Skip to main content
Top
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Distinct association between educational attainment and overweight/obesity in unmarried and married women: evidence from a population-based study in Japan

Authors: Keiko Murakami, Takayoshi Ohkubo, Hideki Hashimoto

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Associations between education and obesity have been consistently reported among women in developed countries, but few studies have considered the influence of marital status and husbands’ education. This study aimed to examine differences in the association between education and overweight/obesity by marital status and to determine the contribution of husbands’ education to overweight/obesity among community-dwelling Japanese women.

Methods

A questionnaire survey was conducted from 2010 to 2011 among residents aged 25–50 years in Japanese metropolitan areas. Of 2145 women who agreed to participate and completed the survey, 582 were unmarried and 1563 were married. Overweight/obesity was defined as body mass index ≥25 kg/m2. Multiple logistic regression analysis was conducted to determine whether women’s or their husbands’ education was associated with overweight/obesity after adjusting for age, work status, and equivalent income.

Results

The prevalence of overweight/obesity was 11.9% among unmarried women and 10.3% among married women. Women’s own education was significantly associated with overweight/obesity among unmarried women but not among married women. The multivariate-adjusted odds ratio of high school education or lower compared with university education or higher was 3.21 (95% confidence interval: 1.59–6.51) among unmarried women. Among married women, husbands’ education was significantly associated with overweight/obesity: women whose husbands’ educational attainment was high school or lower had significantly higher odds of overweight/obesity than did those whose husbands had a university education or higher (1.67, 95% confidence interval: 1.10–2.55). Among married women whose educational attainment was college or higher, women whose husbands’ educational attainment was high school or lower had a significantly higher risk for overweight/obesity when compared with women whose husbands’ educational attainment was college or higher.

