The Differential Effect of Education and Occupation on Body Mass and Overweight in a Sample of Working People of the General Population

doi:10.1016/S1047-2797(00)00075-2

Annals of Epidemiology

Volume 10, Issue 8, November 2000, Pages 532-537

https://doi.org/10.1016/S1047-2797(00)00075-2 Get rights and content

Abstract

PURPOSE: To assess whether two indicators of social class, education and occupation, have independent and/or synergistic effects in determining the body mass and overweight.

METHODS: Body mass index (BMI), education, and occupation were assessed in a survey of 1767 men and 1268 women from a representative sample of currently working people of the general population of Geneva, Switzerland. Education and occupation were categorized as low, medium, and high. Overweight was defined as BMI ⩾ 25 kg/m².

RESULTS: The prevalence of overweight was 52.1% in men and 28.7% in women. Men with overweight were more likely to have low education while women with overweight had lower education and lower occupation. Education and occupation were inversely related to BMI in both genders and, in women, had a synergistic effect (p-value for the interaction = 0.03).

CONCLUSIONS: Education and occupation have independent and, in women, synergistic effects on BMI. The two indicators may express different mechanisms through which low social class is related to high body mass.

Introduction

Obesity and overweight are more common in lower social classes of affluent societies and in upper social classes of poorer societies (1) independently of the indicator used to measure the social class. Most studies use either education or occupation (2). However, these two indices are moderately correlated 3, 4 and may not be equivalent 3, 5, 6. The fact that the magnitude of the association between social class and obesity varies across societies and with the indicator used raises interesting questions with respect to the causal pathways leading to health inequalities.

Education and occupation characterize different aspects of social class. Higher education provides specific knowledge about health but also skills and a larger cultural background that might facilitate interpreting health information. Occupation generates groups and networks which can have an influence on health habits (7). It also determines income and, therefore, the ability to pursue disease preventive behaviors (8). Moreover, these two indicators reflect someone's social status at different times in life. The highest education is usually achieved at young adulthood and in most cases remains unchanged. In contrast, the occupational level usually starts at the end of the educational process and may vary until retirement.

We perform this study to simultaneously assess the role of education and occupation to body mass and overweight in the general population of Geneva (Switzerland). Our objective is to provide further understanding on the pathways through which social class determines health.

Section snippets

Methods

The Bus Santé 2000 is an ongoing community-based survey of cardiovascular risk factors conducted every year since 1993 (9). Geneva (city and surroundings) has a population of 395,609 distributed over 242 km² of land, from whom 89,000 men and 98,000 women are non-institutionalized residents aged 35 to 74 years and thus eligible for the survey. The data reported here comprise subjects randomly selected every year, from 1993 to 1997.

Subjects were identified from the residents' register published

Results

Table 1 presents the distribution of men and women by level of education and occupation. Most subjects had medium (about 50%) or high level (about 40%) of education. Half of the men had high occupational level while half of the women had medium occupational level.

Table 2 shows the age-adjusted prevalence of overweight in men and women by education and occupation. Prevalence of overweight was higher in men (52.1%) than in women (28.7%). Significant inverse trends were found with both indicators

Discussion

In our study, men with lower education or lower occupation had higher absolute BMI. A higher prevalence of overweight was associated with lower education but not lower occupation. In women, lower levels of both, education and occupation, were associated with higher BMI and overweight. Moreover, there was an additive interaction between both indicators in determining the average BMI.

Previous studies have reported an association between social class and overweight or obesity. The direction and

Acknowledgements

This study was funded by the Swiss National Fund for Scientific Research (Grants No 32.31.326.91, 32–37986.93 and 32–49847.96).

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Original reportsThe Differential Effect of Education and Occupation on Body Mass and Overweight in a Sample of Working People of the General Population

Abstract

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgements

Soc Sci Med.

Prev Med.

Ann Epidemiol.

Prev Med.

Prev Med.

Ann Epidemiol.

J Clin Epidemiol.

Soc Sci Med.

Prev Med.

J Am Diet Assoc.

Ped Clin North Am.

Prev Med.

Socioeconomic status and obesitya review of the literature

Psychol Bull.

The measurement of social class in epidemiology

Epidemiol Rev.

General explanations for social inequalities in health

IARC Sci Publ.

Education and occupational social classWhich is the more important indicator of mortality risk?

J Epidemiol Commun Health.

Original reports
The Differential Effect of Education and Occupation on Body Mass and Overweight in a Sample of Working People of the General Population