Elsevier

Preventive Medicine

Volume 26, Issue 5, September 1997, Pages 734-744
Preventive Medicine

Regular Article
Determinants of Obesity in Relation to Socioeconomic Status among Middle-Aged Swedish Women☆,☆☆

https://doi.org/10.1006/pmed.1997.0199Get rights and content

Abstract

Background.It has been previously demonstrated that obesity is common among women with low socioeconomic status (SES), but the factors accounting for this association are not well known. According to our hypothesis, low SES is associated with psychosocial stress, an unhealthy lifestyle, and reproductive history, which may increase the likelihood of women with low SES to be overweight or obese.

Methods.We examined overweight and obesity in relation to SES among 300 healthy women ages 30–65 years, who constitute the control group of the Stockholm Female Coronary Risk Study, a population-based case–control study of women with coronary heart disease. This control group was compared with a large population-based sample and found to be representative of healthy Swedish women ages 30–65 years. We used an aggregate of education and occupation as a measure of SES and defined overweight as body mass index (BMI) between 23.8 and 28.6 kg/m2and obesity as BMI > 28.6 kg/m2

Results.Low SES was a strong determinant of overweight and obesity among middle-aged healthy Swedish women. The odds of being overweight or obese increased with lower social position. After adjustment for age, the odds ratios for overweight and obesity among women in a low vs high position were 2.2 [95% confidence interval (CI) 1.1 to 4.4) and 2.7 (95% CI 1.1 to 6.7), respectively. Both low social position and obesity were related to reproductive history (higher parity and earlier age at menarche), unhealthy dietary habits, and unfavorable psychosocial factors (poor quality of life, low self-esteem, and job strain). These factors together explained 53% of the low-SES-obesity association.

Conclusions.Reproductive history, unhealthy dietary habits, and psychosocial stress accounted for a large part of the association between low SES and obesity. Dietary habits and psychosocial stress are potentially modifiable factors, which should be taken into account in intervention programs among women with low SES.

References (62)

  • PJ Brown et al.

    An anthropological perspective on obesity

    Ann N Y Acad Sci

    (1987)
  • E Messer

    Small but healthy? Some cultural considerations

    Hum Org

    (1989)
  • J Sobal

    Obesity and socioeconomic status: a framework for examining relationships between physical and social variables

    Med Anthropol

    (1991)
  • J Sobal et al.

    Socioeconomic status and obesity: a review of the literature

    Psychol Bull

    (1989)
  • A Kuskowska-Wolk et al.

    Prevalence of obesity in Sweden: cross sectional study of a representative adult population

    J Intern Med

    (1990)
  • A Kuskowska-Wolk et al.

    Trends in body mass index and prevalence of obesity in Swedish women 1980–1989

    J Epidemiol Community Health

    (1993)
  • BK Jacobsen et al.

    Risk factors for coronary heart disease and level of education: the Tromsö – Heart Study

    Am J Epidemiol

    (1988)
  • RW Jeffrey et al.

    Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project

    Int J Obes

    (1991)
  • JP Leigh et al.

    Gender and race differences in the correlation between body mass and education in the 1971–1975 NHANES I

    J Epidemiol Community Health

    (1992)
  • A Tavani et al.

    Determinants of body mass index: a study from Northern Italy

    Int J Obes

    (1994)
  • H Noppa et al.

    Obesity in relation to socioeconomic status: a population based study of women in Göteborg, Sweden

    J Epidemiol Community Health

    (1980)
  • GL Burke et al.

    Correlates of obesity in younger black and white women: the CARDIA Study

    Am J Public Health

    (1992)
  • RW Jeffery et al.

    The relationship between social status and body mass index in the Minnesota Heart Health Program

    Int J Obes

    (1989)
  • JB Croft et al.

    Socioeconomic and behavioural correlates of obesity in black adults: the Pitti County Study

    Am J Public Health

    (1992)
  • MC Shewry et al.

    Variation in coronary risk factors by social status: results from the Scottish Heart Healthy Study

    Br J Gen Pract

    (1992)
  • RV Luepker et al.

    Socioeconomic status and coronary heart disease risk factor trends: the Minnesota Heart Survey

    Circulation

    (1993)
  • KM Felgal et al.

    Secular trends in body mas index and skin fold thickness with socioeconomic factors in young adult women

    Am J Clin Nutr

    (1988)
  • SM Dornbusch et al.

    Sexual maturation, social class, and the desire to be thin among adolescent females

    J Dev Behav Pediatr

    (1984)
  • M Garn et al.

    Educational level, fatness and fatness differences between husbands and wives

    Am J Clin Nutr

    (1989)
  • L Rodin et al.

    Women and weight: a normative discontent

    Nebraska symposium on motivation, psychology and gender

    (1986)

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    ☆

    This work was supported by Grant HL45785 from the U.S. National Institutes of Health, by Grant B93-19X-10407 from the Swedish Medical Research Council, and by a grant from the Swedish Labor Market Insurance Company.

    ☆☆

    T, B, Sonderegger, editor

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