Socioeconomic Position Score Research Articles

Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China health and nutrition survey

BackgroundThe social disparities in obesity may originate in early life or in adulthood, and the associations of socioeconomic position (SEP) with obesity could alter over time. It is unclear how lifetime-specific and life-course SEP influence adult obesity development in China.MethodsBased on the China Health and Nutrition Survey (CHNS), three SEP-related indicators, including the father’s occupational position and the participant’s education and occupational position, were obtained. The life-course socioeconomic changes and a cumulative SEP score were established to represent the life-course SEP of the participants in the study. The growth mixture modeling was used to identify BMI trajectories in adulthood. Multinomial logistic regression was adopted to assess the associations between SEP and adult BMI trajectories.ResultsA total of 3,138 participants were included in the study. A positive correlation was found between the paternal occupational position, the participants’ occupational position, education, and obesity in males, whereas an inverse correlation was observed among females. Males who experienced social upward mobility or remained stable high SEP during the follow-up had 2.31 and 2.52-fold risks of progressive obesity compared to those with a stable-low SEP. Among females, stable high SEP in both childhood and adulthood was associated with lower risks of progressive obesity (OR = 0.63, 95% CI: 0.43–0.94). Higher risks of obesity were associated with the life-course cumulative SEP score among males, while the opposite relationship was observed among females.ConclusionsThe associations between life-course SEP and BMI development trajectories differed significantly by gender. Special emphasis should be placed on males experiencing upward and stable high socioeconomic change.

Association between socioeconomic position and coronary artery calcium score in patients with symptoms suggestive of obstructive coronary artery disease

AimLow socioeconomic-position (SEP) is associated with increased prevalence of cardiovascular disease. Whether this is caused by earlier development of atherosclerotic calcifications is not well understood. This study aimed to investigate the association between SEP and coronary artery calcium score (CACS) in a population presenting with symptoms suggestive of obstructive coronary artery disease. MethodsWe included 50,561 patients (mean age 57 ​± ​11, 53% women) from a national registry undergoing coronary computed tomography angiography (CTA) from 2008 to 2019. CACS was used as outcome in categories; 1–399 and ​≥ ​400 in regression analyses. SEP was obtained from central registries and defined as mean personal income and length of education. ResultsThe number of risk factors were negatively associated with income and education among both men and women. The adjusted OR of having a CACS≥400 was 1.67(1.50–1.86) among women with <10 years of education compared to >13 years. For men the corresponding OR was 1.03(0.91–1.16).For women with low income the adjusted OR of CACS ≥400 was 2.29(1.96–2.69) using high income as a reference. For men the corresponding OR was 1.13(0.99–1.29). ConclusionIn patients referred for coronary CTA we found an increased level of risk factors among men and women with short education and low income. Among women with longer education and a higher income we demonstrated a lower CACS compared to other women and men. Socioeconomic differences seem to affect the development of CACS beyond what can be explained by traditional risk factors. Part of the observed result may be due to referral bias. ClinicalTrials.gov identifierNone.

Combining education and income into a socioeconomic position score for use in studies of health inequalities

BackgroundIn studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinations of education and income in estimating subjective SEP, and examine how this score performs in predicting inequalities in health-related quality of life (HRQoL).MethodsWe used data from a comprehensive health survey from Northern Norway, conducted in 2015/16 (N = 21,083). A composite SEP score was developed using adjacent-category logistic regression of subjective SEP as a function of four education and four household income levels. Weights were derived based on these indicators’ coefficients in explaining variations in respondents’ subjective SEP. The composite SEP score was further applied to predict inequalities in HRQoL, measured by the EQ-5D and a visual analogue scale.ResultsEducation seemed to influence SEP the most, while income added weight primarily for the highest income category. The weights demonstrated clear non-linearities, with large jumps from the middle to the higher SEP score levels. Analyses of the composite SEP score indicated a clear social gradient in both HRQoL measures.ConclusionsWe provide new insights into the relative contribution of education and income as sources of SEP, both separately and in combination. Combining education and income into a composite SEP score produces more comprehensive estimates of the social gradient in health. A similar approach can be applied in any cohort study that includes education and income data.

