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

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.