Socioeconomic patterns of overweight and obesity in Scania, Sweden
Author
Summary, in English
The overall objective of this thesis was to assess the association between socioeconomic and lifestyle factors vis-à-vis weight change, overweight, and obesity among Swedish adults in Scania, Sweden. The study population is based on the data from two waves (1999/2000 and 2005) of the Scania Public Health Cohort. It was generated from a large (n = 25,000) random selection of the adult population in the region of Scania, southern Sweden. Participants completed a self-administered postal questionnaire (baseline response rate = 59%). BMI was calculated from self-reported body height and weight. Socioeconomic status was determined by means of job title and description, or by years of education. Mediating mechanisms as well as confounding control was assessed in logistic regression models with special attention to effect-modifying interactions.
Study I found that adult and childhood socioeconomic position influence weight gain, but differently by gender and age group. Two waves of socioeconomically determined weight gain patterns appeared in the population studied: one across generations and another contemporary one. Study II concluded that cohort effects play a role in BMI change. However, it was difficult to distinguish between age-period and cohort-period effects because of the linear relationship between age, period, and cohort, and due to the short follow-up. Study III showed a two-fold correlation between social capital and obesity: as a determinant in its own right, and as a modifier of the effect of socioeconomic status on obesity. Study IV demonstrated that women around retirement age with low and mid-level educations were at higher risk of weight gain over a five-year follow-up period, although this association could not be explained by changes in their leisure time physical activity or their social participation.
The thesis confirmed a relationship between socioeconomic status and overweight/obesity in the population studied. However, it concluded that these relations are highly complex and dependent on a number of individual and contextual factors that vary over time, between different age groups and birth cohorts, and by gender. The concept of social capital emerged as promising in the developing of general and specific interventions for addressing obesity and overweight on the community level. Such interventions must be created for different age groups. In this regard, the period near retirement appears to play a significant role in weight gain.
Department/s
Publishing year
2013
Language
English
Publication/Series
Lund University Faculty of Medicine Doctoral Dissertation Series
Volume
2013:94
Document type
Dissertation
Publisher
Department of Clinical Sciences, Lund University
Topic
- Clinical Medicine
Keywords
- Overweight
- obesity
- socioeconomic inequality
- social gradient
- SES
- BMI
- social capital
- birth cohort
- ageing
- retirement
- Scania Public Health Cohort
- Sweden
Status
Published
Research group
- Social Medicine and Global Health
Supervisor
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-87449-66-6
Defence date
19 September 2013
Defence time
09:00
Defence place
CRC's Aula, ing 72, Skånes Universitetssjukhus i Malmö
Opponent
- Urban Janlert (Professor)