Socioeconomic Inequalities in Elective and Nonelective Hospitalizations in Older Men

Among older adults, there is limited and inconsistent evidence on the association between socioeconomic position (SEP) and elective and nonelective hospitalization. To evaluate the association between SEP and all-cause and cause-specific elective and nonelective hospitalization and hospital length of stay among older men. This population-based, prospective cohort study used data from the Concord Health and Aging in Men Project (CHAMP). CHAMP recruited 1705 men aged 70 years or older between January 28, 2005, and June 4, 2007, in Sydney, Australia. Data were analyzed from February 1 to September 30, 2021. Indicators of SEP, including education (university degree certificate, diploma or no postschool qualifications), occupation (professionals and managers; small employers and self-employed; or lower clerical, service, sales workers, skilled, and unskilled workers), and source of income (other sources of income than government pension, reliance on government pensions and other sources of income, or reliant solely on a government pension), and a cumulative SEP score (tertiles) as SEP indicators; 3-level variables present high, intermediate, and low SEP. All-cause and cause-specific elective and nonelective hospitalizations, number of hospitalizations, and length of stay were the study outcomes, ascertained through data linkage. Associations were quantified using competing-risks survival regression and negative binomial regression. A total of 1566 men (mean [SD] age, 76.8 [5.4] years) were included. During a mean (SD) 9.07 (3.53) years of follow-up, 1067 men had at least 1 elective hospitalization, and 1255 men had at least 1 nonelective hospitalization. No associations were found between SEP and elective hospitalizations. Being in the lowest tertile for educational level (subhazard ratio [SHR], 1.32; 95% CI, 1.11-1.58), occupational position (SHR, 1.30; 95% CI, 1.12-1.50), sources of income (SHR, 1.33; 95% CI, 1.17-1.52), and cumulative SEP tertile groups (SHR, 1.45; 95% CI, 1.24-1.68) were all associated with having at least 1 nonelective hospitalization compared with those in the highest tertiles. Significant associations were found between being in the lowest SEP groups and increased numbers and longer length of stay of nonelective hospitalizations. In this prospective cohort study, low SEP was inversely associated with nonelective hospitalizations but not elective hospitalization in older men in Australia. These findings point to the existence of socioeconomic inequalities in health care use, indicative of a need to take action to reduce these inequalities.

Individual Life-Course Socioeconomic Position and Hearing Aid Use in the Atherosclerosis Risk in Communities Study.

To measure the association between individual life-course socioeconomic position (SEP) and hearing aid use, we examined childhood and adulthood socioeconomic variables collected at the Atherosclerosis Risk in Communities (ARIC) study baseline visit (1987-1989)/Life Course Socioeconomic Status study (2001-2002) and hearing aid use data collected at visit 6 (2016-2017). ARIC is a prospective cohort study of older adults (45-64 years) recruited from 4 U.S. communities. This analysis included a subset of 2 470 participants with hearing loss at visit 6 (≥25 decibels hearing level [dB HL] better-ear) with complete hearing aid use data. Childhood SEP variables included parental education, parental occupation, and parental home ownership. Young and older adulthood SEP variables included income, education, occupation, and home ownership. Each life epoch was assigned a score ranging from 0 to 5 and then summed to calculate the individual cumulative SEP score. Multivariable-adjusted logistic regression was used to estimate the association between individual cumulative SEP and hearing aid use. Missing SEP scores were imputed for participants with incomplete socioeconomic data. Of the 2 470 participants in the analytic cohort (median [interquartile interval] age 79.9 [76.7-84.0], 1 330 [53.8%] women, 450 [18.2%] Black), 685 (27.7%) participants reported hearing aid use. Higher cumulative SEP was positively associated with hearing aid use (odds ratio [OR] = 1.09, 95% confidence interval [CI]: 1.04-1.14), and slightly stronger for childhood (OR = 1.09, 95% CI: 1.00-1.20) than older adulthood SEP score (OR = 1.06, 95% CI: 0.95-1.18). In this community-based cohort of older adults with hearing loss, higher individual life-course SEP was positively associated with hearing aid use.

