Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The diminishing socioeconomic disparity in obesity in a Chinese population with rapid economic development: analysis of serial cross-sectional health survey data 2002–2010

Authors: Xiang Qian Lao, WenJun Ma, Roger Yat-Nork Chung, YongHui Zhang, YanJun Xu, XiaoJun Xu, ShaoPing Nie, QiuMao Cai, Liang Xia, XueFen Su, Lei Jin, Tony Tam, Benny Chung-ying Zee

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Social changes and economic development are associated with obesity epidemic. This study is to investigate the trends of socio-economic disparity in obesity from 2002 to 2010 in a Chinese population experiencing the world’s fastest economic development.

Methods

Four standardized surveys were conducted in a population of 85 million residents in Guangdong, China between 2002 and 2010. Multistage random cluster sampling was used to recruit representative samples. Information on socio-economic status (SES), proxied by education, occupation and residential area, was collected by face-to-face interviews. The weight, height and waist circumference of the participants were also measured.

Results

Women with low education had an increased BMI of 0.85 kg/m2, while women with high education had a decreased BMI of 0.16 kg/m2 (p = 0.032 for interaction test). Similar trends were observed by using occupation and residential area as the SES indicators. Analysis in men yielded similar patterns. Waist circumference increased from 73.7 to 78.4 cm, and the increasing trends of statistical significance (p < 0.01) were observed in both genders and across all SES levels, with the magnitudes of increase in low SES levels being more pronounced. The impact of gradient in food attainment and occupational physical activity across the SES levels may wear off with further economic development, while factors such as health awareness, diet pattern and leisure activity may become increasingly important in driving the disparity.

