An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland


Obesity has received increased attention arising from its increasing prevalence and the implications of obesity-related problems for society and the wider economy. To estimate healthcare and non-healthcare obesity impacts, many studies rely on body mass index (BMI) as a measure of obesity. However BMI is considered to be a noisy measure of total body fat that unlike some other measures does not capture fat distribution. This study uses one such measure, the waist-to-hip ratio, as both an alternative and in conjunction with BMI in the estimation of the relationship between adiposity and health service use. The article uses data from a large-scale study of older adults living in Ireland (the Tilda data set). The findings indicate that studies that include both measures of general and central adiposity may provide a more comprehensive characterisation of the relationship between healthcare service use and adiposity.

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    The residual term is created by using the adiposity measures as the only regressors on a count model with the number of chronic conditions as the dependent variable. The difference between the predicted and actual number of counts of chronic health conditions is the residual. The same approach was adopted by Doherty et al. [10] but for self-reported BMI.

  2. 2.

    We tested how sensitive the adiposity marginal effects were to the inclusion of sampling weights. We did not observe any significant differences; therefore the results presented in the paper are for the unweighted sample with robust standard errors.


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Correspondence to Ciaran O’Neill.

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Doherty, E., Queally, M. & O’Neill, C. An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland. Eur J Health Econ 16, 951–956 (2015).

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  • Adiposity
  • BMI
  • Waist to hip
  • Health service use

JEL Classification

  • C31
  • I12