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Abstract
This study examines the association between state and county unemployment rates and individuals’ body weight status during the latest recession in the U.S. We used the U.S. Behavioral Risk Factor Surveillance System (BRFSS) data in 2007, 2009 and 2011, which were collected from 722,692 American adults aged 18 or older. Overweight and obesity were defined as body mass index (BMI) ≥25, and ≥30, respectively. Multivariate linear and logistic regressions were applied to assess the association between BMI, risks of overweight and obesity, and state and county unemployment rates. State unemployment rates were negatively associated with individual BMI across years, while county unemployment rates were significantly positively associated with BMI and obesity rates in all years (p < 0.05). However, the scale of the positive relationship was reduced in 2009 and 2011. Stratified analyses were conducted among adults with employment and without employment. The unemployed group’s body weight status was not related to state- and county-level economic conditions in most times. In the pooled analyses with all three years’ data, the relationship between unemployment rates and body weight status were consistently reduced after the recession of 2008–2009. Our results indicated that macroeconomic conditions at different levels can have different associations with individuals’ obesity risk across time.
Highlights
The scale, length and depth of the latest economic recession has exceeded all recessions since theGreat Depression [1]
To provide more evidence to clarify the associations between economic conditions and obesity, we examined the associations between obesity and state or county unemployment rates using cross-sectional waves of the Behavioral Risk Factor Surveillance
Comparing the associations of unemployment rates with individual body weight status during, before and after the economic recession of 2008–2009, we found the following patterns: First, the positive relationship between the county unemployment rates and body weight status was reduced after the economic recession; Second, the reduction of the relationship between state unemployment rates and body weight status after the recession was more evident among women and the employed adults; Lastly, little significant relationship was found among the unemployed adults, and this pattern did not change after the recession
Summary
The scale, length and depth of the latest economic recession has exceeded all recessions since theGreat Depression [1]. The U.S economy reached its worst level in 26 years, while the national unemployment rate reached 9.3% in 2009, a 60.3% jump from the previous year [2] This prolonged recession will further increase unemployment and poverty, potentially resulting in significant health consequences affecting millions of Americans [3,4]. Earlier studies have demonstrated the negative impact of economic recessions on general health outcomes. Brenner demonstrated this association with time-series studies, observing increases in psychiatric hospital admission, infant mortality rates and deaths in recessions due to cardiovascular disease, cirrhosis, suicide and homicide [5,6,7]. Gerdtham and Johannsson found a highly significant effect of unemployment on mortality [9]
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