Lifecourse socioeconomic position and diabetes incidence in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, 2003 to 2016

Low socioeconomic position (SEP) across the lifecourse is associated with Type 2 diabetes (T2DM). We examined whether these economic disparities differ by race and sex. We included 5448 African American (AA) and white participants aged ≥45 years from the national (United States) REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort without T2DM at baseline (2003–07). Incident T2DM was defined by fasting glucose ≥126 mg/dL, random glucose ≥200 mg/dL, or using T2DM medications at follow-up (2013–16). Derived SEP scores in childhood (CSEP) and adulthood (ASEP) were used to calculate a cumulative (CumSEP) score. Social mobility was defined as change in SEP. We fitted race-stratified logistic regression models to estimate the association between each lifecourse SEP indicator and T2DM, adjusting for covariates; additionally, we tested SEP-sex interactions. Over a median of 9.0 (range 7–14) years of follow-up, T2DM incidence was 167.1 per 1000 persons among AA and 89.9 per 1000 persons among white participants. Low CSEP was associated with T2DM incidence among AA (OR = 1.61; 95%CI 1.05–2.46) but not white (1.06; 0.74–2.33) participants; this was attenuated after adjustment for ASEP. In contrast, low CumSEP was associated with T2DM incidence for both racial groups. T2DM risk was similar for stable low SEP and increased for downward mobility when compared with stable high SEP in both groups, whereas upward mobility increased T2DM risk among AAs only. No differences by sex were observed. Among AAs, low CSEP was not independently associated with T2DM, but CSEP may shape later-life experiences and health risks.

Family socioeconomic position and abnormal birth weight: evidence from a Chinese birth cohort.

Birth weight is a strong determinant of infant short- and long-term health outcomes. Family socioeconomic position (SEP) is usually positively associated with birth weight. Whether this association extends to abnormal birth weight or there exists potential mediator is unclear. We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study. We used multivariable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight (LBW), and examined the potential mediation effect of maternal pre-pregnancy body mass index (BMI) using causal mediation analysis. The prevalence of macrosomia and LBW was 2.62% (n = 392) and 4.26% (n = 638). Higher family SEP was associated with a higher risk of macrosomia (OR 1.30, 95% CI 0.93-1.82; OR 1.53, 95% CI 1.11-2.11; and OR 1.59, 95% CI 1.15-2.20 for the 2nd, 3rd, and 4th SEP quartile respectively) and a lower risk of LBW (OR 0.69, 95% CI 0.55-0.86; OR 0.76, 95% CI 0.61-0.94; and OR 0.61, 95% CI 0.48-0.77 for the 2nd, 3rd, and 4th SEP quartile respectively), compared to the 1st SEP quartile. We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW. Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China. Whether the results can be applied to other populations should be further investigated.

Aspects of social participation and neighborhood perception

ABSTRACTOBJECTIVE To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults.METHODS The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression.RESULT Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93–0.98) among both women (PR = 0.96; 95%CI 0.92–0.99) and men (PR = 0.94; 95%CI 0.90–0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91–0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation.CONCLUSIONS Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.

Socioeconomic Disadvantage across the Life Course Is Associated with Diet Quality in Young Adulthood.

