Unevenly distributed: a systematic review of the health literature about socioeconomic inequalities in adult obesity in the United Kingdom

BMC Public Health

Sandro Galea²  Peter Scarborough¹  Abdulrahman M El-Sayed³ 

[1] British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Richards Building Old Road Campus Headington, Oxford, UK OX3 7LF;Department of Epidemiology, Columbia University, New York, NY, USA;College of Physicians and Surgeons, Columbia University, New York, NY, USA

关键词: Northern Ireland;    Scotland;    Wales;    England;    Deprivation;    Disparities;    Income;    Education;    Social class;    Socioeconomic status;    Socioeconomic position;    Overweight;    Adiposity;   

Others  :  1163956
DOI  :  10.1186/1471-2458-12-18

 received in 2011-08-06, accepted in 2012-01-09,  发布年份 2012

【 摘 要 】

Background

There is a growing literature documenting socioeconomic inequalities in obesity risk among adults in the UK, with poorer groups suffering higher risk.

Methods

In this systematic review, we summarize and appraise the extant peer-reviewed literature about socioeconomic inequalities in adult obesity risk in the UK published between 1980 and 2010. Only studies featuring empirical assessments of relations between socioeconomic indicators and measures of obesity among adults in the UK were included.

Results

A total of 35 articles met inclusion criteria, and were reviewed here.

Conclusion

Socioeconomic indicators of low socioeconomic position (SEP), including occupational social class of the head-of-household at birth and during childhood, earlier adulthood occupational social class, contemporaneous occupational social class, educational attainment, and area-level deprivation were generally inversely associated with adult obesity risk in the UK. Measures of SEP were more predictive of obesity among women than among men. We outline important methodological limitations to the literature and recommend avenues for future research.

