Twenty-five year trends in body mass index by education and income in Finland

BMC Public Health

Eva Roos¹  Tomi Mäkinen⁴  Mikko T Laaksonen²  Marjaana Lahti-Koski³  Risto Sippola⁴  Ritva Prättälä⁴ 

[1] Folkhälsan Research Center, Department of Public Health, University of Helsinki, Helsinki, Finland;Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland;Finnish Heart Association, Helsinki, Finland;National Institute for Health and Welfare, Helsinki, Finland

关键词: Finnish men and women;    Income;    Education;    25-year time trends;    Body mass index;   

Others  :  1162895
DOI  :  10.1186/1471-2458-12-936

 received in 2012-05-15, accepted in 2012-10-22,  发布年份 2012

【 摘 要 】

Background

The socioeconomic gradient in obesity and overweight is amply documented. However, the contribution of different socioeconomic indicators on trends of body mass index (BMI) over time is less well known. The aim of this study was to investigate the associations of education and income with (BMI) from the late 1970s to the early 2000s.

Methods

Data were derived from nationwide cross-sectional health behaviour surveys carried out among Finns annually since 1978. This study comprises data from a 25-year period (1978–2002) that included 25 339 men and 25 330 women aged 25–64 years. BMI was based on self-reported weight and height. Education in years was obtained from the questionnaire and household income from the national tax register. In order to improve the comparability of the socioeconomic position measures, education and income were divided into gender-specific tertiles separately for each study year. Linear regression analysis was applied.

Results

An increase in BMI was observed among men and women in all educational and income groups. In women, education and income were inversely associated with BMI. The magnitudes of the associations fluctuated but stayed statistically significant over time. Among the Finnish men, socioeconomic differences were more complicated. Educational differences were weaker than among the women and income differences varied according to educational level. At the turn of the century, the high income men in the lowest educational group had the highest BMI whereas the income pattern in the highest educational group was the opposite.

Conclusion

No overall change in the socio-economic differences of BMI was observed in Finland between 1978 and 2002. However, the trends of BMI diverged in sub-groups of the studied population: the most prominent increase in BMI took place in high income men with low education and in low income men with high education. The results encourage further research on the pathways between income, education, living conditions and the increasing BMI.

