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. 2017 May 8;14(1):63.
doi: 10.1186/s12966-017-0517-8.

Trends in educational inequalities in obesity in 15 European countries between 1990 and 2010

Kristina Hoffmann  1   2 , Rianne De Gelder  1 , Yannan Hu  1 , Matthias Bopp  3 , Jozsef Vitrai  4 , Eero Lahelma  5 , Gwenn Menvielle  6 , Paula Santana  7 , Enrique Regidor  8 , Ola Ekholm  9 , Johan P Mackenbach  1 , Frank J van Lenthe  10
Affiliations

Trends in educational inequalities in obesity in 15 European countries between 1990 and 2010

Kristina Hoffmann et al. Int J Behav Nutr Phys Act. .

Abstract

Background: The prevalence of obesity increased dramatically in many European countries in the past decades. Whether the increase occurred to the same extent in all socioeconomic groups is less known. We systematically assessed and compared the trends in educational inequalities in obesity in 15 different European countries between 1990 and 2010.

Methods: Nationally representative survey data from 15 European countries were harmonized and used in a meta-regression of trends in prevalence and educational inequalities in obesity between 1990 and 2010. Educational inequalities were estimated by means of absolute rate differences and relative rate ratios in men and women aged 30-64 years.

Results: A statistically significant increase in the prevalence of obesity was found for all countries, except for Ireland (among men) and for France, Hungary, Italy and Poland (among women). Meta-regressions showed a statistically significant overall increase in absolute inequalities of 0.11% points [95% CI 0.03, 0.20] per year among men and 0.12% points [95% CI 0.04, 0.20] per year among women. Relative inequalities did not significantly change over time in most countries. A significant reduction of relative inequalities was found among Austrian and Italian women.

Conclusion: The increase in the overall prevalence aligned with a widening of absolute but not of relative inequalities in obesity in many European countries over the past two decades. Our findings urge for a further understanding of the drivers of the increase in obesity in lower education groups particularly, and an equity perspective in population-based obesity prevention strategies.

Keywords: Health inequalities; Obesity; Time trends.

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Figures

Fig. 1
Fig. 1
Forest plot of meta-regression slopes for trends in prevalence of total obesity (BMI ≥30 kg/m2) in (a) men and (b) women. ES, effect estimator (% points change of obesity prevalence per year); CI, confidence interval
Fig. 2
Fig. 2
Prevalence (%) of obesity (BMI ≥30 kg/m2) over time in (a) men and (b) women aged 30–64 in all countries stratified by educational level (ISCED 0–2, ISCED 3–4, ISCED 5–6)
Fig. 3
Fig. 3
Forest plot of meta-regression slopes for trends in absolute inequality in obesity prevalence (BMI ≥30 kg/m2) in (a) men and (b) women. RD, rate difference between low and high educational level; ES, effect estimator (% points change of absolute inequalities in obesity per year); CI, confidence interval
Fig. 4
Fig. 4
Forest plot of meta-regression slopes for trends in relative inequality in obesity prevalence (BMI ≥30 kg/m2) in (a) men and (b) women. RR, rate ratio between low and high educational level; ES, effect estimator (relative change of relative inequalities in obesity per year); CI, confidence interval
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