【 授权许可】

   
2012 El-Sayed et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]McPherson K, Marsh T, Brown M: Tackling Obesities: future choices-modelling future trends in obesity and the impact on health. Foresight: The J of Futures Studies, Strategic Thinking and Policy 2007.
• [2]National Obesity Observatory: Data Briefing: Adult Weight. Oxford, England: National Obesity Observatory; 2010.
• [3]Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB: Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002, 162(16):1867.
• [4]Wellman NS, Friedberg B: Causes and consequences of adult obesity: health, social and economic impacts in the United States. Asia Pac J Clin Nutr 2002, 11(S8):s705-709.
• [5]Must A, Strauss RS: Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999, 23:s2-11.
• [6]Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003, 289(1):76-9.
• [7]Veer P, Kampman E: Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. Washington, DC: World Cancer Research Fund/American Institute for Cancer Research; 2007.
• [8]Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N England J Med 2003, 348(17):1625-38.
• [9]Møller H, Mellemgaard A, Lindvig K, Olsen JH: Obesity and cancer risk: a Danish record-linkage study. Eur J Cancer 1994, 30(3):344-50.
• [10]Suk SH, Sacco RL, Boden-Albala B, Cheun JF, Pittman JG, Elkind MS, Paik MC, Northern Manhattan Stroke Study: Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. Stroke 2003, 34(7):1586-92.
• [11]Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW: Is obesity associated with major depression? Results from the third national health and nutrition examination survey. Am J Epidemiol 2003, 158(12):1139-47.
• [12]Flegal KM, Graubard BI, Williamson DF, Gail MH: Excess deaths associated with underweight, overweight, and obesity. JAMA 2005, 293(15):1861-7.
• [13]Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey Smith G: Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 1998, 67(6):1111-8.
• [14]Mackenbach JP, Stirbu I, Roskam A-R, Schaap MM, Menvielle G, Leinsalu M, Kunst AE, European Union Working Group on Socioeconomic Inequalities in Health: Socioeconomic inequalities in health in 22 European countries. New England J Med 2008, 358(23):2468.
• [15]Marmot MG, Smith GD, Stansfield S, Patel C, North F, Head J, White I, Brunner E, Feeney A: Health inequalities among British civil servants: the Whitehall II study. Lancet 1991, 337(8754):1387-93.
• [16]Fair Society, Health Lives: Strategic Review of the Health Inequalities in England post-2010. London: The Marmot Review; 2010.
• [17]Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, Reid A, Hemstrom O, Valkonen T, Kunst AE: Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol 2003, 32(5):830-7.
• [18]Brunner E, Shipley MJ, Blane D, Smith GD, Marmot MG: When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood. J Epidemiol Community Health 1999, 53(12):757-64.
• [19]Ferrie JE, Head J, Shipley MJ, Vahtera J, Marmot MG, Kivimaki M: BMI, obesity, and sickness absence in the Whitehall II study. Obesity (Silver Spring) 2007, 15(6):1554-64.
• [20]Hardy R, Wadsworth M, Kuh D: The influence of childhood weight and socioeconomic status on change in adult body mass index in a British national birth cohort. Int J Obes Relat Metab Disord 2000, 24(6):725-734.
• [21]Hart C, McConnachie A, Upton M, Watt G: Risk factors in the Midspan family study by social class in childhood and adulthood. Int J Epidemiol 2008, 37(3):604-614.
• [22]Kuh D, Hardy R, Chaturvedi N, Wadsworth ME: Birth weight, childhood growth and abdominal obesity in adult life. Int J Obes Relat Metab Disord 2002, 26(1):40-47.
• [23]Ball K, Crawford D: Socioeconomic status and weight change in adults: a review. Soc Sci Med 2005, 60:1987-2010.
• [24]McLaren L: Socioeconomic status and obesity. Epidemiol Rev 2007, 29:29-48.
• [25]Balakrishnan R, Webster P, Sinclair D: Trends in overweight and obesity among 5-7-year-old White and South Asian children born between 1991 and 1999. J Public Health (Oxf) 2008, 30(2):139-144.
• [26]Jebb SA, Rennie KL, Cole TJ: Prevalence of overweight and obesity among young people in Great Britain. Public Health Nutr 2004, 7(3):461-465.
• [27]Duran-Tauleria E, Rona RJ, Chinn S: Factors associated with weight for height and skinfold thickness in British children. J Epidemiol Community Health 1995, 49(5):466-473.
• [28]Rona RJ, Chinn S: National Study of Health and Growth: social and biological factors associated with weight-for-height and triceps skinfold of children from ethnic groups in England. Ann Hum Biol 1987, 14(3):231-248.
• [29]Chinn S, Hughes JM, Rona RJ: Trends in growth and obesity in ethnic groups in Britain. Arch Dis Child 1998, 78(6):513-517.
• [30]Blane D, Hart CL, Smith GD, Gillis CR, Hole DJ, Hawthorne VM: Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood. BMJ 1996, 313(7070):1434-1438.
• [31]Heraclides A, Witte D, Brunner EJ: The association between father's social class and adult obesity is not explained by educational attainment and an unhealthy lifestyle in adulthood. Eur J Epidemiol 2008, 23(8):573-579.
