Social disadvantages associated with increased likelihood of obesity
Cumulative social disadvantages, indicated by higher score on a novel social determinants of health tool, were associated with increased odds for obesity, according to study results published in Obesity.
“Careful assessment of individuals’ social and environmental conditions that predispose them to poor health outcomes, including obesity and more distal cardiovascular outcomes, is essential for progressing toward evidence-based disease prevention,” Zulqarnain Javed, PhD, MPH, MBBS, senior fellow in the division of health equity and disparities research at the Center for Outcomes Research at Houston Methodist, and colleagues wrote. “Whereas traditional risk factors for obesity, such as unhealthy diet and physical inactivity, are well established, the role of social determinants of health is less well understood.”
Javed and colleagues collected data on 161,795 adults from the 2013-2017 National Health Interview Survey. The researchers developed a survey of 38 social determinants of health (SDOH) related to economic stability; neighborhood, physical environment and social cohesion; community and social context; food insecurity; education; and health care system. Each of the 38 determinants was rated as favorable or unfavorable, and the sum of unfavorable items yielded a score for SDOH. Scores were then divided into four quartiles to categorize levels of SDOH burden. The prevalence of overweight and obesity was analyzed across all quartiles in the total population and stratified by age, sex and race/ethnicity.
There was a 34% prevalence of overweight, 25% of obesity class 1 and 2, and 8% of obesity class 3 in the total population. As SDOH burden increased, so did obesity prevalence, with higher rates of overweight and obesity among middle-aged and non-Hispanic Black participants compared with their counterparts.
In addition, researchers noted differences when stratified by sex. Men had higher rates of overweight and obesity compared with women for each quartile for obesity class 1 and 2. However, women had higher rates of obesity class 3 in each quartile.
SDOH quartile 4 was associated with a 15% higher prevalence of overweight, 50% higher prevalence of obesity class 1 and 2, and 70% higher prevalence of obesity class 3 compared with quartile 1 in the fully adjusted model.
“Effective integration of SDOH into existing CV disease screening and management approaches may help identify socially vulnerable populations with a high burden of traditional CV risk factors; such efforts may reduce the overall burden of obesity, improve CV health outcomes on a population level, and advance the cause of health equity,” the researchers wrote.
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