Conclusions

Associations between women’s own education and overweight/obesity varied by marital status, and husbands’ educational level was important for married women’s overweight/obesity. These findings indicate that the social influences bound to educational background affect women’s overweight/obesity.
Literature
4.
go back to reference Cutler DM, Lleras-Muney A. Understanding differences in health behaviors by education. J Health Econ. 2010;29:1–28.CrossRefPubMed Cutler DM, Lleras-Muney A. Understanding differences in health behaviors by education. J Health Econ. 2010;29:1–28.CrossRefPubMed
6.
go back to reference Monden CW, van Lenthe F, de Graaf ND, Kraaykamp G. Partner’s and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption? Soc Sci Med. 2003;57:1901–12.CrossRefPubMed Monden CW, van Lenthe F, de Graaf ND, Kraaykamp G. Partner’s and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption? Soc Sci Med. 2003;57:1901–12.CrossRefPubMed
7.
go back to reference Li Y, Fu H, Zhao F, Luo J, Kawachi I. Influence of spousal education on partner's self-rated health: cross-sectional study among 1382 married couples in shanghai, China. Asia Pac J Public Health. 2013;25:398–408.CrossRefPubMed Li Y, Fu H, Zhao F, Luo J, Kawachi I. Influence of spousal education on partner's self-rated health: cross-sectional study among 1382 married couples in shanghai, China. Asia Pac J Public Health. 2013;25:398–408.CrossRefPubMed
8.
go back to reference Brown DC, Hummer RA, Hayward MD. The importance of spousal education for the self-rated health of married adults in the United States. Popul Res Policy Rev. 2014;33:127–51.CrossRefPubMed Brown DC, Hummer RA, Hayward MD. The importance of spousal education for the self-rated health of married adults in the United States. Popul Res Policy Rev. 2014;33:127–51.CrossRefPubMed
9.
go back to reference Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Effects of husbands' and wives' education on each other’s mortality. Soc Sci Med. 2006;62:2014–23.CrossRefPubMed Jaffe DH, Eisenbach Z, Neumark YD, Manor O. Effects of husbands' and wives' education on each other’s mortality. Soc Sci Med. 2006;62:2014–23.CrossRefPubMed
10.
go back to reference Kravdal Ø. A broader perspective on education and mortality: are we influenced by other people's education? Soc Sci Med. 2008;66:620–36.CrossRefPubMed Kravdal Ø. A broader perspective on education and mortality: are we influenced by other people's education? Soc Sci Med. 2008;66:620–36.CrossRefPubMed
11.
go back to reference Vandenheede H, Vanroelen C, Gadeyne S, De Grande H, Deboosere P. Household-based socioeconomic position and diabetes-related mortality among married and cohabiting persons: findings from a census-based cohort study (Flanders, 2001-2010). J Epidemiol Community Health. 2013;67:765–71.CrossRefPubMed Vandenheede H, Vanroelen C, Gadeyne S, De Grande H, Deboosere P. Household-based socioeconomic position and diabetes-related mortality among married and cohabiting persons: findings from a census-based cohort study (Flanders, 2001-2010). J Epidemiol Community Health. 2013;67:765–71.CrossRefPubMed
12.
go back to reference Spoerri A, Schmidlin K, Richter M, Egger M, Clough-Gorr KM, Swiss National Cohort (SNC). Individual and spousal education, mortality and life expectancy in Switzerland: a national cohort study. J Epidemiol Community Health. 2014;68:804–10.CrossRefPubMed Spoerri A, Schmidlin K, Richter M, Egger M, Clough-Gorr KM, Swiss National Cohort (SNC). Individual and spousal education, mortality and life expectancy in Switzerland: a national cohort study. J Epidemiol Community Health. 2014;68:804–10.CrossRefPubMed
13.
go back to reference Vanthomme K, Vandenheede H, Hagedoorn P, Gadeyne S. Socioeconomic disparities in lung cancer mortality in Belgian men and women (2001-2011): does it matter who you live with? BMC Public Health. 2016;16:493.CrossRefPubMedPubMedCentral Vanthomme K, Vandenheede H, Hagedoorn P, Gadeyne S. Socioeconomic disparities in lung cancer mortality in Belgian men and women (2001-2011): does it matter who you live with? BMC Public Health. 2016;16:493.CrossRefPubMedPubMedCentral
14.
go back to reference Yang L, Martikainen P, Silventoinen K. Effects of individual, spousal, and offspring socioeconomic status on mortality among elderly people in China. J Epidemiol. 2016;26:602–9.CrossRefPubMedPubMedCentral Yang L, Martikainen P, Silventoinen K. Effects of individual, spousal, and offspring socioeconomic status on mortality among elderly people in China. J Epidemiol. 2016;26:602–9.CrossRefPubMedPubMedCentral
15.
