Socioeconomic factors and obesity.

BACKGROUND It is already known from multiple studies that obesity is distributed along a socioeconomic gradient. In the present study, we attempt to determine the relative importance of three different status indicators: income, education, and occupational position. METHOD Data were drawn from the 2003 Telephone Health Survey in Germany (n = 8318), which yielded representative information on the resident population in Germany aged 18 and older. The socioeconomic variables studied were the net equivalent household income, the highest level of general education completed, and the autonomy of occupational activity as measured on the Hoffmeyer-Zlotnik scale. Age- and sex-specific prevalences of obesity were determined, and odds ratios with 95% confidence intervals were calculated by binary logistic regression. RESULTS In Germany in the year 2003, 17% of men and 20% of women aged 18 and older were obese. For men, both the highest level of general education completed and the individual's occupational position were found to have a significant effect on the prevalence of obesity, after statistical controls for the influence of age and the other two status indicators. In women, a statistically significant social gradient was found for all three status indicators. For example, women in the lowest income group were three times as likely to be obese as women in the highest income group. CONCLUSION The fight against obesity is a main goal of health-care policy because of its increasing prevalence and its contribution to the causation of many secondary diseases. The results reported here demonstrate that socioeconomic factors play an important role. These factors should be taken into account in the design of target-group-specific measures for the prevention and treatment of obesity.