Socioeconomic position (SEP) is a key determinant of diet quality across the life course. Young adulthood is a unique period of transition where dietary inequities between groups with lower and higher SEP may widen. This study investigated associations between SEP in both childhood and young adulthood and diet quality in young adulthood. Data from 1949 Canadian young adults aged 18–30 who participated in the Canada Food Study were analyzed. Healthy Eating Index–2015 (HEI-2015) scores were calculated based on one 24-hour dietary recall. Childhood and young adult SEP were represented by self-report of participants’ parent(s)’ and their own highest educational level, respectively. Linear regression was used to examine associations between childhood and adult SEP and adult HEI-2015 score. Mediation analyses examined whether adult SEP mediated the relationship between childhood SEP and adult HEI-2015 score. Lower SEPs in childhood and adulthood were each associated with lower HEI-2015 scores in young adulthood. Adult SEP mediated up to 13.0% of the association between childhood SEP and adult HEI-2015 scores. Study findings provide support for key life course hypotheses and suggest latent, pathway, and cumulative effects of SEP across the early life course in shaping the socioeconomic patterning of diet quality in young adulthood.

Impact of Childhood and Adult Socioeconomic Position (SEP) on Incidence of Type 2 Diabetes—The REGARDS Study, 2003–2016

Exposure to socioeconomic stressors during early life may influence the incidence of type 2 diabetes (T2DM). We examined data from 1,207 African American (AA) and 4,149 white REGARDS participants aged ≥45 years with no evidence of T2DM at baseline (2003-2007), who completed the Childhood and Family Life Questionnaire (2011-2013) and the 2nd in-home visit (2013-2016). Incident T2DM cases were identified by self-reported physician diagnosis plus use of hypoglycemic drugs, fasting plasma glucose ≥126 mg/dL, or random plasma glucose ≥200 mg/dL. We estimated incidence rate as cases/1000 persons. Childhood SEP (CSEP) was derived from participants’ parental/caregiver education level and material assets. Adult SEP (ASEP) was derived from participants’ own education level and annual household income at baseline. SEP scores were categorized as low/medium/high. We fit multivariable logistic regression models to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) for the separate and simultaneous effects of SEP measures on T2DM incidence, stratified by race. In 9.1 years of follow-up, 572 new cases of T2DM occurred; crude incidence rate=106.8/1000 (AA=168.2/1000; white= 88.9/1000). Controlled for age, sex, and percent life lived in Stroke Belt, low CSEP was associated with incident T2DM in AAs (aOR=1.65, 95% CI 1.05-2.52) but not in whites (aOR=1.01, 95% CI 0.703-1.46). Low ASEP was associated with incident DM in both racial groups: AA aOR=2.57 (95% CI 1.42-4.64); white aOR=2.42 (95% CI 1.69-3.45). With both SEP measures in the model, CSEP was no longer significant in AA but ASEP remained significant in both racial groups. Controlling for traditional T2DM risk factors the ASEP ORs remained significant in AA and whites. Low CSEP was associated with incident T2DM among AA but not whites; however, this may reflect indirect action through low ASEP. Low ASEP was associated with T2DM in both racial groups, partly explained by traditional T2DM risk factors. Disclosure G.L.A. Beckles: None. C. Wu: None. L.A. McClure: None. A.P. Carson: Research Support; Self; Amgen Inc.. K.M. Bullard: None. G. Imperatore: None. F. Unverzagt: None. V.J. Howard: None.

The role of social support in family socio-economic disparities in depressive symptoms during early pregnancy: Evidence from a Chinese birth cohort