• [32]Langenberg C, Hardy R, Kuh D, Brunner E, Wadsworth M: Central and total obesity in middle aged men and women in relation to lifetime socioeconomic status: evidence from a national birth cohort. J Epidemiol Community Health 2003, 57(10):816-822.
• [33]Lawlor DA, Batty GD, Morton SM, Clark H, Macintyre S, Leon DA: Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study. Am J Public Health 2005, 95(7):1245-1251.
• [34]Okasha M, McCarron P, McEwen J, Durnin J, Davey Smith G: Childhood social class and adulthood obesity: findings from the Glasgow Alumni Cohort. J Epidemiol Community Health 2003, 57(7):508-509.
• [35]Pierce MB, Leon DA: Age at menarche and adult BMI in the Aberdeen children of the 1950s cohort study. Am J Clin Nutr 2005, 82(4):733-739.
• [36]Power C, Hertzman C, Matthews S, Manor O: Social differences in health: life-cycle effects between ages 23 and 33 in the 1958 British birth cohort. Am J Public Health 1997, 87(9):1499-1503.
• [37]Power C, Moynihan C: Social class and changes in weight-for-height between childhood and early adulthood. Int J Obes 1988, 12(5):445-453.
• [38]Power C, Manor O, Matthews S: Child to adult socioeconomic conditions and obesity in a national cohort. Int J Obes Relat Metab Disord 2003, 27(9):1081-1086.
• [39]Power C, Graham H, Due P, Hallqvist J, Joung I, Kuh D, Lynch J: The contribution of childhood and adult socioeconomic position to adult obesity and smoking behaviour: an international comparison. Int J Epidemiol 2005, 34(2):335-344.
• [40]Power C, Atherton K, Strachan DP, Shepherd P, Fuller E, Davis A, Gibb I, Kumari M, Lowe G, MacFarlane GJ, Rahi J, Rodgers B, Stansfield S: Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood. Int J Epidemiol 2007, 36(3):532-539.
• [41]Wannamethee SG, Whincup PH, Shaper G, Walker M: Influence of fathers' social class on cardiovascular disease in middle-aged men. Lancet 1996, 348(9037):1259-1263.
• [42]Martikainen PT, Marmot MG: Socioeconomic differences in weight gain and determinants and consequences of coronary risk factors. Am J Clin Nutr 1999, 69(4):719-726.
• [43]Townsend P: Health and deprivation. Inequality and the North. In "Classic Texts in Health Care". Edited by Soothill K, Mackay L, Malia L. Oxford: Reed Educational and Professional Publishing, Ltd; 1997.
• [44]Lyratzopoulos G, McElduff P, Heller RF, Hanily M, Lewis PS: Mid-term Body Mass Index increase among obese and non-obese individuals in middle life and deprivation status: a cohort study. BMC Public Health 2005, 5:32. BioMed Central Full Text
• [45]Power C, Hertzman C: Social and biological pathways linking early life and adult disease. Br Med Bull 1997, 53(1):210-221.
• [46]Baker IA, Sweetnam PM, Yarnell JW, Bainton D, Elwood PC: Haemostatic and other risk factors for ischaemic heart disease and social class: evidence from the Caerphilly and Speedwell studies. Int J Epidemiol 1988, 17(4):759-765.
• [47]Bhopal R, Hayes L, White M, Unwin N, Harland J, Ayis S, Alberti G: Ethnic and socio-economic inequalities in coronary heart disease, diabetes and risk factors in Europeans and South Asians. J Public Health Med 2002, 24(2):95-105.
• [48]Brunner EJ, Marmot MG, Nanchahal K, Shipley MJ, Stansfeld SA, Juneja M, Alberti KG: Social inequality in coronary risk: central obesity and the metabolic syndrome. Evidence from the Whitehall II study. Diabetologia 1997, 40(11):1341-1349.
• [49]Ellaway A, Anderson A, Macintyre S: Does area of residence affect body size and shape? Int J Obes Relat Metab Disord 1997, 21(4):304-308.
• [50]Fehily AM, Phillips KM, Yarnell JW: Diet, smoking, social class, and body mass index in the Caerphilly Heart Disease Study. Am J Clin Nutr 1984, 40(4):827-833.
• [51]Gulliford MC, Rona RJ, Chinn S: Trends in body mass index in young adults in England and Scotland from 1973 to 1988. J Epidemiol Community Health 1992, 46(3):187-190.
• [52]Parkes KR: Demographic and lifestyle predictors of body mass index among offshore oil industry workers: cross-sectional and longitudinal findings. Occup Med (Lond) 2003, 53(3):213-221.
• [53]Power C, Atherton K, Manor O: Co-occurrence of risk factors for cardiovascular disease by social class: 1958 British birth cohort. J Epidemiol Community Health 2008, 62(12):1030-1035.
• [54]Rona RJ, Morris RW: National study of health and growth: social and family factors and overweight in English and Scottish parents. Ann Hum Biol 1982, 9(2):147-156.
• [55]Scarborough P, Allender S: The North-south gap in overweight and obesity in England. Br J Nutr 2008, 100(3):677-684.
• [56]Moon G, Quarendon G, Barnard S, Twigg L, Blyth B: Fat nation: deciphering the distinctive geographies of obesity in England. Soc Sci Med 2007, 65(1):20-31.
• [57]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.
• [58]Weatherall R, Shaper AG: Overweight and obesity in middle-aged British men. Eur J Clin Nutr 1988, 42(3):221-231.
• [59]Riva M, Curtis S, Gauvin L, Fagg J: Unravelling the extent of inequalities in health across urban and rural areas: evidence from a national sample in England. Soc Sci Med 2009, 68(4):654-663.
• [60]Sobal J, Stunkard AJ: Socioeconomic status and obesity: a review of the literature. Psychol Bull 1989, 105(2):260-275.
