Role of educational level in the relationship between Body Mass Index (BMI) and health-related quality of life (HRQL) among rural Spanish women

María José García-Mendizábal,Gonzalo López-Abente,Fernando Rodríguez-Artalejo,José Miguel Carrasco,Pilar Guallar-Castillón,Beatriz Pérez-Gómez,Nuria Aragonés,Marina Pollán

doi:10.1186/1471-2458-9-120

Abstract

BackgroundThe impact of obesity on health-related quality of life (HRQL) has been little explored in rural areas. The goal of this study is to ascertain the association between obesity and HRQL among Spanish women living in a rural area, and the influence of their educational level.MethodsCross-sectional study with personal interview of 1298 women (aged 18 to 60) randomly selected from the electoral rolls of 14 towns in Galicia, a region in the north-west of Spain. HRQL was assessed using the SF-36 questionnaire. The association between body mass index (BMI) and suboptimal scores in the different HRQL dimensions was summarised using odds ratios (ORs), obtained from multivariate logistic regression models. Separate analyses were conducted for women who had finished their education younger than 16 years old and women with secondary education to assess differences in the relationship between BMI and HRQL according to educational level.ResultsAmong women with primary or lower education, obesity was associated with a higher prevalence of suboptimal values in the following dimensions: Physical functioning (OR: 1.97; 95%CI: 1.22–3.18); Role-physical (OR: 1.81; 95%CI: 1.04–3.14); General health (OR: 1.76; 95%CI: 1.10–2.81); and Role-emotional (OR: 2.52; 95%CI: 1.27–5.03). In women with higher education, physical functioning was the only dimension associated with obesity (OR: 2.02: 95%CI 0.83–4.97).ConclusionThe impact of obesity on women's HRQL is greater among those with a lower educational level. This group registered higher prevalence of obesity and poorer self-perceived health.

Highlights

The impact of obesity on health-related quality of life (HRQL) has been little explored in rural areas
This study aims to examine the association between obesity and HRQL in women residing in a rural area of Galicia, a region in the north-west of Spain having one of the highest prevalences of obesity in the country [28] and whether this association varies in accordance with these women's educational level
No differences in HRQL scores were observed between the two areas covered by this study, except in perceived mental health, which appeared to be worse among women from coastal towns

Summary

Introduction

The impact of obesity on health-related quality of life (HRQL) has been little explored in rural areas. Obesity is a multifactorial disorder stemming from the interaction between genetic and metabolic factors on the one hand, and nutritional lifestyles and physical activity on the other, both of which are, in turn, conditioned by social, behavioural and cultural factors. It constitutes a major and increasing public health problem worldwide [1]. Available data show that the prevalence of obesity rose from 1987 to 2003 across all groups of women, those with higher education registered the lowest increase, going from 3.9% in 1987 to 5.6% in 2003. This was in contrast to women without any formal education, among whom the prevalence of obesity, ascertained with reported measures, rose from 13.5% in 1987 to an alarming 27.8% in 2003 [5]

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