BackgroundFew studies have examined the association between a composite measure of family socio-economic position (SEP)22SEP, socio-economic position. and depressive symptoms among Chinese pregnant women, nor any potential underlying mechanisms which may be amenable to preventative interventions. MethodsWe investigated the association between a composite SEP measure and depressive symptoms during early pregnancy, and tested for mediation by social support and moderation by parity in the Born in Guangzhou Cohort Study (n = 12,382) using adjusted logistic regression and causal mediation analysis. ResultsIn this population, 18.4% of women experienced depressive symptoms before the 20th gestational week. Compared with the highest quartile, the lowest SEP score quartile was associated with a higher risk of depressive symptoms (OR 1.50, 95% CI 1.31–1.71), which was more pronounced among multiparous women than nulliparous women (P for interaction <0.001). Social support mediated the association between SEP and depressive symptoms, with greater proportion mediated in nulliparous women (73.4% for the lowest SEP score quartile) than multiparous women (30.5%). LimitationsDepressive symptoms were measured by Self-rated Depression Scale, which is not designed as a clinical diagnosis tool for depression. We only had information on perceived social support but not actual social support, although these two parameters were modestly correlated. ConclusionLower SEP was associated with higher risk of depressive symptoms in pregnant women, driven by social support. And the association between SEP and depressive symptoms and mediation by social support were modified by parity. Whether this association extends to the post pregnancy period or is amenable to cost-effective interventions should be investigated in further studies.

Operationalizing the Measurement of Socioeconomic Position in Our Urogynecology Study Populations: An Illustrative Review.

The purpose of this illustrative review is to provide guidance for the measurement of socioeconomic position when conducting health disparities research in urogynecology study populations. Deidentified data were extracted from existing investigational review board-approved research databases for illustrative purposes. Attributes collected included the study participant's marital status, level of educational attainment (in number of years of school completed) and occupation as well as the study participant's last/only spouses' level of education and occupation. Average household and female socioeconomic position scores were calculated using two established composite indices: (1) Hollingshead Four Factor Index of Social Position, (2) Green's Socioeconomic Status scores, and 2 single-item indices: (1) Hauser-Warren Socioeconomic Index of Occupation, (2) level of educational attainment. The Hollingshead Four Factor Index of Social Position more than the Hauser-Warren Socioeconomic Index of Occupation provides researchers with a continuous score that is normally distributed with the least skew from the dataset. Their greater standard deviations and low kurtotic values increase the probability that statistically significant differences in health outcomes predicted by socioeconomic position will be detected compared with Green's socioeconomic status scores. Collection of socioeconomic data is an important first step in gaining a better understanding of health disparities through elimination of confounding bias, and for the development of behavioral, educational, and legislative strategies to eliminate them. We favor average household socioeconomic position scores over female socioeconomic position scores because average household socioeconomic position scores are more reflective of overall resources and opportunities available to each family member.

Intergenerational transmission of socioeconomic position and ideal cardiovascular health: 32-year follow-up study.

Socioeconomic position (SEP) in childhood predicts cardiovascular health in adulthood but the underlying mechanisms remain unclear. Using a longitudinal study design, we examined the extent to which adult SEP acts as a pathway (mediator) connecting childhood SEP with adult cardiovascular health, and if upward social mobility mitigates the health-effects of early low SEP. The sample comprised 697 participants from a prospective Finnish cohort followed during 32 years. Childhood SEP was assessed from the parents in 1980 (participant mean age 10.9) and adulthood SEP was examined in 2007 and 2012 (participant mean age 43.2 in 2012). Both childhood and adulthood SEP scores comprised education, income, occupational status, and occupational stability. Ideal cardiovascular health was assessed in 2007 and 2012 according to the American Heart Association's guidelines. Higher childhood SEP was associated with higher ideal cardiovascular health index in adulthood (β = 0.13, p < .001) independently of sex, age, childhood cardiovascular risk factors, and chronic conditions. Mediation analysis showed that adult SEP accounted for 33% of the association between childhood SEP and ideal cardiovascular health index. Upwardly mobile participants scored higher on ideal cardiovascular health in adulthood compared with participants staying in lower SEP (M = 4.05 vs. 3.56, p < .001). Transmission of SEP over generations is a predictor of health inequalities, which should be considered in cardiovascular prevention. Although upward social mobility mitigates some of the effect of early SEP disadvantage on later cardiovascular health, childhood SEP remains an important predictor of future health. (PsycINFO Database Record

Lifecourse socioeconomic position indicators and tooth loss in Korean adults.

