264543 Association of education and occupational status with abdominal obesity in an older population in China: An interaction study

Monday, October 29, 2012

Amina Aitsi-selmi, MD MPH , Epidemiology and Public Health, University College London, London, United Kingdom
Ruoling Chen, PhD , Primary Care and Public Health Sciences, King's College London, London, United Kingdom
Michael Marmot, PhD , International Institute for Society and Health, University College London, London, United Kingdom
Background Few studies explore the relationship between individual socioeconomic indicators and excess adiposity in depth in economic transition settings. Aim To examine the independent and joint effects of education and occupation in relation to excess adiposity in China. Methods A household-based, community survey of four provinces collected data on socioeconomic status, health behaviours and anthropometry using standardised instruments from 4,154 people aged ≥60 years (2,362 women). The interaction of education (none/any) and occupation (peasant/other) on waist circumference (WC) and body mass index (BMI) was investigated using a logistic regression model. Population-specific cut-off points for China were used (overweight=BMI≥24 and central obesity=WC≥80cm for women and ≥90cm for men). Results In men, there was no evidence of an interaction between education and occupation. Subsequent analyses were confined to women. In total, 57.9% of women reported a peasant occupational status, 52.0% had no education, 38.0% were overweight and 57.5% were centrally obese. An interaction was present between women's occupation and their education (P=0.001). In the group with no education, having a higher vs peasant occupational status was associated with an increase in the odds of excess adiposity (OR[95%CI]: 2.75[1.74-4.34]) for overweight and 2.98[1.81-4.91] for central obesity), while in the educated group there was no evidence of such a relationship. Conclusion In China, having a higher (post-transition) occupational status was associated with higher levels of excess adiposity in women with no education, while in educated women, no association was found. These findings suggest education may be an important protective factor against excess adiposity for women in transition settings.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Compare the different risk distributions of excess body weight in populations from high and low income countries in terms of socio-economic status; and identify the consequent public health challenge in obesity prevention facing countries undergoing economic transition 2. List the advantages and disadvantages of using Chinese specific cutoff points for body mass index and waist circumference measurement 3. Analyse the interaction between education and occupational status on excess body weight, and examine gender differences 4. Demonstrate the application of a social determinants of health perspective in transition settings

Keywords: Obesity, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Public Health Physician and currently a Wellcome Trust Clinical Research Fellow, with experience of public presentation of clinical and academic material over many years. I have previously won a Young Investigator of the Year award for an abstract submitted to the European Society in Cardiology (2008). I am principal investigator on a grant to research the social epidemiology of obesity in low-and-middle-income countries. The submitted abstract forms part of this grant.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.