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Introduction: Prior cross-national studies of socioeconomic inequalities in obesity have only compared summary indices of inequality but not specific, policy-relevant dimensions of inequality: (a) shape of the socioeconomic gradient in obesity, (b) magnitude of differentials in obesity across socioeconomic levels and, (c) level of obesity at any given socioeconomic level. We use unique data on two highly comparable societies - U.S. and Canada - to contrast each of these inequality dimensions. Methods: Data came from the 2002/2003 Joint Canada/U.S. Survey of Health. We calculated adjusted prevalence ratios (APRs) for obesity (compared to normal weight) by income quintile and education group separately for both nations and, between Canadians and Americans in the same income or education group. Results: In the U.S., every socioeconomic group except the college educated had significant excess prevalence of obesity. By contrast in Canada, only those with less than high school were worse off, suggesting that the shape of the socioeconomic gradient differs in the two countries. U.S. differentials between socioeconomic levels were also larger than in Canada (e.g., PR quintile 1 compared to quintile 5 was 1.82 in the U.S. [95 % CI: 1.52-2.19] but 1.45 in Canada [95 % CI: 1.10-1.91]). At the lower end of the socioeconomic gradient, obesity was more prevalent in the U.S. than in Canada. Conclusions: Our results suggest there is variation between U.S. and Canada in different dimensions of socioeconomic inequalities in obesity. Future research should examine a broader set of nations and test whether specific policies or environmental exposures can explain these differences. [ABSTRACT FROM AUTHOR]

Background: Food banks are a common community-based response to household food insecurity in high-income countries. While the profile of their users and nature of the quality of food they provide have been researched, few studies have examined their operational characteristics to explore the accessibility of their services for people at risk of food insecurity. This study describes the nature of operations in a food bank network operating in Britain and explores how operations are associated with volume of use.Methods: Data from The Trussell Trust Foodbank's network of 1145 distribution centres in 2015/16 on hours of operation, locations, and usage were combined with national statistics on Working Tax Credit claimants, disability and unemployment. Descriptive statistics focused on how often and when food banks were open within local authorities. The relationships between operational characteristics and volume of use were examined using regression analyses. Interaction terms tested how relationships between indicators of need with food bank usage changed with operational characteristics.Results: Weekday operating hours were primarily between the hours of 10 a.m. and 2 p.m., but at any given hour no more than 20% of distribution centres were open, with fewer than 3% open after 4 pm. Where food banks had fewer distribution centres and operating hours, the volume of food bank usage was lower. In-work poverty, disability, and unemployment rates were all associated with higher volume of usage; however, the relationship between disability and food bank use was modified by the density of food banks and number of operating hours. Where food banks were less accessible, the relationship between disability and food bank use was diminished.Conclusions: These findings suggest operational characteristics are an important part of access to food banks and raise questions about the ability of food banks to meet the needs of people at risk of food insecurity in Britain. [ABSTRACT FROM AUTHOR]