Socioeconomic inequalities in obesity during 2006-2017 in Spain: An outcome-wide epidemiology approach

Abstract

Abstract Purpose: In Western developed countries, people living in less affluent circumstances are more likely to have obesity, while individuals in the upper socioeconomic strata are in a better position to protect themselves against this medical condition. The current study used the Spanish National Health Survey during 2006-2017 to investigate trends between men and women in the socioeconomic patterns of obesity in Spain from an outcome-wide epidemiology approach. Methods: The data came from the 2006, 2011, and 2017 Spanish National Health Surveys. The Spanish National Health Surveys are nationally representative surveys with a stratified multistage design. Sample sizes were 29,478 in 2006, 20,884 in 2011, and 22,903 in 2017, with a total sample size of 73,265 individuals. Results: A statistically significant increase of obesity (men 15.39% vs. 18.11%, women 13.38% vs. 16.11%, p <.001) was observed in the three years analyzed (2006, 2011, and 2017). The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) showed that obesity was mainly concentrated in individuals from lower social strata. Both indices were higher in women than in men in the three years analyzed and these inequalities increased significantly during the studied period (RII p for trend: .009, SII p for trend <.001). Conclusion: The current research shows the presence of socioeconomic inequalities in obesity in Spain during the years between 2006 and 2017. Obesity was mainly concentrated in disadvantaged social classes. Level of evidence: Level V, descriptive cross-sectional survey