RESEARCH REPORT

Wider income gaps, wider waistbands? An ecological study of obesity and income inequality

Kate E Pickett¹, Shona Kelly², Eric Brunner³, Tim Lobstein⁴, Richard G Wilkinson²

¹ Department of Health Sciences, University of York, UK
² Division of Epidemiology and Public Health, University of Nottingham, UK
³ Department of Epidemiology and Public Health, University College London, UK
⁴ International Obesity TaskForce, UK

Correspondence to:
Correspondence to:
Dr K E Pickett
Department of Health Sciences, University of York, Seebohm Rowntree Building, Area 3, Heslington, York YO10 5DD, UK; kp6{at}york.ac.uk

Objectives: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries.

Design: Ecological study of 21 developed countries.

Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures.

Main outcome measures: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day.

Results: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake.

Conclusions: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society.

Abbreviations: BMI, body mass index; GNI, gross national income

Keywords: income inequality; obesity; socioeconomic factors

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