1. Cohort-based income gradients in obesity among U.S. adults
- Author
-
Enrico A. Marcelli, Audrey N. Beck, Suzanne P. Lindsay, Jongho Heo, Brian Karl Finch, and Shih-Fan Lin
- Subjects
Adult ,Male ,Cross-sectional study ,Ethnic group ,Psychological intervention ,030209 endocrinology & metabolism ,Social class ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Sex Factors ,Risk Factors ,Genetics ,Medicine ,Humans ,030212 general & internal medicine ,Obesity ,Socioeconomic status ,Ecology, Evolution, Behavior and Systematics ,Aged ,business.industry ,Middle Aged ,medicine.disease ,Nutrition Surveys ,United States ,Cross-Sectional Studies ,Social Class ,Socioeconomic Factors ,Anthropology ,Cohort ,Income ,Female ,Anatomy ,business ,Demography ,Cohort study - Abstract
Objectives No studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth-cohorts (inter-cohort variations) and within each birth-cohort (intra-cohort variations) by gender and race/ethnicity. Methods Our sample includes 56,820 white and black adults from pooled, cross-sectional National Health and Nutrition Examination Surveys (1971-2012). We fit a series of logistic hierarchical Age-Period-Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty-to-income ratio were estimated and graphed for 5-year cohort groups from 1901-1990. We also stratified this relationship for four gender and racial/ethnic subgroups. Results Obesity disparities due to income were weaker for post-World War I and II generations, specifically the mid-1920s and the mid-1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid-1940s and mid-1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts. Conclusions Our findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period-based approaches that ignore life-course experiences captured in significant cohort-based experiences may limit the utility of policies and interventions.
- Published
- 2017