IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v166y2016icp223-232.html
   My bibliography  Save this article

Alternative measures to BMI: Exploring income-related inequalities in adiposity in Great Britain

Author

Listed:
  • Davillas, Apostolos
  • Benzeval, Michaela

Abstract

Socio-economic inequalities in adiposity are of particular interest themselves but also because they may be associated with inequalities in overall health status. Using cross-sectional representative data from Great Britain (1/2010-3/2012) for 13,138 adults (5652 males and 7486 females) over age 20, we aimed to explore the presence of income-related inequalities in alternative adiposity measures by gender and to identify the underlying factors contributing to these inequalities. For this reason, we employed concentration indexes and regression-based decomposition techniques. To control for non-homogeneity in body composition, we employed a variety of adiposity measures including body fat (absolute and percentage) and central adiposity (waist circumference) in addition to the conventional body mass index (BMI). The body fat measures allowed us to distinguish between the fat- and lean-mass components of BMI. We found that the absence of income-related obesity inequalities for males in the existing literature may be attributed to their focus on BMI-based measures. Pro-rich inequalities were evident for the fat-mass and central adiposity measures for males, while this was not the case for BMI. Irrespective of the adiposity measure applied, pro-rich inequalities were evident for females. The decomposition analysis showed that these inequalities were mainly attributable to subjective financial well-being measures (perceptions of financial strain and material deprivation) and education, with the relative contribution of the former being more evident in females. Our findings have important implications for the measurement of socio-economic inequalities in adiposity and indicate that central adiposity and body composition measures should be included health policy agendas. Psycho-social mechanisms, linked to subjective financial well-being, and education -rather than income itself-are more relevant for tackling inequalities.