Conclusion

The impact of gradient in food attainment and occupational physical activity across the SES levels may wear off with further economic development, while factors such as health awareness, diet pattern and leisure activity may become increasingly important in driving the disparity. Our findings suggest that health education should focus on the disadvantaged populations on health awareness for adopting healthier diet pattern and increasing physical activity.
Literature
4.
go back to reference Song YM. Commentary: varying relation of socioeconomic status with obesity between countries at different stages of development. Int J Epidemiol. 2006;5:112–3. Song YM. Commentary: varying relation of socioeconomic status with obesity between countries at different stages of development. Int J Epidemiol. 2006;5:112–3.
6.
go back to reference Howel D, Stamp E, Chadwick TJ, Adamson AJ, White M. Are social inequalities widening in generalised and abdominal obesity and overweight among English adults? PLoS One. 2013;8:e79027.CrossRefPubMedPubMedCentral Howel D, Stamp E, Chadwick TJ, Adamson AJ, White M. Are social inequalities widening in generalised and abdominal obesity and overweight among English adults? PLoS One. 2013;8:e79027.CrossRefPubMedPubMedCentral
7.
8.
go back to reference Kark M, Rasmussen F. Growing social inequalities in the occurrence of overweight and obesity among young men in Sweden. Scand J Public Healt. 2005;33:472–7.CrossRef Kark M, Rasmussen F. Growing social inequalities in the occurrence of overweight and obesity among young men in Sweden. Scand J Public Healt. 2005;33:472–7.CrossRef
9.
go back to reference Faeh D, Braun J, Bopp M. Prevalence of obesity in Switzerland 1992–2007: the impact of education, income and occupational class. Obes Rev. 2011;12:151–66.CrossRefPubMed Faeh D, Braun J, Bopp M. Prevalence of obesity in Switzerland 1992–2007: the impact of education, income and occupational class. Obes Rev. 2011;12:151–66.CrossRefPubMed
10.
go back to reference Zhang Q, Wang Y. Trends in the association between obesity and socioeconomic status in U.S. adults: 1971 to 2000. Obes Res. 2004;12:1622–32.CrossRefPubMed Zhang Q, Wang Y. Trends in the association between obesity and socioeconomic status in U.S. adults: 1971 to 2000. Obes Res. 2004;12:1622–32.CrossRefPubMed
11.
go back to reference Statistics Bureau of Guangdong Province. Guangdong Statistical Yearbook (2000). Beijing: China Statistics Publishing House; 2001. Statistics Bureau of Guangdong Province. Guangdong Statistical Yearbook (2000). Beijing: China Statistics Publishing House; 2001.
12.
go back to reference Statistics Bureau of Guangdong Province. Guangdong Statistical Yearbook (2011). Beijing: China Statistics Publishing House; 2012. Statistics Bureau of Guangdong Province. Guangdong Statistical Yearbook (2011). Beijing: China Statistics Publishing House; 2012.
13.
go back to reference Lao XQ, Xu YJ, Wong MC, Zhang YH, Ma WJ, Xu XJ, et al. Hypertension Prevalence, Awareness, Treatment, Control and Associated Factors in a Developing Southern Chinese Population: Analysis of Serial Cross-Sectional Health Survey Data 2002–2010. Am J Hypertens. 2013;26:1335–45.CrossRefPubMed Lao XQ, Xu YJ, Wong MC, Zhang YH, Ma WJ, Xu XJ, et al. Hypertension Prevalence, Awareness, Treatment, Control and Associated Factors in a Developing Southern Chinese Population: Analysis of Serial Cross-Sectional Health Survey Data 2002–2010. Am J Hypertens. 2013;26:1335–45.CrossRefPubMed
14.
go back to reference Lao XQ, Ma WJ, Sobko T, Zhang YH, Xu YJ, Xu XJ, et al. Overall obesity is leveling off while abdominal obesity continues to rise in a chinese population experiencing rapid economic development: Analysis of serial cross-sectional health survey data 2002–2010. Int J Obes (Lond). 2014;39:288–94.CrossRef Lao XQ, Ma WJ, Sobko T, Zhang YH, Xu YJ, Xu XJ, et al. Overall obesity is leveling off while abdominal obesity continues to rise in a chinese population experiencing rapid economic development: Analysis of serial cross-sectional health survey data 2002–2010. Int J Obes (Lond). 2014;39:288–94.CrossRef
15.
go back to reference Zhang YH, Ma WJ, Thomas GN, Xu YJ, Lao XQ, Xu XJ, et al. Diabetes and pre-diabetes as determined by glycated haemoglobin A1c and glucose levels in a developing southern Chinese population. PLoS One. 2012;7:e37260.CrossRefPubMedPubMedCentral Zhang YH, Ma WJ, Thomas GN, Xu YJ, Lao XQ, Xu XJ, et al. Diabetes and pre-diabetes as determined by glycated haemoglobin A1c and glucose levels in a developing southern Chinese population. PLoS One. 2012;7:e37260.CrossRefPubMedPubMedCentral
16.
go back to reference Ma WJ, Tang JL, Zhang YH, Xu YJ, Lin JY, Li JS, et al. Hypertension prevalence, awareness, treatment, control, and associated factors in adults in southern China. Am J Hypertens. 2012;25:590–6.CrossRefPubMed Ma WJ, Tang JL, Zhang YH, Xu YJ, Lin JY, Li JS, et al. Hypertension prevalence, awareness, treatment, control, and associated factors in adults in southern China. Am J Hypertens. 2012;25:590–6.CrossRefPubMed
17.
go back to reference Lao XQ, Zhang YH, Wong MC, Xu YJ, Xu HF, Nie SP, et al. The prevalence of metabolic syndrome and cardiovascular risk factors in adults in southern China. BMC Public Health. 2012;12:64.CrossRefPubMedPubMedCentral Lao XQ, Zhang YH, Wong MC, Xu YJ, Xu HF, Nie SP, et al. The prevalence of metabolic syndrome and cardiovascular risk factors in adults in southern China. BMC Public Health. 2012;12:64.CrossRefPubMedPubMedCentral
