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Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold.

ABSTRACT: We combine two of the most widely used measures in the inequality and poverty literature, the concentration index and Foster-Greer-Thorbecke metric to the analysis of socioeconomic inequality in obesity. This enables us to describe socioeconomic inequality not only in obesity status but also in its depth and severity. We apply our method to 1971-2012 US data and show that while the socioeconomic inequality in obesity status has now almost disappeared, this is not the case when depth and severity of obesity are considered. Such socioeconomic gradient is found to be greatest among non-Hispanic whites, but decomposition analysis also reveals an inverse relationship between income and obesity outcomes among Mexican Americans once the effect of immigrant status has been accounted for. The socioeconomic gradient is also greater among women with marital status further increasing it for severity of obesity while the opposite is true among men. Overall, the socioeconomic gradient exists as poorer individuals lie further away from the obesity threshold. Our study stresses the need for policies that jointly consider obesity and income to support those who suffer from the double burden of poverty and obesity-related health conditions. © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.

SUBMITTER: Bilger M

PROVIDER: S-EPMC5516143 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold.

Bilger Marcel M Kruger Eliza J EJ Finkelstein Eric A EA

Health economics 20160812 8

We combine two of the most widely used measures in the inequality and poverty literature, the concentration index and Foster-Greer-Thorbecke metric to the analysis of socioeconomic inequality in obesity. This enables us to describe socioeconomic inequality not only in obesity status but also in its depth and severity. We apply our method to 1971-2012 US data and show that while the socioeconomic inequality in obesity status has now almost disappeared, this is not the case when depth and severity ...[more]

PMID: 27515829

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Project description:IntroductionPrevious research has shown that the socioeconomic status (SES)-health gradient also extends to high-cost patients; however, little work has examined high-cost patients with mental illness and/or addiction. The objective of this study was to examine associations between individual-, household- and area-level SES factors and future high-cost use among these patients.MethodsWe linked survey data from adult participants (ages 18 and older) of 3 cycles of the Canadian Community Health Survey to administrative health care data from Ontario, Canada. Respondents with mental illness and/or addiction were identified based on prior mental health and addiction health care use and followed for 5 years for which we ascertained health care costs covered under the public health care system. We quantified associations between SES factors and becoming a high-cost patient (i.e., transitioning into the top 5%) using logistic regression models. For ordinal SES factors, such as income, education and marginalization variables, we measured absolute and relative inequalities using the slope and relative index of inequality.ResultsAmong our sample, lower personal income (odds ratio [OR] = 2.11, 95% confidence interval [CI], 1.54 to 2.88, for CAD$0 to CAD$14,999), lower household income (OR = 2.11, 95% CI, 1.49 to 2.99, for lowest income quintile), food insecurity (OR = 1.87, 95% CI, 1.38 to 2.55) and non-homeownership (OR = 1.34, 95% CI, 1.08 to 1.66), at the individual and household levels, respectively, and higher residential instability (OR = 1.72, 95% CI, 1.23 to 2.42, for most marginalized), at the area level, were associated with higher odds of becoming a high-cost patient within a 5-year period. Moreover, the inequality analysis suggested pro-high-SES gradients in high-cost transitions.ConclusionsPolicies aimed at high-cost patients with mental illness and/or addiction, or those concerned with preventing individuals with these conditions from becoming high-cost patients in the health care system, should also consider non-clinical factors such as income as well as related dimensions including food security and homeownership.

Dataset Information

Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold.

Publications

Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold.

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