go back to reference Skalická V, Kunst AE. Effects of spouses’ socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study. Soc Sci Med. 2008;66:2035–47.CrossRefPubMed Skalická V, Kunst AE. Effects of spouses’ socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study. Soc Sci Med. 2008;66:2035–47.CrossRefPubMed
16.
go back to reference Torssander J, Erikson R. Marital partner and mortality: the effects of the social positions of both spouses. J Epidemiol Community Health. 2009;63:992–8.CrossRefPubMed Torssander J, Erikson R. Marital partner and mortality: the effects of the social positions of both spouses. J Epidemiol Community Health. 2009;63:992–8.CrossRefPubMed
17.
go back to reference Di Castelnuovo A, Quacquaruccio G, Donati MB, de Gaetano G, Iacoviello L. Spousal concordance for major coronary risk factors: a systematic review and meta-analysis. Am J Epidemiol. 2009;169:1–8.CrossRefPubMed Di Castelnuovo A, Quacquaruccio G, Donati MB, de Gaetano G, Iacoviello L. Spousal concordance for major coronary risk factors: a systematic review and meta-analysis. Am J Epidemiol. 2009;169:1–8.CrossRefPubMed
18.
go back to reference Honjo K, Iso H, Iwata M, Cable N, Inoue M, Sawada N, Tsugane S, JPHC Study Group. Effectiveness of the combined approach for assessing social gradients in stroke risk among married women in Japan. J Epidemiol. 2012;22:324–30.CrossRefPubMedPubMedCentral Honjo K, Iso H, Iwata M, Cable N, Inoue M, Sawada N, Tsugane S, JPHC Study Group. Effectiveness of the combined approach for assessing social gradients in stroke risk among married women in Japan. J Epidemiol. 2012;22:324–30.CrossRefPubMedPubMedCentral
19.
go back to reference Takada M, Kondo N, Hashimoto H, J-SHINE Data Management Committee. Japanese study on stratification, health, income, and neighborhood: study protocol and profiles of participants. J Epidemiol. 2014;24:334–44.CrossRefPubMed Takada M, Kondo N, Hashimoto H, J-SHINE Data Management Committee. Japanese study on stratification, health, income, and neighborhood: study protocol and profiles of participants. J Epidemiol. 2014;24:334–44.CrossRefPubMed
20.
go back to reference Takagi D, Kondo N, Takada M, Hashimoto H. Differences in spousal influence on smoking cessation by gender and education among Japanese couples. BMC Public Health. 2014;14:1184.CrossRefPubMedPubMedCentral Takagi D, Kondo N, Takada M, Hashimoto H. Differences in spousal influence on smoking cessation by gender and education among Japanese couples. BMC Public Health. 2014;14:1184.CrossRefPubMedPubMedCentral
21.
go back to reference Umeda M, Oshio T, Fujii M. The impact of the experience of childhood poverty on adult health-risk behaviors in Japan: a mediation analysis. Int J Equity Health. 2015;14:145.CrossRefPubMedPubMedCentral Umeda M, Oshio T, Fujii M. The impact of the experience of childhood poverty on adult health-risk behaviors in Japan: a mediation analysis. Int J Equity Health. 2015;14:145.CrossRefPubMedPubMedCentral
22.
go back to reference Murakami K, Kondo N, Ohkubo T, Hashimoto H. The effect of fathers’ and mothers' educational level on adult oral health in Japan. Community Dent Oral Epidemiol. 2016;44:283–91.PubMed Murakami K, Kondo N, Ohkubo T, Hashimoto H. The effect of fathers’ and mothers' educational level on adult oral health in Japan. Community Dent Oral Epidemiol. 2016;44:283–91.PubMed
23.
go back to reference World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation (WHO technical report series 894). Geneva: World Health Organization; 2000. World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation (WHO technical report series 894). Geneva: World Health Organization; 2000.
24.
go back to reference Examination Committee of Criteria for ‘Obesity Disease’ in Japan; Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J. 2002;66:987–92.CrossRef Examination Committee of Criteria for ‘Obesity Disease’ in Japan; Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J. 2002;66:987–92.CrossRef
25.
go back to reference WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef
26.
go back to reference Hagenaars AJM, de Vos K, Zaidi MA. Poverty statistics in the late 1980s: research based on micro-data. Luxembourg: Office for Official Publications of the European Communities; 1994. Hagenaars AJM, de Vos K, Zaidi MA. Poverty statistics in the late 1980s: research based on micro-data. Luxembourg: Office for Official Publications of the European Communities; 1994.
27.
