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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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    1. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    2. Costa-Font, Joan & Gil, Joan, 2008. "What lies behind socio-economic inequalities in obesity in Spain A decomposition approach," Food Policy, Elsevier, vol. 33(1), pages 61-73, February.
    3. Foster, James & Greer, Joel & Thorbecke, Erik, 1984. "A Class of Decomposable Poverty Measures," Econometrica, Econometric Society, vol. 52(3), pages 761-766, May.
    4. Lakdawalla, Darius & Philipson, Tomas, 2009. "The growth of obesity and technological change," Economics & Human Biology, Elsevier, vol. 7(3), pages 283-293, December.
    5. Bilger, Marcel & Carrieri, Vincenzo, 2013. "Health in the cities: When the neighborhood matters more than income," Journal of Health Economics, Elsevier, vol. 32(1), pages 1-11.
    6. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    7. David Madden, 2012. "A profile of obesity in Ireland, 2002–2007," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(4), pages 893-914, October.
    8. Andrew M. Jones (ed.), 2012. "The Elgar Companion to Health Economics, Second Edition," Books, Edward Elgar Publishing, number 14021.
    9. Adam Wagstaff & Marcel Bilger & Zurab Sajaia & Michael Lokshin, 2011. "Health Equity and Financial Protection : Streamlined Analysis with ADePT Software," World Bank Publications - Books, The World Bank Group, number 2306.
    10. Jolliffe, Dean, 2011. "Overweight and poor? On the relationship between income and the body mass index," Economics & Human Biology, Elsevier, vol. 9(4), pages 342-355.
    11. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
    12. Finkelstein, Eric A. & Zhen, Chen & Bilger, Marcel & Nonnemaker, James & Farooqui, Assad M. & Todd, Jessica E., 2013. "Implications of a sugar-sweetened beverage (SSB) tax when substitutions to non-beverage items are considered," Journal of Health Economics, Elsevier, vol. 32(1), pages 219-239.
    13. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    14. Cawley, John & Meyerhoefer, Chad, 2012. "The medical care costs of obesity: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 31(1), pages 219-230.
    15. Dean Jolliffe, 2004. "Continuous and robust measures of the overweight epidemic: 1971–2000," Demography, Springer;Population Association of America (PAA), vol. 41(2), pages 303-314, May.
    16. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    17. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
    18. Robert A. Pollak, 2005. "Bargaining Power in Marriage: Earnings, Wage Rates and Household Production," NBER Working Papers 11239, National Bureau of Economic Research, Inc.
    19. Ruhm Christopher J, 2007. "Current and Future Prevalence of Obesity and Severe Obesity in the United States," Forum for Health Economics & Policy, De Gruyter, vol. 10(2), pages 1-28, September.
    20. Shelly J. Lundberg & Robert A. Pollak & Terence J. Wales, 1997. "Do Husbands and Wives Pool Their Resources? Evidence from the United Kingdom Child Benefit," Journal of Human Resources, University of Wisconsin Press, vol. 32(3), pages 463-480.
    21. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
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    3. 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.
    4. 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.
    5. Apostolos Davillas & Victor Hugo Oliveira & Andrew M. Jones, 2024. "A model of errors in BMI based on self-reported and measured anthropometrics with evidence from Brazilian data," Empirical Economics, Springer, vol. 67(5), pages 2371-2410, November.
    6. 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.
    7. 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.
    8. 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.
    9. Nie, Peng & Ding, Lanlin & Jones, Andrew M., 2020. "Inequality of Opportunity in Bodyweight among Middle-Aged and Older Chinese: A Distributional Approach," IZA Discussion Papers 13421, Institute of Labor Economics (IZA).
    10. 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.
    11. 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).
    12. 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.
    13. 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.
    14. 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).
    15. 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.
    16. 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.
    17. 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.

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