The aim of this study was to assess the association between lifecourse socioeconomic position (SEP) indicators and tooth loss in a large representative sample of the Korean adult population. Data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey on 17,549 Korean adults aged 50 years or older were analyzed. The study design was cross-sectional. Tooth loss was defined as either edentulism (0 teeth) or severe tooth loss (<20 teeth). Parental education, own education, and income were used as indicators of early childhood SEP, adolescent SEP, and adulthood SEP, respectively. The association between the lifecourse SEPs and tooth loss was estimated with three different lifecourse models: the independent impact model for three different lifecourse SEPs, the cumulative impact model using the sum of the three SEP scores, and the social mobility model using the pathway information of the three SEPs. The covariates were demographic factors and health behaviors. The prevalence ratios (PRs), slope index of inequality (SII), and relative index of inequality (RII) for tooth loss were estimated with log-binomial regression analyses. In the independent impact model, significant associations of each SEP with edentulism (SII=3.61%, 4.76%, 2.17% and RII=1.67, 1.52, 1.41 for parental education, own education, and income, respectively) and severe tooth loss (SII=8.03%, 17.73%, 12.73% and RII=1.26, 1.72, 1.42 for parental education, own education, and income, respectively) were found after adjusting for all covariates. For the cumulative impact model, stepwise patterns of PRs according to the summed SEP scores were found. In addition, in the social mobility model, the PR of tooth loss was greatest in the persistently low SEP group over the life course (PR=2.10 for edentulism and 2.33 for severe tooth loss). The other mobile groups in lifecourse SEPs also presented higher PRs of tooth loss than the persistently high SEP group. Parental education was independently associated with edentulism in later life, and own education showed the strongest associations with tooth loss. The cumulative and social mobility models for the social impacts of life course on oral health should be considered in oral epidemiological studies.

Temporal trends in socioeconomic inequalities in obesity prevalence among economically-active working-age adults in Scotland between 1995 and 2011: a population-based repeated cross-sectional study.

ObjectivesObesity has been an alarming public health issue in the UK. Socioeconomic inequalities in obesity have been well-studied, however limited studies addressed inequality trends over time and none of them in Scotland.MethodsWe used nationally-representative data from the Scottish Health Survey (SHeS) across four time points between 1995 and 2010/2011. Respondents were economically active adults aged 16–65 years (N=27 059, 12 218 men). Socioeconomic position (SEP) was assessed by highest educational qualification, occupational social class and household income (2003 and 2010/2011 only) as well as a composite SEP score. We carried out sex-stratified logistic regression analyses (adjusted for age, smoking status, alcohol consumption, self-rated general health and physical activity) and we computed the relative index of inequality (RII).ResultsBetween 1995 and 2010/2011, obesity prevalence increased in both men (from 17% in 1995 to 30.2% in 2010/2011, 2010/2011 OR of obesity compared with 1995=2.07; 95% CI 1.83 to 2.34) and women (from 18.4% to 30.2%; OR=1.85; 95% CI 1.66 to 2.07). Increase in obesity prevalence was observed across all socioeconomic strata, within which the most rapid increase was among males from the highest socioeconomic groups. RII showed that educational inequalities in obesity narrowed for both men (p=0.007) and women (p=0.008). Income inequalities in obesity between 2003 and 2010/2011 in women were also reduced (p=0.046) on the relative scale.ConclusionsObesity prevalence in Scotland increased substantially between 1995 and 2010/2011, although socioeconomic inequalities have decreased due to the more rapid increase in the higher socioeconomic strata.

The association between socio-economic position and diet quality in Australian adults.

