
  12. Lissau-Lund-Sorensen I, Sorensen TIA (1992) Prospective study of the influence of social factors in childhood on risk of overweight in young adulthood. Int J Obes Rel Met Disord 16:169–175Google Scholar
  13. Lorant V, Tonglet R (2000) Obesity: trend in inequality. J Epidemiol Commun Health 54:637–638CrossRefGoogle Scholar
  14. McLaren L (2007) Socioeconomic status and obesity. Epidemiol Rev, Department of Community Health Sciences, University of Calgary :1–20Google Scholar
  15. Miech RA, Kumanyida SK, Stettler N, Link BG, Phelan JC, Chang VW (2006) Trends in the association of poverty with overweight among US adolescents, 1971–2004. J Am Med Ass 295:2385–2393CrossRefGoogle Scholar
  16. Newey WK, West KD (1994) Automatic lag selection in covariance matrix estimation. Rev Econ Stud 61(4):631–653CrossRefGoogle Scholar
  17. Pickett KE, Kelly S, Brunner E, Lobstein T, Wilkinson RG (2005) Wider income gaps, wider waistbands? An ecological study of obesity and income inequality. J Epidemiol Commun Health 59:670–674CrossRefGoogle Scholar
  18. Power C, Moynihan C (1988) Social class and changes in weight-for-height between childhood and early adulthood. Int J Obes Rel Met Disord 12:445–453Google Scholar
  19. Sarlio- Lähteenkorva S, Lissau I, Lahelma E (2005) The social patterning of relative body weight and obesity in Denmark and Finland. Eur J Pub Health 16(1):36–40CrossRefGoogle Scholar
  20. Sobal J, Stunkard AJ (1989) Socioeconomic status and obesity: a review of the literature. Psychol Bull 105:260–275PubMedCrossRefGoogle Scholar
  21. Soobader MJ, LeClere FB (1999) Aggregation and the measurement of income inequality: effects on morbidity. Soc Sci Med 48:733–744PubMedCrossRefGoogle Scholar
  22. Subramanian SV, Kawachi I (2004) Income inequality and health: what have we learned so far? Epidemiol Rev 26:78–91PubMedCrossRefGoogle Scholar
  23. van Doorslaer E, Wagstaff A, Bleichrodt H, Calonge S, Gerdtham Ulf-G, Gerfin M, Geurts J, Gross L, Hakkinen U, Leu RE, O’ Donnell O, Propper C, Puffer F, Rodriguez M, Sundberg G, Winkelhake O (1997) Income-related inequalities in health: some international comparisons. J Health Econ 16:93–112PubMedCrossRefGoogle Scholar
  24. Wagstaff A, Paci P, Van Doorslaer E (1991) On the measurement of inequalities in health. Soc Sci Med 33:545–557PubMedCrossRefGoogle Scholar
  25. Wamala SP, Wolk A, Orth-Gomer C (1997) Determinants of obesity in relation to socioeconomic status among middle-aged Swedish women. Prev Med 26:734–744PubMedCrossRefGoogle Scholar
  26. Wang Y (2001) Cross-national comparison of childhood obesity: the epidemic and the relationship between obesity and socioeconomic status. Int J Epidemiol 30:1129–1136PubMedCrossRefGoogle Scholar
  27. Wardle J, Griffith J (2001) Socioeconomic status and weight control practices in British adults. J Epidemiol Commun Health 55:185–190CrossRefGoogle Scholar
  28. Wilkinson R (1997) Health inequalities: relative or absolute material standards. Brit Med J 314:591–595PubMedGoogle Scholar
  29. Zhang Q, Wang Y (2004) Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter? Soc Sci Med 58:1171–1180PubMedCrossRefGoogle Scholar
  30. Zhang Q, Wang Y (2007) Using concentration index to study changes in socioeconomic inequality of overweight among US adolescents between 1971 and 2002. Int J Epidemiol1–10Google Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Department of EconomicsUniversity of MacedoniaThessalonikiGreece

Personalised recommendations