Abstract
Social inequalities in overweight and obesity (OWOB) have persisted in the affluent and reputedly egalitarian Nordic countries. In this review we examine associations between socioeconomic position (SEP) and OWOB, and secular trends in such associations. Determinants and possible causes of the relations are discussed together with opportunities to cope with OWOB as a public health problem. The findings show a persisting inverse social gradient. An interaction between SEP and gender is noted for adults in Denmark, Finland and Iceland and for children in Sweden. There are overall tendencies for increased inequality, however no consistent trend for an increased social gradient in OWOB. Reasons that increased inequality does not unequivocally mirror in a steepened social gradient in obesity may include methodological questions as well as societal efforts to counteract obesity. Multi-level efforts are needed to prevent OWOB.
Highlights
The occurrence of obesity in humans is associated with socioeconomic position (SEP)
The study found a higher prevalence of obesity among those children that came from low SEP families, and the inverse social gradient in overweight became steeper with age for girls while it emerged for boys in late adolescence [29]
In both Denmark and Finland the inverse social gradient has in general been stronger in women than in men, and the same seems to be true for Iceland
Summary
The occurrence of obesity in humans is associated with socioeconomic position (SEP). A trend towards an inverse social gradient, first documented in the USA [1, 2], has since spread to most populations in the Western world [3, 4] and thereafter to the poorer countries [5]. Inequality within countries seems to be positively associated with an inverse gradient between SEP and overweight and obesity (OWOB) [7]. A population based cohort of elderly residents in western Sweden indicated that the gradient was getting steeper between 1971–2000, with greatest obesity prevalence increases observed in 70 year olds with basic education only [19].
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