Socioeconomic patterns of obesity in Canada: modeling the role of health behaviour

Abstract

Among Canadians, previous research has associated obesity with indicators of socioeconomic position. Several health behaviours have demonstrated similar variation, suggesting that social patterning of obesity may be partially explained by behavioural differences. The objective of this study was to examine obesity in relation to income and education among Canadians, and to characterize the indirect associations potentially occurring through fruit and vegetable intake, leisure-time physical activity (LTPA), and smoking. The present secondary analysis of the 2004 Canadian Community Health Survey was restricted to adults (25-64 y) with measured height and weight data (men, n = 3767; women, n = 3823). Interrelationships among socioeconomic indicators, behaviours, and BMI groups were examined by age-adjusted path analysis. For men, obesity was positively associated with income directly and through current smoking. Obesity was also negatively associated with education, directly and through fruit and vegetable intake, and was negatively associated with income through LTPA (r2 = 0.17). For women, obesity was negatively associated with education both directly and indirectly through LTPA and with fruit and vegetable intake. No direct association was observed between income and obesity for women, but an indirect negative association existed via LTPA and fruit and vegetable intake (r2 = 0.15). The direct and indirect associations between obesity and socioeconomic indicators were consistently inverse among women, but this relationship was not the case in men, suggesting that clearer social patterns of adiposity exist for Canadian women. The limited amount of variance explained by these models likely reflects the complexity of obesity development.