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Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess


  • Wells, Jonathan C.K.
  • Marphatia, Akanksha A.
  • Cole, Tim J.
  • McCoy, David


Obesity is widely assumed to be associated with economic affluence; it has therefore been assumed to become more common with economic development. However, obesity has also been associated with poverty. These contrary findings highlight the need for an examination of the contribution of social and economic factors to the global distribution of obesity. Males and females may be differently exposed to social and economic inequality, however few studies have considered possible gender differences in the association between socio-economic indices and obesity prevalence. We analysed between-country associations between obesity prevalence and three social or economic indices: per capita gross domestic product (GDP), the Gini index of national wealth inequality, and the gender inequality index (GII). We considered the genders separately, the gender average, and also the gender difference (female excess) in obesity prevalence. Across 68 countries listing sample size, there were 3 obese women for every 2 obese men. Within populations, obesity prevalence in males and females was strongly correlated (r = 0.74), however, only 17% of the female excess prevalence was accounted for by the gender-average prevalence. In both genders, there was a positive association between obesity prevalence and GDP that attenuated at higher GDP levels, with this association weaker in females than males. Adjusting for GDP, both the Gini index and GII were associated with excess female obesity. These analyses highlight significant gender differences in the global distribution of obesity, and a gender difference in the association of obesity prevalence with socio-economic factors. The magnitude of female excess obesity is not constant across populations, and is greater in countries characterised by gender inequality and lower GDP. These findings indicate that improving women’s status may be a key area for addressing the global obesity epidemic over the long term, with potential benefits for the women themselves and for their offspring.

Suggested Citation

  • Wells, Jonathan C.K. & Marphatia, Akanksha A. & Cole, Tim J. & McCoy, David, 2012. "Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess," Social Science & Medicine, Elsevier, vol. 75(3), pages 482-490.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:3:p:482-490
    DOI: 10.1016/j.socscimed.2012.03.029

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    References listed on IDEAS

    1. Kennedy, Eileen & Peters, Pauline, 1992. "Household food security and child nutrition: the interaction of income and gender of household head," World Development, Elsevier, vol. 20(8), pages 1077-1085, August.
    2. Khlat, Myriam & Jusot, Florence & Ville, Isabelle, 2009. "Social origins, early hardship and obesity: A strong association in women, but not in men?," Social Science & Medicine, Elsevier, vol. 68(9), pages 1692-1699, May.
    3. Borooah, Vani K., 2004. "Gender bias among children in India in their diet and immunisation against disease," Social Science & Medicine, Elsevier, vol. 58(9), pages 1719-1731, May.
    4. Hadley, Craig & Lindstrom, David & Tessema, Fasil & Belachew, Tefara, 2008. "Gender bias in the food insecurity experience of Ethiopian adolescents," Social Science & Medicine, Elsevier, vol. 66(2), pages 427-438, January.
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    Cited by:

    1. Rosinger, Asher & Tanner, Susan & Leonard, William R., 2013. "Precursors to overnutrition: The effects of household market food expenditures on measures of body composition among Tsimane' adults in lowland Bolivia," Social Science & Medicine, Elsevier, vol. 92(C), pages 53-60.
    2. Palència, Laia & Malmusi, Davide & De Moortel, Deborah & Artazcoz, Lucía & Backhans, Mona & Vanroelen, Christophe & Borrell, Carme, 2014. "The influence of gender equality policies on gender inequalities in health in Europe," Social Science & Medicine, Elsevier, vol. 117(C), pages 25-33.
    3. Ferretti, Fabrizio & Mariani, Michele, 2017. "Gender Discrimination, Gender Disparities in Obesity and Human Development," MPRA Paper 77728, University Library of Munich, Germany.


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