Hoffmann Kristina, De Gelder Rianne, Hu Yannan, Bopp Matthias, Vitrai Jozsef, Lahelma Eero, Menvielle Gwenn, Santana Paula, Regidor Enrique, Ekholm Ola, Mackenbach Johan P, van Lenthe Frank J
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands.
Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Int J Behav Nutr Phys Act. 2017 May 8;14(1):63. doi: 10.1186/s12966-017-0517-8.
The prevalence of obesity increased dramatically in many European countries in the past decades. Whether the increase occurred to the same extent in all socioeconomic groups is less known. We systematically assessed and compared the trends in educational inequalities in obesity in 15 different European countries between 1990 and 2010.
Nationally representative survey data from 15 European countries were harmonized and used in a meta-regression of trends in prevalence and educational inequalities in obesity between 1990 and 2010. Educational inequalities were estimated by means of absolute rate differences and relative rate ratios in men and women aged 30-64 years.
A statistically significant increase in the prevalence of obesity was found for all countries, except for Ireland (among men) and for France, Hungary, Italy and Poland (among women). Meta-regressions showed a statistically significant overall increase in absolute inequalities of 0.11% points [95% CI 0.03, 0.20] per year among men and 0.12% points [95% CI 0.04, 0.20] per year among women. Relative inequalities did not significantly change over time in most countries. A significant reduction of relative inequalities was found among Austrian and Italian women.
The increase in the overall prevalence aligned with a widening of absolute but not of relative inequalities in obesity in many European countries over the past two decades. Our findings urge for a further understanding of the drivers of the increase in obesity in lower education groups particularly, and an equity perspective in population-based obesity prevention strategies.
在过去几十年中，许多欧洲国家肥胖症的患病率急剧上升。肥胖症患病率在所有社会经济群体中的上升幅度是否相同，目前尚鲜为人知。我们系统地评估并比较了1990年至2010年间15个不同欧洲国家肥胖症教育不平等的趋势。
对来自15个欧洲国家具有全国代表性的调查数据进行统一处理，并用于对1990年至2010年间肥胖症患病率和教育不平等趋势的元回归分析。通过30至64岁男性和女性的绝对率差和相对率比来估计教育不平等。
除爱尔兰（男性）以及法国、匈牙利、意大利和波兰（女性）外，所有国家的肥胖症患病率均出现了统计学上的显著上升。元回归分析显示，男性的绝对不平等总体上每年有统计学上的显著增加，增幅为0.11个百分点[95%置信区间0.03, 0.20]，女性为每年0.12个百分点[95%置信区间0.04, 0.20]。在大多数国家，相对不平等并未随时间发生显著变化。奥地利和意大利女性的相对不平等出现了显著下降。
在过去二十年中，许多欧洲国家肥胖症总体患病率的上升与绝对不平等的扩大相关，但相对不平等并未扩大。我们的研究结果促使人们进一步了解尤其是低教育群体肥胖症患病率上升的驱动因素，并在基于人群的肥胖症预防策略中纳入公平视角。