go back to reference Galobardes B, Shaw M, Lawlor DA, Davey Smith G, Lynch JW. Indicators of socioeconomic position. In: Oakes JM, Kaufman JS, editors. Methods in social epidemiology. San Francisco, CA: Jossey-Bass; 2006. p. 47–85. Galobardes B, Shaw M, Lawlor DA, Davey Smith G, Lynch JW. Indicators of socioeconomic position. In: Oakes JM, Kaufman JS, editors. Methods in social epidemiology. San Francisco, CA: Jossey-Bass; 2006. p. 47–85.
28.
go back to reference Bourdieu P. Distinction: a social critique of the judgement of taste. London: Routledge; 1984. Bourdieu P. Distinction: a social critique of the judgement of taste. London: Routledge; 1984.
29.
go back to reference Abel T. Cultural capital and social inequality in health. J Epidemiol Community Health. 2008;62:e13.CrossRefPubMed Abel T. Cultural capital and social inequality in health. J Epidemiol Community Health. 2008;62:e13.CrossRefPubMed
30.
go back to reference Berkman LF, Krishna A. Social network epidemiology. In: Berkman LF, Kawachi I, Glymour MM, editors. Social epidemiology. New York: Oxford University Press; 2014. p. 234–89. Berkman LF, Krishna A. Social network epidemiology. In: Berkman LF, Kawachi I, Glymour MM, editors. Social epidemiology. New York: Oxford University Press; 2014. p. 234–89.
31.
go back to reference Organisation for Economic Co-operation and Development. Japan. In: Education at a Glance 2016: OECD Indicators. OECD Publishing, Paris. 2016. 10.1787/eag-2016-65-en. Accessed 14 Mar 2017. Organisation for Economic Co-operation and Development. Japan. In: Education at a Glance 2016: OECD Indicators. OECD Publishing, Paris. 2016. 10.​1787/​eag-2016-65-en. Accessed 14 Mar 2017.
32.
go back to reference Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357:370–9.CrossRefPubMed Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357:370–9.CrossRefPubMed
33.
go back to reference Chao D, Hashimoto H, Kondo N. Dynamic impact of social stratification and social influence on smoking prevalence by gender: an agent-based model. Soc Sci Med. 2015;147:280–7.CrossRefPubMed Chao D, Hashimoto H, Kondo N. Dynamic impact of social stratification and social influence on smoking prevalence by gender: an agent-based model. Soc Sci Med. 2015;147:280–7.CrossRefPubMed
34.
35.
go back to reference Egeland GM, Tverdal A, Meyer HE, Selmer R. A man’s heart and a wife's education: a 12-year coronary heart disease mortality follow-up in Norwegian men. Int J Epidemiol. 2002;31:799–805.CrossRefPubMed Egeland GM, Tverdal A, Meyer HE, Selmer R. A man’s heart and a wife's education: a 12-year coronary heart disease mortality follow-up in Norwegian men. Int J Epidemiol. 2002;31:799–805.CrossRefPubMed
36.
go back to reference Harald K, Salomaa V, Jousilahti P, Koskinen S, Vartiainen E. Non-participation and mortality in different socioeconomic groups: the FINRISK population surveys in 1972-92. J Epidemiol Community Health. 2007;61:449–54.CrossRefPubMedPubMedCentral Harald K, Salomaa V, Jousilahti P, Koskinen S, Vartiainen E. Non-participation and mortality in different socioeconomic groups: the FINRISK population surveys in 1972-92. J Epidemiol Community Health. 2007;61:449–54.CrossRefPubMedPubMedCentral
37.
go back to reference Tolonen H, Dobson A, Kulathinal S, WHO MONICA Project. Effect on trend estimates of the difference between survey respondents and non-respondents: results from 27 populations in the WHO MONICA project. Eur J Epidemiol. 2005;20:887–98.CrossRefPubMed Tolonen H, Dobson A, Kulathinal S, WHO MONICA Project. Effect on trend estimates of the difference between survey respondents and non-respondents: results from 27 populations in the WHO MONICA project. Eur J Epidemiol. 2005;20:887–98.CrossRefPubMed
38.
go back to reference Ikeda N. Validity of self-reports of height and weight among the general adult population in Japan: findings from National Household Surveys, 1986. PLoS One. 2016;11:e0148297.CrossRefPubMedPubMedCentral Ikeda N. Validity of self-reports of height and weight among the general adult population in Japan: findings from National Household Surveys, 1986. PLoS One. 2016;11:e0148297.CrossRefPubMedPubMedCentral
39.
go back to reference Meyler D, Stimpson JP, Peek MK. Health concordance within couples: a systematic review. Soc Sci Med. 2007;64:2297–310.CrossRefPubMed Meyler D, Stimpson JP, Peek MK. Health concordance within couples: a systematic review. Soc Sci Med. 2007;64:2297–310.CrossRefPubMed
Metadata
Title
Distinct association between educational attainment and overweight/obesity in unmarried and married women: evidence from a population-based study in Japan
Authors
Keiko Murakami
Takayoshi Ohkubo
Hideki Hashimoto
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4912-5

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue