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Education, income, occupational status and health risk behaviour

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Socio-economic status is associated with a variety of health-related behaviours. In our study, we determined the independent effects of income, educational attainment and occupational status on overweight, smoking and physical activity in the German population.

Subjects and methods

The German National Health Interview and Examination Survey is a representative sample of the German adult population and includes 7,124 men and women. Prevalences of obesity, smoking and physical inactivity stratified for education, income and occupational status were calculated. Multiple logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for education, income, occupational status and health-related behaviour, adjusted for age and gender.


Health risk behaviours were more prevalent in subjects with lower education, income or occupational status. After mutual adjustment, education, income and occupation were independently associated with physical inactivity. Low education was strongly associated with both obesity (OR: 2.58, 95% CI: 1.99–3.34) and smoking (OR: 2.09, 95% CI: 1.71–2.54). Low income was associated with smoking (OR: 1.40, 95% CI: 1.07–1.83), but not with obesity, and low occupational status was associated with obesity (OR: 1.42, 95% CI: 1.05–1.92), but not with smoking. High income or occupation could not compensate for the impact of low education on obesity and smoking.


Low socio-economic status is associated with health risk behaviours. Concerning obesity and smoking, education was more important than income or occupational status. Public health programmes to reduce these risk factors should focus on early-life health education.

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

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Correspondence to Marc Nocon.

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Nocon, M., Keil, T. & Willich, S.N. Education, income, occupational status and health risk behaviour. J Public Health 15, 401–405 (2007).

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