Suggested Citation

  • Davillas, Apostolos & Benzeval, Michaela, 2016. "Alternative measures to BMI: Exploring income-related inequalities in adiposity in Great Britain," Social Science & Medicine, Elsevier, vol. 166(C), pages 223-232.
    • Handle: RePEc:eee:socmed:v:166:y:2016:i:c:p:223-232
    DOI: 10.1016/j.socscimed.2016.08.032
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953616304683
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2016.08.032?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Averett, Susan L. & Smith, Julie K., 2014. "Financial hardship and obesity," Economics & Human Biology, Elsevier, vol. 15(C), pages 201-212.
    2. Cawley, John & Maclean, Johanna Catherine & Hammer, Mette & Wintfeld, Neil, 2015. "Reporting error in weight and its implications for bias in economic models," Economics & Human Biology, Elsevier, vol. 19(C), pages 27-44.
    3. Costa-Font, Joan & Gil, Joan, 2008. "What lies behind socio-economic inequalities in obesity in Spain A decomposition approach," Food Policy, Elsevier, vol. 33(1), pages 61-73, February.
    4. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    5. Borg, Vilhelm & Kristensen, Tage S., 2000. "Social class and self-rated health: can the gradient be explained by differences in life style or work environment?," Social Science & Medicine, Elsevier, vol. 51(7), pages 1019-1030, October.
    6. Lakdawalla, Darius & Philipson, Tomas, 2009. "The growth of obesity and technological change," Economics & Human Biology, Elsevier, vol. 7(3), pages 283-293, December.
    7. David Madden, 2013. "The Socio-Economic Gradient Of Obesity In Ireland," The Economic and Social Review, Economic and Social Studies, vol. 44(2), pages 181-196.
    8. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    9. Ljungvall, Åsa & Gerdtham, Ulf-G., 2010. "More equal but heavier: A longitudinal analysis of income-related obesity inequalities in an adult Swedish cohort," Social Science & Medicine, Elsevier, vol. 70(2), pages 221-231, January.
    10. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
    11. Rashad, Inas, 2006. "Structural estimation of caloric intake, exercise, smoking, and obesity," The Quarterly Review of Economics and Finance, Elsevier, vol. 46(2), pages 268-283, May.
    12. Mohammad Hajizadeh & M. Karen Campbell & Sisira Sarma, 2014. "Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 203-221, March.
    13. Costa-Font, Joan & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores, 2014. "Income inequalities in unhealthy life styles in England and Spain," Economics & Human Biology, Elsevier, vol. 13(C), pages 66-75.
    14. Arber, Sara & Fenn, Kirsty & Meadows, Robert, 2014. "Subjective financial well-being, income and health inequalities in mid and later life in Britain," Social Science & Medicine, Elsevier, vol. 100(C), pages 12-20.
    15. Zhang, Qi & Wang, Youfa, 2004. "Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter?," Social Science & Medicine, Elsevier, vol. 58(6), pages 1171-1180, March.
    16. Baum II, Charles L. & Ruhm, Christopher J., 2009. "Age, socioeconomic status and obesity growth," Journal of Health Economics, Elsevier, vol. 28(3), pages 635-648, May.
    17. O’Neill, Donal, 2015. "Measuring obesity in the absence of a gold standard," Economics & Human Biology, Elsevier, vol. 17(C), pages 116-128.
    18. Fiona Imlach Gunasekara & Kristie Carter & Peter Crampton & Tony Blakely, 2013. "Erratum to: Income and individual deprivation as predictors of health over time," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(6), pages 959-960, December.
    19. Burkhauser, Richard V. & Cawley, John, 2008. "Beyond BMI: The value of more accurate measures of fatness and obesity in social science research," Journal of Health Economics, Elsevier, vol. 27(2), pages 519-529, March.
    20. Erreygers, Guido & Van Ourti, Tom, 2011. "Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice," Journal of Health Economics, Elsevier, vol. 30(4), pages 685-694, July.
    21. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    22. Fiona Imlach Gunasekara & Kristie Carter & Peter Crampton & Tony Blakely, 2013. "Income and individual deprivation as predictors of health over time," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 501-511, August.
    23. Donal O’Neill & Olive Sweetman, 2013. "The consequences of measurement error when estimating the impact of obesity on income," IZA Journal of Labor Economics, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 2(1), pages 1-20, December.
    24. Åsa Ljungvall & Ulf Gerdtham & Ulf Lindblad, 2015. "Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 5-20, January.
    25. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    26. Gabriella Conti & James Heckman & Sergio Urzua, 2010. "The Education-Health Gradient," American Economic Review, American Economic Association, vol. 100(2), pages 234-238, May.
    27. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432, April.
    28. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Davillas, Apostolos & Burlinson, Andrew & Liu, Hui-Hsuan, 2022. "Getting warmer: Fuel poverty, objective and subjective health and well-being," Energy Economics, Elsevier, vol. 106(C).