We aimed to investigate the association between multiple measures of socio-economic position (SEP) and diet quality, using a diet quality index representing current national dietary guidelines, in the Australian adult population. Cross-sectional study. Linear regression analyses were used to estimate the association between indicators of SEP (educational attainment, level of income and area-level disadvantage) and diet quality (measured using the Dietary Guideline Index (DGI)) in the total sample and stratified by sex and age (≤55 years and >55 years). A large randomly selected sample of the Australian adult population. Australian adults (n 9296; aged ≥25 years) from the Australian Diabetes, Obesity and Lifestyle Study. A higher level of educational attainment and income and a lower level of area-level disadvantage were significantly associated with a higher DGI score, across the gradient of SEP. The association between indicators of SEP and DGI score was consistently stronger among those aged ≤55 years compared with their older counterparts. The most disadvantaged group had a DGI score between 2 and 5 units lower (depending on the marker of SEP) compared with the group with the least disadvantage. A higher level of SEP was consistently associated with a higher level of diet quality for all indicators of SEP examined. In order to reduce socio-economic inequalities in diet quality, healthy eating initiatives need to act across the gradient of socio-economic disadvantage with a proportionate focus on those with greater socio-economic disadvantage.

Objectively-assessed and self-reported sedentary time in relation to multiple socioeconomic status indicators among adults in England: a cross-sectional study

ObjectivesTo examine the associations between socioeconomic position (SEP) and multidomain self-reported and objectively-assessed sedentary time (ST).DesignCross-sectional.SettingGeneral population households in England.Participants2289 adults aged 16–96 years who participated in the 2008 Health...

Maternal life course socio-economic position and offspring body composition at birth in a multi-ethnic population.

Size and body composition at birth may affect long-term health. Mean birthweight and body composition differ between ethnic groups living in Europe. We wanted to explore if this relates to differences in socio-economic conditions in country of origin and over the maternal life course. This is a population-based cohort study of healthy pregnant women living in Oslo, Norway. Data on maternal early life and present socio-economic position (SEP) were collected in early gestation, and SEP scores were extracted through two separate principal components analyses. The associations between maternal present SEP and four different offspring anthropometric measures at birth were assessed separately, stratified by maternal early life SEP (dichotomised score) and Human Development Index (HDI, a country-level socio-economic indicator) in the country of origin [high HDI (Reference), n = 287 and low HDI, n = 250]. A strong positive association between maternal present SEP and offspring birthweight was observed if maternal early life SEP was high, but not if maternal early life SEP was low (P < 0.001 for the interaction term). This interactional effect was observed in both HDI groups. Maternal life course SEP affected offspring birthweight mainly through an effect on length and sum of skin folds. Offspring of mothers with origin from low HDI countries had smaller abdominal circumference, possibly indicating less fat-free mass, regardless of maternal life course SEP. Our results suggest that there are transgenerational effects of maternal past socio-economic conditions on offspring size and body composition at birth that modify the associations with present socio-economic factors.

Children's and adolescents' sedentary behaviour in relation to socioeconomic position

BackgroundSedentary behaviour is an emerging cardiometabolic risk factor in young people. Little is known about how socioeconomic position (SEP) and sedentary behaviour are associated in children and adolescents. This study...

Influence of social factors on weight-related behaviors according to gender in the French adult population

Although the prevalence of obesity is higher in low socioeconomic position (SEP), the relationship between SEP and body mass index (BMI) differs according to gender. The purpose of this study is to investigate the relationships between BMI and SEP according to gender and explore the weight-related behaviors. In a cross-sectional survey, 1646 French adults were weighed and answered a questionnaire about eating behavior (DEBQ), SEP markers, ideal weight perception, physical activity and smoking. Our study showed that BMI was inversely correlated with SEP score in women only, independently of other BMI-associated factors (age, restrained eating, smoking status, TV viewing and physical activity). The SEP gradient was the same in both genders for some weight-related behaviors, such as restrained eating, physical activity and TV viewing, but differs for others, such as smoking and weight consciousness. There was an interaction between the SEP score and the actual BMI on the ideal BMI in women only, thus the difference in ideal body weight according to SEP is mainly due to difference in obese women. Our study concluded that gender differences in the relationship between BMI and SEP could be mainly due to the subjects’ perception of weight appropriateness and their weight-related behaviors.