• [61]Link BG, Phelan J: Social conditions as fundamental causes of disease. J Health Soc Behav 1995, 80-94.
• [62]British Heart Foundation: Mortality from Coronary Heart Disease Statistics 2010. 2010. Available at: http://www.bhf.org.uk/publications/publications-search-results.aspx?m=simple&q=mortality webcite
• [63]Galesic M, Garcia-Retamero R: Statistical numeracy for health; A cross-cultural comparison with probabilistic national samples. Arch Intern Med 2010, 170(5):462-468.
• [64]Nelson M, Erens B, Bates B, Church S, Boshier T: Low income diet and nutrition survey: London: TSO. 2007., 3
• [65]Ali SM, Lindstrom M: Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: differing patterns for underweight and overweight/obesity. Eur J Public Health 2006, 16(3):324-330.
• [66]Bickel G, Nord M, Price C, Hamilton W, Cook J: Guide to measuring food insecurity, revised 2000. [http://www.fns.usda.gov/FSEC/FILES/FSGuide.pdf] webciteUnited States Department of Agriculture Report 2000.
• [67]Dietz WH: Does hunger cause obesity? Pediatrics 1995, 95:766-767.
• [68]Adams EJ, Grummer-Strawn L, Chavez G: Food insecurity is associated with increased risk of obesity in California women. J Nutr 2003, 133:1070-1704.
• [69]Black JL, Macingko J: Neighborhoods and obesity. Nutr Rev 2008, 66(1):2-20.
• [70]Poortinga W: Perceptions of the environment, physical activity, and obesity. Soc Sci Med 2006, 63:2835-2846.
• [71]Zweiniger-Bargielowska I: Austerity in Britain: rationing, controls, and consumption. New York: Oxford University Press; 2002:1939-1955.
• [72]Huang JS, Lee TA, Lu MC: Prenatal programming of childhood overweight and obesity. Matern Child Health J 2007, 11(5):461-473.
• [73]Breier BH, Vickers MH, Ikenasio BA, Chan KY, Wong WP: Fetal programming of appetite and obesity. Mol Cell Endocrinol 2001, 185(1-2):73-79.
• [74]Ravelli AC, van Der Meulen JH, Osmond C, Barker DJ, Bleker OP: Obesity at age of 50 y in men and women exposed to famin prenatally. Am J Clin Nutr 1999, 70(5):811-816.
• [75]Chevalier A: Education, Occupation and Career Expectations: Determinants of the Gender Pay Gap for UK Graduates*. Oxford Bull Econ Stat 2007, 69(6):819-842.
• [76]Blackaby DH, Leslie DG, Murphy PD, O'Leary NC: The ethnic wage gap and employment differentials in the 1990s: evidence for Britain. Econ Lett 1998, 58(1):97-103.
• [77]Krieger N, Williams DR, Moss NE: Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 1997, 18(1):341-378.
• [78]Stevenson THC: The vital statistics of wealth and poverty. J Royal Stat Soc 1928, 91(2):207-230.
• [79]Marmot MG, McDowall ME: Mortality decline and widening social inequalities. Lancet 1986, 328(8501):274-276.
• [80]Green MJ, Benzeval M: Social class differences in anxiety and depression across the life-course: evidence from three cohorts in the west of Scotland. J Epidemiol Community Health 2009, 63(suppl 2):19.
• [81]Pugh H, Moser K: Measuring women's mortality differences. In Women's Health Counts London Routledge Edited by Roberts H. 1990, 93-112.
• [82]Diez-Roux AV: Multilevel analysis in public health research. Annu Rev Public Health 2000, 21:171-192.
• [83]Blalock HM: Contextual-effects models: theoretical and methodological issues. Annu Rev Sociol 1984, 10(1):353-372.
• [84]DiPrete TA, Forristal JD: Multilevel models: methods and substance. Annu Rev Sociol 1994, 20(1):331-357.
• [85]Hox JJ, Kreft IGG: Multilevel analysis methods. Sociol Meth Res 1994, 22(3):283-299.
• [86]Galea S, Hall C, Kaplan GA: Social epidemiology and complex system dynamic modelling as applied to health behaviour and drug use research. Int J Drug Policy 2009, 20(3):209-216.
• [87]Baker EA, Metzler MM, Galea S: Addressing social determinants of health inequities: learning from doing. Am J Public Health 2005, 95(4):553-555.
• [88]National Child Development Study 2010. Available at: http://www.cls.ioe.ac.uk/studies.asp?section=000100020003 webcite Accessed 10 May, 2010.
• [89]Social Focus In Brief: Ethnicity, 2002 Office for National Statistics. 2002. Available at: http://www.ons.gov.uk/ons/rel/ethnicity/social-focus-in-brief--ethnicity/full-report/index.html webcite.Accessed 13 January, 2012.
• [90]Fitzpatrick J, Jacobson B, Aspinall P: Ethnicity and Health: Executive Summary. Association of Public Health Observatories; 2007.
• [91]Bhattacharyya G, Ison L, Blair M: Minority ethnic attainment and participation in education and training: the evidence. Nottingham: Department for Education and Skills; 2003, RTP01-03.
• [92]Department of Health, Healthcare Commission: Report on the self reported experience of patients from black and minority ethnic groups. London: Office of National Statistics; 2009.
• [93]Falagas ME, Pitsouni EI, Malietzis GA, Pappas G: Comparison of PubMed, Scopus, Web of Science, and Google Scholar: strengths and weaknesses. Faseb J 2008, 22:338-342.
• [94]Viner TJRM: Adult socioeconomic, educational, social, and psychological outcomes of childhood obesity: a national birth cohort study. BMJ 2005, 330(7504):1354.
• [95]Wardle J, Boniface D: Changes in the distributions of body mass index and waist circumference in English adults, 1993/1994 to 2002/2003. Int J Obes 2008, 32:527-532.