    2. Davillas, Apostolos & de Oliveira, Victor Hugo & Jones, Andrew M., 2022. "Model of Errors in BMI Based on Self‐reported and Measured Anthropometrics with Evidence from Brazilian Data," CINCH Working Paper Series (since 2020) 76143, Duisburg-Essen University Library, DuEPublico.
    3. Antonio Di Paolo & Joan Gil Trasfi & Athina Raftopoulou, 2018. "“What drives regional differences in BMI? Evidence from Spain”," IREA Working Papers 201808, University of Barcelona, Research Institute of Applied Economics, revised Oct 2018.
    4. Davillas, A.; Jones, A.M.; Benzeval, M.;, 2017. "The income-health gradient: Evidence from self-reported health and biomarkers using longitudinal data on income," Health, Econometrics and Data Group (HEDG) Working Papers 17/04, HEDG, c/o Department of Economics, University of York.
    5. Hughes, Amanda & Kumari, Meena, 2019. "Testosterone, risk, and socioeconomic position in British men: Exploring causal directionality," Social Science & Medicine, Elsevier, vol. 220(C), pages 129-140.
    6. Wu, Hania Fei, 2021. "Social determination, health selection or indirect selection? Examining the causal directions between socioeconomic status and obesity in the Chinese adult population," Social Science & Medicine, Elsevier, vol. 269(C).
    7. Davillas, Apostolos & Jones, Andrew M., 2020. "Regional inequalities in adiposity in England: distributional analysis of the contribution of individual-level characteristics and the small area obesogenic environment," Economics & Human Biology, Elsevier, vol. 38(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mohammad Hajizadeh & M. Karen Campbell & Sisira Sarma, 2014. "Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 203-221, March.
    2. Costa-Font, Joan & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores, 2014. "Income inequalities in unhealthy life styles in England and Spain," Economics & Human Biology, Elsevier, vol. 13(C), pages 66-75.
    3. Olufunke Alaba & Lumbwe Chola, 2014. "Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis," IJERPH, MDPI, vol. 11(3), pages 1-20, March.
    4. Åsa Ljungvall & Ulf Gerdtham & Ulf Lindblad, 2015. "Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 5-20, January.
    5. Merino Ventosa, María & Urbanos-Garrido, Rosa M.maria.merino.ven@gmail.com, 2016. "Disentangling effects of socioeconomic status on obesity: A cross-sectional study of the Spanish adult population," Economics & Human Biology, Elsevier, vol. 22(C), pages 216-224.
    6. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    7. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    8. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    9. Daouli, Joan & Davillas, Apostolos & Demoussis, Michael & Giannakopoulos, Nicholas, 2014. "Obesity persistence and duration dependence: Evidence from a cohort of US adults (1985–2010)," Economics & Human Biology, Elsevier, vol. 12(C), pages 30-44.
    10. Baltica Cabieses & Richard Cookson & Manuel Espinoza & Gillian Santorelli & Iris Delgado, 2015. "Did Socioeconomic Inequality in Self-Reported Health in Chile Fall after the Equity-Based Healthcare Reform of 2005? A Concentration Index Decomposition Analysis," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-21, September.
    11. Karina Acosta, 2012. "La obesidad y su concentración según nivel socioeconómico en Colombia," Revista de Economía del Rosario, Universidad del Rosario, July.
    12. Carrieri, Vincenzo & Wuebker, Ansgar, 2013. "Assessing inequalities in preventive care use in Europe," Health Policy, Elsevier, vol. 113(3), pages 247-257.
    13. Martha Tangeni Nghipandulwa & Alfred Kechia Mukong, 2023. "Estimating Income-Related Health Inequalities Associated with Tobacco and Alcohol Consumption in Namibia," IJERPH, MDPI, vol. 20(2), pages 1-17, January.
    14. Kjellsson, Gustav, 2014. "Extending Decomposition Analysis to Account for Socioeconomic Background: Income-Related Smoking Inequality among Swedish Women," Working Papers 2014:29, Lund University, Department of Economics.
    15. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    16. Giuliano Resce & Raffaele Lagravinese & Elisa Benedetti & Sabrina Molinaro, 2019. "Income-related inequality in gambling: evidence from Italy," Review of Economics of the Household, Springer, vol. 17(4), pages 1107-1131, December.
    17. Hajizadeh, Mohammad & Nandi, Arijit & Heymann, Jody, 2014. "Social inequality in infant mortality: What explains variation across low and middle income countries?," Social Science & Medicine, Elsevier, vol. 101(C), pages 36-46.
    18. Emamian, Mohammad Hassan & Fateh, Mansooreh & Hosseinpoor, Ahmad Reza & Alami, Ali & Fotouhi, Akbar, 2017. "Obesity and its socioeconomic determinants in Iran," Economics & Human Biology, Elsevier, vol. 26(C), pages 144-150.
    19. Laia Maynou & Marc Saez & Jordi Bacaria & Guillem Lopez-Casasnovas, 2015. "Health inequalities in the European Union: an empirical analysis of the dynamics of regional differences," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 543-559, June.
    20. John E. Ataguba, 2022. "A short note revisiting the concentration index: Does the normalization of the concentration index matter?," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1506-1512, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:166:y:2016:i:c:p:223-232. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.