Cohort-based income gradients in obesity among U.S. adults.
Cohort-based income gradients in obesity among U.S. adults.
复制标题
美国成年人肥胖的基于队列的收入梯度。
DOI：
10.1002/ajhb.23084
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
KarlFinch,Brian
中科院分区：
文献类型：
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作者：
Heo,Jongho;Beck,AudreyN;Lin,Shih-Fan;Marcelli,Enrico;Lindsay,Suzanne;KarlFinch,Brian
目的没有研究关注队列内和队列之间肥胖的社会经济差异。我们的目标是按性别和种族/民族检查出生队列之间(队列间变量)和每个出生队列内(队列内变量)肥胖的收入梯度。方法我们的样本包括来自联合的、横断面的国民健康和营养调查(1971-2012)的56,820名白人和黑人成年人。我们拟合了一系列Logistic分层年龄-时期-队列模型，以同时控制年龄和时期的影响。根据贫困与收入比估计并绘制了1901-1990年间5年队列组的肥胖预测概率。我们还将这种关系分成四个性别和种族/民族亚组。结果第一次世界大战后和第二次世界大战后，特别是20世纪20年代中期和20世纪40年代中期至50年代的人群中，由于收入原因导致的肥胖差距比其他人群更弱。相比之下，我们发现，在20世纪30年代至40年代中期和60年代中期至70年代，肥胖人群的收入差距更大。此外，各队列中因收入而导致的肥胖差距因性别和种族/族裔而有显著差异。自20世纪初以来，收入较高的白人女性患肥胖症的可能性一直低于收入较低的女性；而在大多数队列中，收入较高的黑人男性患肥胖症的风险高于收入较低的男性。结论我们的研究结果表明，解决肥胖问题上的种族和/或性别不平等的策略应该认识到可能是队列所独有的重大历史因素。基于时期的方法忽视了在基于队列的重大经历中捕捉到的人生经历，可能会限制政策和干预措施的效用。
ObjectivesNo studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth‐cohorts (inter‐cohort variations) and within each birth‐cohort (intra‐cohort variations) by gender and race/ethnicity.MethodsOur sample includes 56,820 white and black adults from pooled, cross‐sectional National Health and Nutrition Examination Surveys (1971–2012). We fit a series of logistic hierarchical Age‐Period‐Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty‐to‐income ratio were estimated and graphed for 5‐year cohort groups from 1901–1990. We also stratified this relationship for four gender and racial/ethnic subgroups.ResultsObesity disparities due to income were weaker for post‐World War I and II generations, specifically the mid‐1920s and the mid‐1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid‐1940s and mid‐1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts.ConclusionsOur findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period‐based approaches that ignore life‐course experiences captured in significant cohort‐based experiences may limit the utility of policies and interventions.