Pronounced social inequality in health-related factors and quality of life in women and men from Austria who are overweight or obese

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Abstract

Background

The burden of social inequalities in health as well as the association between obesity with morbidity and mortality is a worldwide problem. Therefore, the aim of our study was to investigate health-related factors, health, and quality of life in Austrian women and men with normal weight, overweight, and obesity with a different socioeconomic status (SES) based on actual data from 2015.

Methods

This representative population-based study was based on self-reported data of 15,338 Austrian adults (8,425 women and 6,933 men) in 2014/2015. Data of the Austrian Health Interview Survey was analyzed stratified by sex and adjusted for age concerning health-related behavior, health, and quality of life.

Results

The results have shown that people with a low SES differ significantly from those of high SES concerning health-related factors (e.g., eating behavior, physical activity), health and impairment due to chronic conditions, as well as quality of life. Obesity in women and men was associated with poorer health-related factors and more chronic conditions as well as unfavorable psychological aspects. In women, the results showed a significant body mass index*SES interaction for impairment due to disorders, the number of chronic conditions and quality of life in the domain of physical health. In men, the interaction was significant regarding alcohol consumption, as well as health impairment. The SES has a strong negative impact on health which implies that people of low SES have more health problems which especially concerns individuals who are obese. Therefore, a continuous target group-oriented, non-discriminatory, interdisciplinary public health program is required, prioritizing women, and men with obesity with a low SES.

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Most cited references 38

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Social inequalities in obesity and overweight in 11 OECD countries.

Franco Sassi, M A Devaux (2013)

Evidence of inequalities in obesity and overweight is available mostly from national studies. This article provides a broad international comparison of inequalities by education level and socio-economic status, in men and women and over time. Data from national health surveys of 11 OECD countries were used. The size of inequalities was assessed on the basis of absolute and relative inequality indexes. A regression-analysis approach was used to assess differences between social groups in trends over time. Of the countries examined, USA and England had the highest rates of obesity and overweight. Large social inequalities were consistently detected in all countries, especially in women. Absolute inequalities were largest in Hungary and Spain with a difference of 11.6 and 10% in obesity rates in men, and 18.3 and 18.9% in women, respectively, across the education spectrum. Relative inequalities were largest in France and Sweden with poorly educated men 3.2 and 2.8 times as likely to be obese as men with the highest education (18 and 17 times for women in Spain and Korea, respectively). Pro-poor inequalities in overweight were observed for men in USA, Canada, Korea, Hungary, Australia and England. Inequalities remained virtually stable during the last 15 years, with only small variations in England, Korea, Italy and France. Large and persistent social inequalities in obesity and overweight by education level and socio-economic status exist in OECD countries. These are consistently larger in women than in men.

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Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults.

Paula M Lantz, Ezra Golberstein, James S. House … (2010)

Many demographic, socioeconomic, and behavioral risk factors predict mortality in the United States. However, very few population-based longitudinal studies are able to investigate simultaneously the impact of a variety of social factors on mortality. We investigated the degree to which demographic characteristics, socioeconomic variables and major health risk factors were associated with mortality in a nationally-representative sample of 3617 U.S. adults from 1986 to 2005, using data from the 4 waves of the Americans' Changing Lives study. Cox proportional hazard models with time-varying covariates were employed to predict all-cause mortality verified through the National Death Index and death certificate review. The results revealed that low educational attainment was not associated with mortality when income and health risk behaviors were included in the model. The association of low income with mortality remained after controlling for major behavioral risks. Compared to those in the "normal" weight category, neither overweight nor obesity was significantly associated with the risk of mortality. Among adults age 55 and older at baseline, the risk of mortality was actually reduced for those were overweight (hazard rate ratio = 0.83) and those who were obese (hazard rate ratio = 0.68), controlling for other health risk behaviors and health status. Having a low level of physical activity was a significant risk factor for mortality (hazard rate ratio = 1.58). The results from this national longitudinal study underscore the need for health policies and clinical interventions focusing on the social and behavioral determinants of health, with a particular focus on income security, smoking prevention/cessation, and physical activity. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status

Jens Hoebel, Ulrike Maske, Hajo Zeeb … (2017)

Background There is substantial evidence that lower objective socioeconomic status (SES)—as measured by education, occupation, and income—is associated with a higher risk of depression. Less is known, however, about associations between perceptions of social status and the prevalence of depression. This study investigated associations of both objective SES and subjective social status (SSS) with depressive symptoms among adults in Germany. Methods Data were obtained from the 2013 special wave of the German Health Update study, a national health survey of the adult population in Germany. Objective SES was determined using a composite index based on education, occupation, and income. The three single dimensions of the index were also used individually. SSS was measured using the MacArthur Scale, which asks respondents to place themselves on a 10-rung ‘social ladder’. Regression models were employed to examine associations of objective SES and SSS with current depressive symptoms, as assessed with the eight-item Patient Health Questionnaire depression scale (PHQ-8 sum score ≥10). Results After mutual adjustment, lower objective SES and lower SSS were independently associated with current depressive symptoms. The associations were found in both sexes and persisted after further adjustment for sociodemographic factors, long-term chronic conditions, and functional limitations. Mediation analyses revealed a significant indirect relationship between objective SES and depressive symptoms through SSS. When the three individual dimensions of objective SES were mutually adjusted, occupation and income were independently associated with depressive symptoms. After additional adjustment for SSS, these associations attenuated but remained significant. Conclusions The findings suggest that perceptions of low social status in adults may be involved in the pathogenesis of depression and play a mediating role in the relationship between objective SES and depressive symptoms. Prospective studies are needed to establish the direction of effects and to address questions of causality.

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Author and article information

Contributors

Wolfgang Freidl

Journal

Journal ID (nlm-ta): PeerJ

Journal ID (iso-abbrev): PeerJ

Journal ID (pmc): PeerJ

Journal ID (publisher-id): PeerJ

Title: PeerJ

Publisher: PeerJ Inc. (San Diego, USA )

ISSN (Electronic): 2167-8359

Publication date (Electronic): 7 May 2019

Publication date Collection: 2019

Volume: 7

Electronic Location Identifier: e6773

Affiliations

Institute of Social Medicine and Epidemiology, Medical University Graz , Graz, Austria

Article

Publisher ID: 6773

DOI: 10.7717/peerj.6773

PMC ID: 6510219

PubMed ID: 31119069

SO-VID: fa7a4a4a-e38b-4d0d-a2fa-2ebba3ccc073

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

History

Date received : 6 November 2018

Date accepted : 13 March 2019

Funding

The authors received no funding for this work.

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Pronounced social inequality in health-related factors and quality of life in women and men from Austria who are overweight or obese

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Most cited references 38

Social inequalities in obesity and overweight in 11 OECD countries.

Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults.

Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status

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