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Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold

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  • Marcel Bilger
  • Eliza J. Kruger
  • Eric A. Finkelstein

Abstract

We combine two of the most widely used measures in the inequality and poverty literature, the concentration index and Foster–Greer–Thorbecke metric to the analysis of socioeconomic inequality in obesity. This enables us to describe socioeconomic inequality not only in obesity status but also in its depth and severity. We apply our method to 1971–2012 US data and show that while the socioeconomic inequality in obesity status has now almost disappeared, this is not the case when depth and severity of obesity are considered. Such socioeconomic gradient is found to be greatest among non‐Hispanic whites, but decomposition analysis also reveals an inverse relationship between income and obesity outcomes among Mexican Americans once the effect of immigrant status has been accounted for. The socioeconomic gradient is also greater among women with marital status further increasing it for severity of obesity while the opposite is true among men. Overall, the socioeconomic gradient exists as poorer individuals lie further away from the obesity threshold. Our study stresses the need for policies that jointly consider obesity and income to support those who suffer from the double burden of poverty and obesity‐related health conditions. © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.

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  • Marcel Bilger & Eliza J. Kruger & Eric A. Finkelstein, 2017. "Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold," Health Economics, John Wiley & Sons, Ltd., vol. 26(8), pages 1052-1066, August.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:8:p:1052-1066
    DOI: 10.1002/hec.3383
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    2. Bénédicte Apouey & David Madden, 2023. "Health poverty," Chapters, in: Jacques Silber (ed.), Research Handbook on Measuring Poverty and Deprivation, chapter 19, pages 202-211, Edward Elgar Publishing.
    3. Sinha, Kompal & Davillas, Apostolos & Jones, Andrew M. & Sharma, Anurag, 2021. "Do socioeconomic health gradients persist over time and beyond income? A distributional analysis using UK biomarker data," Economics & Human Biology, Elsevier, vol. 43(C).
    4. Khaled, Mohamad A. & Makdissi, Paul & Yazbeck, Myra, 2018. "Income-related health transfers principles and orderings of joint distributions of income and health," Journal of Health Economics, Elsevier, vol. 57(C), pages 315-331.
    5. French, Declan & Vigne, Samuel, 2019. "The causes and consequences of household financial strain: A systematic review," International Review of Financial Analysis, Elsevier, vol. 62(C), pages 150-156.
    6. Ousmane Traoré, 2021. "The relationship between health poverty and income poverty in Sub-Saharan African countries: evidence from index correlations," SN Business & Economics, Springer, vol. 1(10), pages 1-19, October.
    7. Hudomiet, Péter & Hurd, Michael D. & Rohwedder, Susann, 2021. "Forecasting mortality inequalities in the U.S. based on trends in midlife health," Journal of Health Economics, Elsevier, vol. 80(C).
    8. Mohamad A. Khaled & Paul Makdissi & Myra Yazbeck, 2023. "On absolute socioeconomic health inequality comparisons," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(1), pages 5-25, February.
    9. Davillas, Apostolos & de Oliveira, Victor Hugo & Jones, Andrew M., 2022. "Model of Errors in BMI Based on Self‐reported and Measured Anthropometrics with Evidence from Brazilian Data," CINCH Working Paper Series (since 2020) 76143, Duisburg-Essen University Library, DuEPublico.
    10. Mohamad A. Khaled & Paul Makdissi & Myra Yazbeck, 2018. "On the importance of the upside down test in absolute socioeconomic health inequality comparisons," Discussion Papers Series 600, School of Economics, University of Queensland, Australia.
    11. Cleary, Rebecca & Liu, Yizao & Carlson, Andrea C., 2022. "Differences in the Distribution of Nutrition Between Households Above and Below Poverty," 2022 Annual Meeting, July 31-August 2, Anaheim, California 322267, Agricultural and Applied Economics Association.
    12. Nancy Kong & Weina Zhou, 2021. "The curse of modernization? Western fast food and Chinese children's weight," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2345-2366, September.
    13. Nie, P. & Ding, L. & Jones, A.M., 2020. "Inequality of opportunity in bodyweight among middle-aged and older Chinese: a distributional approach," Health, Econometrics and Data Group (HEDG) Working Papers 20/14, HEDG, c/o Department of Economics, University of York.
    14. Athina Raftopoulou & Joan Gil Trasfi, 2024. "Income-related inequality in obesity and its determinants in Spain: What happens beyond the obesity threshold?," International Journal of Health Economics and Management, Springer, vol. 24(1), pages 135-153, March.
    15. Mohamad A. Khaled & Paul Makdissi & Rami V. Tabri & Myra Yazbeck, 2018. "A framework for testing the equality between the health concentration curve and the 45‐degree line," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 887-896, May.
    16. Khalid Abu-Ismail & Verena Gantner & Paul Makdissi & Myra Yazbeck, 2020. "Socioeconomic inequalities in child malnutrition in Egypt," METRON, Springer;Sapienza Università di Roma, vol. 78(2), pages 175-191, August.
    17. Sarah Tougher & Kara Hanson & Catherine A. Goodman, 2021. "Does subsidizing the private for‐profit sector benefit the poor? Evidence from national antimalarial subsidies in Nigeria and Uganda," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2510-2530, September.

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