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Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Aug 2005; 59(8): 670–674.
PMCID: PMC1733121

Wider income gaps, wider waistbands? An ecological study of obesity and income inequality


Objectives: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries.

Design: Ecological study of 21 developed countries.

Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures.

Main outcome measures: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day.

Results: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake.

Conclusions: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society.

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Selected References

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  • Flegal Katherine M, Carroll Margaret D, Ogden Cynthia L, Johnson Clifford L. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002 Oct 9;288(14):1723–1727. [PubMed]
  • Nishida Chizuru, Uauy Ricardo, Kumanyika Shiriki, Shetty Prakash. The joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases: process, product and policy implications. Public Health Nutr. 2004 Feb;7(1A):245–250. [PubMed]
  • Kimm SY, Obarzanek E, Barton BA, Aston CE, Similo SL, Morrison JA, Sabry ZI, Schreiber GB, McMahon RP. Race, socioeconomic status, and obesity in 9- to 10-year-old girls: the NHLBI Growth and Health Study. Ann Epidemiol. 1996 Jul;6(4):266–275. [PubMed]
  • Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev. 2004 May;5 (Suppl 1):4–104. [PubMed]
  • Björntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obes Rev. 2001 May;2(2):73–86. [PubMed]
  • Dallman Mary F, Pecoraro Norman, Akana Susan F, La Fleur Susanne E, Gomez Francisca, Houshyar Hani, Bell ME, Bhatnagar Seema, Laugero Kevin D, Manalo Sotara. Chronic stress and obesity: a new view of "comfort food". Proc Natl Acad Sci U S A. 2003 Sep 30;100(20):11696–11701. [PMC free article] [PubMed]
  • Drapeau V, Therrien F, Richard D, Tremblay A. Is visceral obesity a physiological adaptation to stress? Panminerva Med. 2003 Sep;45(3):189–195. [PubMed]
  • Brunner E, Juneja M, Marmot M. Abdominal obesity and disease are linked to social position. BMJ. 1998 Jan 24;316(7127):308–309. [PMC free article] [PubMed]
  • Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K. Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA Project. Am J Public Health. 2000 Aug;90(8):1260–1268. [PMC free article] [PubMed]
  • Subramanian SV, Kawachi Ichiro. Income inequality and health: what have we learned so far? Epidemiol Rev. 2004;26:78–91. [PubMed]
  • Kahn HS, Tatham LM, Pamuk ER, Heath CW., Jr Are geographic regions with high income inequality associated with risk of abdominal weight gain? Soc Sci Med. 1998 Jul;47(1):1–6. [PubMed]
  • Diez-Roux AV, Link BG, Northridge ME. A multilevel analysis of income inequality and cardiovascular disease risk factors. Soc Sci Med. 2000 Mar;50(5):673–687. [PubMed]
  • Nielsen Samara Joy, Siega-Riz Anna Maria, Popkin Barry M. Trends in energy intake in U.S. between 1977 and 1996: similar shifts seen across age groups. Obes Res. 2002 May;10(5):370–378. [PubMed]
  • Prentice AM, Jebb SA. Fast foods, energy density and obesity: a possible mechanistic link. Obes Rev. 2003 Nov;4(4):187–194. [PubMed]
  • Goodman Elizabeth. Letting the "Gini" out of the bottle: social causation and the obesity epidemic. J Pediatr. 2003 Mar;142(3):228–230. [PubMed]

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