【 授权许可】

   
2012 Prättälä et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]McLaren L: Socioeconomic status and obesity. Epidemiol Rev 2007, 29:29-48.
• [2]Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL: The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011, 378(9793):804-814.
• [3]Martinez JA, Kearney JM, Kafatos A, Paquet S, Martinez-Gonzalez MA: Variables independently associated with self-reported obesity in the European Union. Public Health Nutr 1999, 2(1A):125-133.
• [4]Roskam AJ: Cross-national comparisons of socio-economic differences in overweight and obesity. Rotterdam: Erasmus University, Department of Public Health; 2009. [PhD thesis]
• [5]Gutierrez-Fisac JL, Regidor E, Banegas Banegas JR, Rodriguez Artalejo F: The size of obesity differences associated with educational level in Spain, 1987 and 1995/97. J Epidemiol Commun Health 2002, 56(6):457-460.
• [6]Lahti-Koski M, Harald K, Mannisto S, Laatikainen T, Jousilahti P: Fifteen-year changes in body mass index and waist circumference in Finnish adults. Eur J Cardiovasc Prev Rehabil 2007, 14(3):398-404.
• [7]Klumbiene J, Petkeviciene J, Helasoja V, Prattala R, Kasmel A: Sociodemographic and health behaviour factors associated with obesity in adult populations in Estonia, Finland and Lithuania. Eur J Public Health 2004, 14(4):390-394.
• [8]Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K: Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA project. Am J Public Health 2000, 90(8):1260-1268.
• [9]Flegal KM, Harlan WR, Landis JR: Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult men. Am J Clin Nutr 1988, 48(3):544-551.
• [10]Flegal KM, Harlan WR, Landis JR: Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women. Am J Clin Nutr 1988, 48(3):535-543.
• [11]Sturm R: Stemming the global obesity epidemic: what can we learn from data about social and economic trends? Public Health 2008, 122(8):739-746.
• [12]Ljungvall A, Zimmerman FJ: Bigger bodies: long-term trends and disparities in obesity and body-mass index among U.S. adults, 1960–2008. Soc Sci Med 2012, 75(1):109-119.
• [13]Grabner M: BMI trends, socioeconomic status, and the choice of dataset. Obes Facts 2012, 5(1):112-126.
• [14]McLaren L, Auld MC, Godley J, Still D, Gauvin L: Examining the association between socioeconomic position and body mass index in 1978 and 2005 among Canadian working-age women and men. Int J Public Health 2010, 55(3):193-200.
• [15]Roskam AJ, Kunst AE: The predictive value of different socio-economic indicators for overweight in nine European countries. Public Health Nutr 2008, 11(12):1256-1266.
• [16]Lahelma E, Martikainen P, Laaksonen M, Aittomaki A: Pathways between socioeconomic determinants of health. J Epidemiol Commun Health 2004, 58(4):327-332.
• [17]Prättälä R, Koskinen S, Martelin T, Lahelma E, Sihto M, Palosuo H, et al.: Health inequalities and the challenge of how to reduce them. In Health inequalities in Finland. Trends of socioeconomic health differences 1980–2005. Edited by Palosuo H, Koskinen S, Lahelma E. Helsinki: Ministry of Social Affairs and Health; 2009:11-19.
• [18]Tarkiainen L, Martikainen P, Laaksonen M, Valkonen T: Trends in life expectancy by income from 1988 to 2007: decomposition by age and cause of death. J Epidemiol Commun Health 2012, 66:573-578.
• [19]Reunanen A, Kattainen A, Salomaa V, et al.: Biological risk factors. In Health inequalities in Finland. Trends of socioeconomic health differences 1980–2005. Edited by Palosuo H, Koskinen S, Lahelma E. Helsinki: Ministry of Social Affairs and Health; 2009:169-177.
• [20]Tolonen H, Helakorpi S, Talala K, Helasoja V, Martelin T, Prattala R: 25-year trends and socio-demographic differences in response rates: Finnish adult health behaviour survey. Eur J Epidemiol 2006, 21(6):409-415.
• [21]Berghofer A, Pischon T, Reinhold T, Apovian CM, Sharma AM, Willich SN: Obesity prevalence from a European perspective: a systematic review. BMC Publ Health 2008, 8:200. BioMed Central Full Text
• [22]Lahti-Koski M, Harald K, Saarni S, Peltonen M, Männistö S: Changes in body mass index and measures of abdominal obesity in Finnish adults between 1992 and 2007, the National FINRISK Study. Clin Obes 2012, 2(1–2):57-63.
• [23]Hayes AJ, Clarke PM, Lung TW: Change in bias in self-reported body mass index in Australia between 1995 and 2008 and the evaluation of correction equations. Popul Health Metr 2011, 9:53. BioMed Central Full Text
• [24]Baecke JA, Burema J, Frijters JE, Hautvast JG, van der Wiel-Wetzels WA: Obesity in young Dutch adults: I, socio-demographic variables and body mass index. Int J Obes 1983, 7(1):1-12.
• [25]Martinez-Ros MT, Tormo MJ, Navarro C, Chirlaque MD, Perez-Flores D: Extremely high prevalence of overweight and obesity in Murcia, a Mediterranean region in south-east Spain. Int J Obes Relat Metab Disord 2001, 25(9):1372-1380.
• [26]Scali J, Siari S, Grosclaude P, Gerber M: Dietary and socio-economic factors associated with overweight and obesity in a southern French population. Public Health Nutr 2004, 7(4):513-522.
• [27]Duvigneaud N, Wijndaele K, Matton L, Deriemaeker P, Philippaerts R, Lefevre J, Thomis M, Duquet W: Socio-economic and lifestyle factors associated with overweight in Flemish adult men and women. BMC Publ Health 2007, 7:23. BioMed Central Full Text
• [28]Helmert U, Mielck A, Classen E: Social inequities in cardiovascular disease risk factors in East and West Germany. Soc Sci Med 1992, 35(10):1283-1292.
• [29]van Lenthe FJ, Droomers M, Schrijvers CT, Mackenbach JP: Socio-demographic variables and 6 year change in body mass index: longitudinal results from the GLOBE study. Int J Obes Relat Metab Disord 2000, 24(8):1077-1084.
• [30]Wardle J, Waller J, Jarvis MJ: Sex differences in the association of socioeconomic status with obesity. Am J Public Health 2002, 92(8):1299-1304.
• [31]Laaksonen M, Sarlio-Lahteenkorva S, Lahelma E: Multiple dimensions of socioeconomic position and obesity among employees: The Helsinki Health Study. Obes Res 2004, 12(11):1851-1858.
• [32]Ball K, Mishra G, Crawford D: Which aspects of socioeconomic status are related to obesity among men and women? Int J Obes Relat Metab Disord 2002, 26(4):559-565.
• [33]Pickett K, Kelly S, Brunner E, Lobstein T, Wilkinson R: Wider income gaps, wider waistbands? An ecological study of obesity and income inequality RID D-1815-2010 RID H-2114-2011. J Epidemiol Commun Health 2005, 59(8):670-674.
• [34]Wilkinson RG, Pickett KE: Income inequality and population health: a review and explanation of the evidence. Soc Sci Med 2006, 62(7):1768-1784.