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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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Abstract

Using longitudinal data over a 17 year period for a Swedish cohort aged 20-68 in 1980/81, this study analyses income-related inequalities in obesity. By use of the concentration index and decomposition techniques we answer the following questions: 1) Does obesity inequality favour or disfavour the poor? 2) What factors explain this inequality at different points in time? 3) How can the pattern of inequality over time be explained? We find that among females, inequalities in obesity favour the rich, but the estimated inequality declines over time. Income and marital status are the main driving forces behind obesity inequality, and income explains the majority of the declined obesity inequality over time. The results indicate that the main reason for the reduced obesity inequality is increased obesity prevalence, because in absolute terms obesity has increased uniformly across income groups. Thus we conclude that the reduced inequality is not due to any health policy success. Since the income elasticity of obesity is the individual most important contributor to the observed inequality, policies directed towards this factor might be the most effective. Similar trends are found for males, although less pronounced. This should be taken into account when evaluating obesity reducing policies.

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  • Ljungvall , Åsa & Gerdtham , Ulf-G, 2009. "More equal but heavier: A longitudinal analysis of income-related obesity inequalities in an adult Swedish cohort," Working Papers 2009:3, Lund University, Department of Economics.
    • Handle: RePEc:hhs:lunewp:2009_003
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    2. 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.
    3. Karina Acosta, 2012. "La obesidad y su concentración según nivel socioeconómico en Colombia," Revista de Economía del Rosario, Universidad del Rosario, July.
    4. 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.
    5. 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.
    6. 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.
    7. Meng, Fan & Nie, Peng & Sousa-Poza, Alfonso, 2023. "Obesity inequality and well-being in Germany," Economics & Human Biology, Elsevier, vol. 49(C).
    8. Antonio Di Paolo & Joan Gil Trasfi & Athina Raftopoulou, 2018. "“What drives regional differences in BMI? Evidence from Spain”," AQR Working Papers 201805, University of Barcelona, Regional Quantitative Analysis Group, revised Apr 2018.
    9. Johnston, D.W. & Lordan, G., 2012. "My body is fat and my wallet is thin: The link between weight perceptions, weight control and income," Health, Econometrics and Data Group (HEDG) Working Papers 12/27, HEDG, c/o Department of Economics, University of York.
    10. 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.
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. 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.
    16. 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.
    17. 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.
    18. 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.
    19. Sukati, Mphumuzi, 2018. "National Income and Malnutrition in Africa: a Rapid Assessment," MPRA Paper 89403, University Library of Munich, Germany.
    20. 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.
    21. Triaca, Lívia Madeira & dos Santos, Anderson Moreira Aristides & Tejada, Cesar Augusto Oviedo, 2020. "Socioeconomic inequalities in obesity in Brazil," Economics & Human Biology, Elsevier, vol. 39(C).

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    More about this item

    Keywords

    obesity; income; inequality; ageing; women; concentration index; decomposition; Oaxaca; panel data;
    All these keywords.

    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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