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More equal but heavier: A longitudinal analysis of income-related obesity inequalities in an adult Swedish cohort

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  • Ljungvall, Åsa
  • Gerdtham, Ulf-G.

Abstract

Using longitudinal data over a 17-year period for a Swedish cohort aged 20-68 in 1980/1981, this study analyses income-related inequalities in obesity. By using the concentration index and decomposition techniques we answer the following questions: 1) Does obesity inequality disfavour the poor? 2) What factors explain the inequality at different points in time? 3) What explains the change in inequality between years? We find that among females, inequalities in obesity favour the rich, but the inequality declines over time. Income itself is the main driving force behind obesity inequality, whereas being single (as opposed to being married or cohabiting) is an important counteracting factor. The main reason for the reduced obesity inequality over time is increased obesity prevalence, because in absolute terms obesity has increased uniformly across income groups. Because the income elasticity of obesity is the single most important contributor to the inequality, policies directed towards this factor might be the most effective for reducing obesity inequality. Our main income variable is within-individual mean of income, and we thereby focus on long-run inequality and are able to standardize for income mobility. The results show that inequality based on short-run income differs substantially from inequality based on long-run income. For males we find similar inequality trends as for women, although less pronounced. This difference between men and women should be taken into account when evaluating obesity reducing policies.

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  • 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.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:2:p:221-231
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    3. Sukati, Mphumuzi, 2018. "National Income and Malnutrition in Africa: a Rapid Assessment," MPRA Paper 89403, University Library of Munich, Germany.
    4. David Madden, 2011. "The Impact of an Economic Boom on the Level and Distribution of Subjective Well-Being: Ireland, 1994–2001," Journal of Happiness Studies, Springer, vol. 12(4), pages 667-679, August.
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    7. Athina Raftopoulou & Joan Gil Trasfi, 2024. "Income-related inequality in obesity and its determinants in Spain: What happens beyond the obesity threshold?," International Journal of Health Economics and Management, Springer, vol. 24(1), pages 135-153, March.
    8. Karina Acosta, 2012. "La obesidad y su concentración según nivel socioeconómico en Colombia," Revista de Economía del Rosario, Universidad del Rosario, July.
    9. 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.
    10. Pampel, Fred C. & Denney, Justin T. & Krueger, Patrick M., 2012. "Obesity, SES, and economic development: A test of the reversal hypothesis," Social Science & Medicine, Elsevier, vol. 74(7), pages 1073-1081.
    11. M. Boubacar Bathily & Omar Sene, 2021. "Décomposition des sources d'inégalité d'accès à la santé de l'enfant: Une analyse comparative de quelques pays d'Afrique Subsaharienne," African Development Review, African Development Bank, vol. 33(2), pages 221-233, June.
    12. 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.
    13. 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.
    14. Meng, Fan & Nie, Peng & Sousa-Poza, Alfonso, 2023. "Obesity inequality and well-being in Germany," Economics & Human Biology, Elsevier, vol. 49(C).
    15. Johnston, David W. & Lordan, Grace, 2014. "Weight perceptions, weight control and income: An analysis using British data," Economics & Human Biology, Elsevier, vol. 12(C), pages 132-139.
    16. Mosquera, Paola A. & San Sebastian, Miguel & Waenerlund, Anna-Karin & Ivarsson, Anneli & Weinehall, Lars & Gustafsson, Per E., 2016. "Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: A decomposition analysis," Social Science & Medicine, Elsevier, vol. 149(C), pages 135-144.
    17. Bissell, Paul & Peacock, Marian & Blackburn, Joanna & Smith, Christine, 2016. "The discordant pleasures of everyday eating: Reflections on the social gradient in obesity under neo-liberalism," Social Science & Medicine, Elsevier, vol. 159(C), pages 14-21.
    18. 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.
    19. 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.
    20. Ljungvall, Åsa, 2013. "The Freer the Fatter? A Panel Study of the Relationship between Body-Mass Index and Economic Freedom," Working Papers 2013:23, Lund University, Department of Economics.
    21. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    22. 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.

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    More about this item

    Keywords

    Sweden Gender Obesity Income Inequality Concentration index Decomposition Change;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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