18.
go back to reference Statistics Bureau of China. Research report of ecnomic development status in China rural area. 1995. Beijing: China Statistics Publishing House; 1996. Statistics Bureau of China. Research report of ecnomic development status in China rural area. 1995. Beijing: China Statistics Publishing House; 1996.
19.
go back to reference Expert Consultation WHO. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef Expert Consultation WHO. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef
20.
go back to reference Alberti KG, Zimmet P, Shaw J. The metabolic syndrome--a new worldwide definition. Lancet. 2005;366:1059–62.CrossRefPubMed Alberti KG, Zimmet P, Shaw J. The metabolic syndrome--a new worldwide definition. Lancet. 2005;366:1059–62.CrossRefPubMed
21.
go back to reference Rokholm B, Baker JL, Sorensen TI. The levelling off of the obesity epidemic since the year 1999--a review of evidence and perspectives. Obes Rev. 2010;11:835–46.CrossRefPubMed Rokholm B, Baker JL, Sorensen TI. The levelling off of the obesity epidemic since the year 1999--a review of evidence and perspectives. Obes Rev. 2010;11:835–46.CrossRefPubMed
22.
go back to reference Chung RY, Schooling CM, Cowling BJ, Leung GM. How does socioeconomic development affect risk of mortality? An age-period-cohort analysis from a recently transitioned population in China. Am J Epidemiol. 2010;171:345–56.CrossRefPubMed Chung RY, Schooling CM, Cowling BJ, Leung GM. How does socioeconomic development affect risk of mortality? An age-period-cohort analysis from a recently transitioned population in China. Am J Epidemiol. 2010;171:345–56.CrossRefPubMed
23.
go back to reference Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.CrossRefPubMed Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.CrossRefPubMed
24.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–90.CrossRefPubMed Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–90.CrossRefPubMed
26.
go back to reference Ford ES, Li C, Zhao G, Tsai J. Trends in obesity and abdominal obesity among adults in the United States from 1999–2008. Int J Obes (Lond). 2011;35:736–43.CrossRef Ford ES, Li C, Zhao G, Tsai J. Trends in obesity and abdominal obesity among adults in the United States from 1999–2008. Int J Obes (Lond). 2011;35:736–43.CrossRef
27.
go back to reference Ko GT, Tang JS, Chan JC. Worsening trend of central obesity despite stable or declining body mass index in Hong Kong Chinese between 1996 and 2005. Eur J Clin Nutr. 2010;64:549–52.CrossRefPubMed Ko GT, Tang JS, Chan JC. Worsening trend of central obesity despite stable or declining body mass index in Hong Kong Chinese between 1996 and 2005. Eur J Clin Nutr. 2010;64:549–52.CrossRefPubMed
29.
go back to reference Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509–38.CrossRefPubMed Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509–38.CrossRefPubMed
30.
go back to reference Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746–53.CrossRefPubMed Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746–53.CrossRefPubMed
32.
go back to reference Monteiro CA, Moura EC, Conde WL, Popkin BM. Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ. 2004;82:940–6.PubMed Monteiro CA, Moura EC, Conde WL, Popkin BM. Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ. 2004;82:940–6.PubMed
33.
go back to reference Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nut. 2004;79:6–16. Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nut. 2004;79:6–16.
34.
go back to reference Zhang Z, Gu D, Hayward MD. Early life influences on cognitive impairment among oldest old Chinese. J Gerontol B-Psychol. 2008;63:S25–33.CrossRef Zhang Z, Gu D, Hayward MD. Early life influences on cognitive impairment among oldest old Chinese. J Gerontol B-Psychol. 2008;63:S25–33.CrossRef
35.
go back to reference Zhu HY, Xie Y. Socioeconomic differentials in mortality among the oldest old in China. Res Aging. 2007;29:125–43.CrossRef Zhu HY, Xie Y. Socioeconomic differentials in mortality among the oldest old in China. Res Aging. 2007;29:125–43.CrossRef
36.
go back to reference Jones-Smith JC, Popkin BM. Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med. 2010;71:1436–46.CrossRefPubMedPubMedCentral Jones-Smith JC, Popkin BM. Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med. 2010;71:1436–46.CrossRefPubMedPubMedCentral
37.
go back to reference Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117:1658–67.CrossRefPubMed Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117:1658–67.CrossRefPubMed
38.
go back to reference Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010;31:737–46.CrossRefPubMed Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010;31:737–46.CrossRefPubMed
39.
go back to reference Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105–20.CrossRefPubMed Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359:2105–20.CrossRefPubMed
Metadata
Title
The diminishing socioeconomic disparity in obesity in a Chinese population with rapid economic development: analysis of serial cross-sectional health survey data 2002–2010
Authors
Xiang Qian Lao
WenJun Ma
Roger Yat-Nork Chung
YongHui Zhang
YanJun Xu
XiaoJun Xu
ShaoPing Nie
QiuMao Cai
Liang Xia
XueFen Su
Lei Jin
Tony Tam
Benny Chung-ying Zee
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2654-9

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue