Socioeconomic – related inequalities in overweight and obesity: findings from the PERSIAN cohort study

1Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. sh-soltani@alumnus.tums.ac.ir.

4Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. sh-soltani@alumnus.tums.ac.ir.

5School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada.

6Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

7Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

8Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

9Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

10Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

11Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

12Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

13Dept. of Neurology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

14Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

15Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical sciences, Tabriz, Iran.

16Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.

17Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.

18Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.

19Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.

20Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.

21Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

22Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

23Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

bmc public health

Abstract

Background: Overweight and obesity are major health concerns worldwide, with adverse health consequences during the life span. This study measured socioeconomic inequality in overweight and obesity among Iranian adults.

Methods: Data were extracted from 129,257 Iranian adults (aged 35 years and older) participated in the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) in 14 provinces of Iran in 2014. Socioeconomic-related inequality in overweight and obesity was estimated using the Concentration Index (Cn). The Cn further decomposed to find factors explaining the variability within the Socioeconomic related inequality in overweight and obesity.

Results: Of the total number of participants, 1.98, 26.82, 40.76 and 30.43% had underweight, normal weight, overweight and obesity respectively. The age-and sex standardized prevalence of obesity was higher in females than males (39.85% vs 18.79%). People with high socioeconomic status (SES) had a 39 and 15% higher chance of being overweight and obese than low SES people, respectively. The positive value of Cn suggested a higher concentration of overweight (0.081, 95% confidence interval [CI]; 0.074-0.087) and obesity (0.027, 95% CI; 0.021-0.034) among groups with high SES. There was a wide variation in socioeconomic-related inequality in overweight and obesity rate across 14 provinces. The decomposition results suggested that SES factor itself explained 66.77 and 89.07% of the observed socioeconomic inequalities in overweight and obesity among Iranian adults respectively. Following SES, province of residence, physical activity, using hookah and smoking were the major contributors to the concentration of overweight and obesity among the rich.

Conclusions: Overall, we found that overweight and obesity is concentrated among high SES people in the study population. . Accordingly, it seems that intersectional actions should be taken to control and prevent overweight and obesity among higher socioeconomic groups.

Keywords: Concentration index; Inequality; Iran; PERSIAN; Socioeconomic Factors; overweight and obesity.

How to Cite

Najafi F, Soltani S, Karami Matin B, Kazemi Karyani A, Rezaei S, Soofi M, Salimi Y, Moradinazar M, Hajizadeh M, Barzegar L, Pasdar Y, Hamzeh B, Haghdoost AA, Malekzadeh R, Poustchi H, Eghtesad S, Nejatizadeh A, Moosazadeh M, Zare Sakhvidi MJ, Joukar F, Hashemi-Shahri SM, Vakilian A, Niknam R, Faramarzi E, Akhavan Akbari G, Ghorat F, Khaledifar A, Vahabzadeh D, Homayounfar R, Safarpour AR, Hosseini SV, Rezvani R, Hosseini SA. Socioeconomic – related inequalities in overweight and obesity: findings from the PERSIAN cohort study. BMC Public Health. 2020 Feb 11;20(1):214. doi: 10.1186/s12889-020-8322-8. PMID: 32046684; PMCID: PMC7014739.